If you’re an HR Manager, you’ve probably noticed that some of your employees are retiring later than in previous years. The age for Medicare eligibility is 65. With many residents in North Carolina working to 67 or beyond, there may be employees who qualify for Medicare and an employer’s group health benefits plan.
A licensed Medicare Health Insurance Agent specializing in offering advice in North Carolina can be a great resource to help guide you through the Medicare process. Your employees can have many questions about Medicare and employer insurance coverage, and we can help you with the answers. Some common questions we experience include, ‘Are there late enrollment penalties?’ and ‘How does Medicare affect Health Savings Accounts?.’
Medicare health insurance agents are professional, licensed insurance agents with expertise in the nuances of Medicare plans and policies. Our knowledgeable and local Medicare agents in North Carolina can assist you with your employees’ Medicare and employer-sponsored plan queries free of charge.
If you’ve been working in HR for a while, you’ll undoubtedly understand the basics of Medicare health insurance. However, with our help, we can save you time by answering some of the more complicated questions relating to Medicare.
A licensed Medicare health insurance agent is an expert in Medicare and employer group health plan coverage regulations. We understand that employees frequently turn to HR to ask about eligibility requirements and Medicare enrollment deadlines. Therefore, having up-to-date and accurate information is crucial. A local Medicare health insurance agent understands how the plans work and can help you provide answers to all of your employees’ Medicare questions.
We regularly work with clients and HR teams to help address questions relating to employer health plans and Medicare. Some typical questions include:
Employees often wonder if they should enroll in Medicare as soon as they become eligible or wait if they’re already covered by their employer. There is a seven-month window to enroll around the employee’s 65th birthday month, known as their initial enrollment period.
Another frequently asked question relates to whether Medicare or the company health plan is the primary health plan for coverage. The answer to this is based on how many employees the company has.
If the company has 20 employees or fewer, Medicare is the primary health insurance. The company group health plan is secondary for an employee 65 or older. To avoid a late enrollment fee, the eligible employee must enroll in Medicare Part B during their initial enrollment period. If the employer doesn’t offer creditable prescription coverage, the employee also needs to enroll in a Part D prescription drug plan. It’s important to note that late enrollment penalties apply to Part B and Part D plans.
When a company has 20 employees or more, the company health plan is considered the primary plan. This arrangement continues as long as the employee remains employed and actively working. Some employees choose to wait to enroll in Medicare while enrolled in the company group health insurance plan. There is no penalty for delaying enrollment in this scenario.
Some employees may be eligible to enroll in Medicare before they turn 65 if they have a disability. However, if they’re receiving company-sponsored group health insurance benefits from an employer with 20 employees or more, they can wait to enroll in Medicare while still actively employed.
Once an employee retires and is no longer enrolled in the group health plan, there is a special eight-month Medicare enrollment period. There’s no enrollment penalty for an employee who enrolls in Original Medicare during this time. However, if they miss this eight-month window, they will have to wait until the next General Enrollment Period to sign up. The annual General Enrollment Period is between January 1 – March 31st every year. Their coverage would then start on July 1.
Unlike private health insurance plans, Medicare doesn’t include coverage for spouses or children. It only provides individual health insurance coverage. Even if the employee receives company group health benefits for spouses and dependents, the Medicare portion of coverage only applies to the employee.
Another common question is when an employee should stop contributing to an HSA. Once an employee has Medicare, an HSA cannot be funded. Therefore, to avoid tax penalties, employees should not make HSA contributions once they turn 65 if they intend to enroll in Medicare in the next six months.
There are four main parts of Medicare, and each has different premiums and levels of coverage.
Part A provides coverage for hospital inpatient care, coverage while in a skilled nursing facility, and in some instances, cover for in-home care. There isn’t usually a premium for Medicare Part A
Part B covers services such as outpatient exams, tests, and visits to the doctor. There is a monthly premium for Medicare Part B.
Part C encompasses the Medicare Advantage Plans that Medicare-authorized insurance companies offer. These plans charge monthly premiums, and each plan has its own costs, benefits, and rules.
Part D offers coverage for prescription drug costs to help reduce the cost when purchasing prescriptions. However, there is a monthly premium for Medicare Part D.
Medicare Supplement plans fill in the gaps that Original Medicare does not cover to help reduce out-of-pocket expenses.
Managing the rules and requirements of Medicare and employer sponsored coverage can be confusing. However, our experienced, licensed Medicare insurance agents can help you find the answers and guidance your employees need. So, if you’re an HR Manager in North Carolina, get in touch with our Medicare agents NC to see how we can help with your questions about Medicare.
Health Plans of NC Staff
Heath Plans of NC, Kelly Quinn
Health Plans of NC Staff