Life After 50 Expo

Dear Marci,

By

Dear Marci, I will be leaving my job soon and my employer has informed me about my right to COBRA coverage. I’ll also be eligible for Medicare soon. How do Medicare and COBRA work together? I want to make sure I make the right enrollment decisions.  -Clayton (Twin Falls, ID) Dear Clayton, The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that lets certain employees, their spouses, and their dependents keep group health plan (GHP) coverage for 18 to 36 months after they leave their job or lose coverage for certain other reasons, as long as they pay the full cost of the premium.  Under COBRA, a GHP is defined as a job-based insurance plan that provides medical benefits to employees, their spouses, and/or their dependents.  As you make COBRA-related decisions, keep in mind that health coverage under COBRA is typically expensive because it tends to be comprehensive, and you may pay the full cost of the premium yourself (employers often pay part of the premium for current employees). However, COBRA coverage may be less expensive than similar individual health coverage.  The way that COBRA and Medicare coordinate depends, in part, on which form of insurance you have first. While it is possible to get COBRA if you already have Medicare, it is not usually possible to keep COBRA if you have it before you become Medicare-eligible. Specifically, whether you can have both COBRA and Medicare depends on which form of insurance you have first. If you have both forms of coverage, COBRA pays secondary to Medicare.   If you have COBRA when you become Medicare-eligible, your COBRA coverage usually ends on the date you get Medicare. You should enroll in Part B immediately because you are not entitled to a Special Enrollment Period (SEP) when COBRA ends. Your spouse and dependents may keep COBRA for up to 36 months, regardless of whether you enroll in Medicare during that time.  You may be able to keep COBRA coverage for services that Medicare does not cover. For example, if you have COBRA dental insurance, the insurance company that provides your COBRA coverage may allow you to drop your medical coverage but keep paying a premium for the dental coverage for as long as you are entitled to COBRA. Contact your plan for more information.  If you have Medicare Part A or Part B when you become eligible for COBRA, you must be allowed to enroll in COBRA. Medicare is your primary insurance, and COBRA is secondary. You should keep Medicare because it is responsible for paying the majority of your health care costs. COBRA is typically expensive, but it may be helpful if you have high medical expenses and your plan covers your Medicare cost-sharing or offers other needed benefits, or if the COBRA policy also covers other family members who are not Medicare eligible.  Note: If you are eligible for Medicare due to End-Stage Renal Disease (ESRD), your COBRA coverage is primary during the 30-month coordination period. -Marci 

Wash your hands!

By

Washing your hands is easy, and it’s one of the most effective ways to prevent the spread of germs. Clean hands can stop germs from spreading from one person to another and throughout an entire community—from your home and workplace to childcare facilities and hospitals.

  1. Follow these five steps every time.
  2. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  3. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
  4. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  5. Rinse your hands well under clean, running water.
  6. Dry your hands using a clean towel or air dry them.

Dear Marci,

By

Dear Marci,I am concerned about the spread of coronavirus and how it might affect my health. I have Medicare–will I be able to get necessary services covered?-Tammy (Tempe, AZ)
Dear Tammy,Medicare is working to address the spread of COVID-19 (also called coronavirus) and inform people with Medicare about the services that Medicare covers. The Centers for Disease Control and Prevention (CDC) has identified older adults and people with serious chronic medical conditions like heart disease, diabetes, and lung disease as being at a higher risk from the virus.In general, Medicare covers medically necessary items and services that you receive from a provider who accepts Original Medicare or is in-network for your Medicare Advantage Plan. Medicare Advantage Plans must cover everything that Original Medicare does, but they can do so with different costs and restrictions.Certain cost and coverage changes may occur, so be sure to visit www.medicare.gov and the Medicare Rights Center’s blog post for the most up-to-date information.Some services related to coronavirus include:Coronavirus testing: Testing will be covered under Medicare Part B as a clinical laboratory test. Your doctor can bill Medicare for this test beginning April 1, 2020 for testing provided after February 4, 2020. If you have a Medicare Advantage Plan, you should contact your plan to learn about its cost and coverage rules.Coronavirus vaccine: There is currently no vaccine for coronavirus. If a vaccine is developed, it will be covered under Medicare Part D. All Part D plans will be required to cover the vaccine. How much you will owe for the vaccine will depend on costs set by your drug plan.Prescription refills: If you want to refill your prescriptions early so you have extra medication on hand, you should contact your Part D plan to learn what is covered. Your plan may require extra approval before it covers early refills, and not every prescription can be refilled in advance. If you take medications that are covered by Original Medicare Part B, you should ask your doctor for advice.Services you receive from a physician (or other provider, such as a registered nurse) who visits your home: These services are covered under Part B. Part B also covers some services that are not face-to-face with a doctor, such as check-in phone calls or assessment using an online patient portal.Telehealth services: A telehealth service is a full visit with a physician using telephone or video technology. Part B generally only covers telehealth services for people who live in rural areas and get the services in certain health care settings, rather than at home. However, Congress has waived some of the restrictions on telehealth. Medicare Rights will monitor these changes and update our related blog post as appropriate. Medicare Advantage Plans may also cover additional telehealth benefits, including telehealth benefits in the home. If a beneficiary has a Medicare Advantage Plan, they should contact their plan to learn more.Note that if you have Medicare and Medicaid, Medicaid may cover additional services as long as you see providers who accept Medicaid. Contact your local Medicaid office for more information.If you have a Medicare Advantage Plan or Part D plan, know that plans must also work to maintain health care and prescription drug access during emergencies-Marci

Dear Marci,

By

Dear Marci,

I will turn 65 and become eligible for Medicare soon. I have insurance coverage through a company that I retired from several years ago. Do I need to take Medicare? If I do, how will it work with my retiree coverage?

-Tito (Santa Fe, NM)

Dear Tito,

Retiree insurance is a form of health coverage an employer may provide to former employees. Retiree insurance is almost always secondary to Medicare, meaning it pays after Medicare and may provide coverage for Medicare cost-sharing, like deductibles, copayments, and coinsurance. Because retiree insurance is secondary, you should enroll in Medicare to be fully covered. If you do not enroll in Medicare, you will likely be without primary coverage, and will face a late enrollment penalty and gaps in coverage if you try to enroll at a later date.

You may be able to keep your retiree insurance as primary after you become Medicare-eligible if you have End-Stage Renal Disease (ESRD) or Federal Employee Health Benefits (FEHB).

Deciding whether to keep retiree coverage after you enroll in Medicare is a personal one that depends on your costs and anticipated health care needs. Retiree coverage premiums can be costly, but it may be worthwhile to keep your plan if you anticipate high Medicare costs. Retiree coverage may also pay for care or other items and services that Medicare does not cover, such as vision care, dental care, and/or off-formulary or over-the-counter prescription drugs. If the plan offers prescription drug coverage that you like, find out if the coverage is creditable and if you can delay Medicare Part D enrollment without penalty.

For more information on the services covered by your retiree insurance plan, contact your benefits administrator or you employer’s human resources department.

Retiree insurance may coordinate with Medicare differently depending on the type of plan you have. Below are a few common types of plans and how you might expect them to work with Medicare. Be sure to speak to your employer’s HR department for more information.

  • Fee-for-service (FFS) plans pay for care from any doctor or hospital. FFS plans cover Medicare cost-sharing and generally act like a supplemental insurance policy.
  • Managed care (HMO or PPO) plans require that you see in-network providers and facilities. Your costs are typically lowest when seeing providers who take both Medicare and your retiree insurance. When seeing Medicare providers who do not take your retiree insurance, you will pay regular Medicare cost-sharing amounts, and your retiree insurance may not pay at all.
  • Employer-sponsored Medicare Advantage Plans offer Medicare-eligible individuals both Medicare and retiree health benefits. Some employers require that you join a Medicare Advantage Plan to continue getting retiree health benefits after becoming Medicare-eligible. You can always choose not to take your employer’s coverage and sign up for Original Medicare or a different Medicare Advantage Plan, but keep in mind that you may not be able to get that retiree coverage back if you want it at a later date.
  • Employer-sponsored supplemental insurance offers secondary coverage for Medicare-eligible individuals. These plans often function similarly to Medigaps, meaning that they pay all or part of certain remaining costs after Original Medicare pays first. Remember: You can always choose not to take your employer’s coverage and sign up for a Medicare Advantage Plan or a different Medigap, but you may not be able to get that retiree coverage back if you want it at a later date.

-Marci

10 tips for graceful aging!

By

A healthy body , mind and spirit calls for graceful aging. Here are 10 tips:

1)    Maintain an appropriate weight. Your diet should be low fat, high fiber and include generous portions of fruit and vegetables daily. Be sure to watch the nutrition information on food product labels.

2)  Have a personal exercise program.  Walking will get the job done as long as you get at least 30 minutes a day three

[Read more…]