Roadmap to Medicare more than 3 months past your 65th birthday and Retiring

Roadmap to Medicare

Over 65, Coming off of Employer Group Plan

More information on:

Your Roadmap is based on…

You are more than 3 months past your 65th birthday and did not enroll in Medicare A (and/or) B at your 65th birthday.
Your Primary Insured is not (or will not be) actively working at the employer providing your benefits.
You are not (or will not be) covered under group benefits.

Recommendation Summary:

Since you will be loosing your creditable coverage (group coverage based on current active employment), you are required to enroll in both Part A and/or Part B during your Special Enrollment Period.
Schedule your Roadmap to Medicare appointment with an HTA Medicare Advisor if you have not done so already.
Select the enrollment instruction that best applies:
- How to Enroll in Medicare Part A and Part B over age 65
- How to Enroll in Medicare Part B only (already have Part A)

What is my deadline to enroll?

You have a Special Enrollment Period and can enroll anytime after age 65, up to 8 months after your group coverage or the employment that it is based on ends (whichever comes first).

Will I receive a penalty if I don’t enroll now?

Yes. You will receive a late enrollment penalty because you will not have creditable coverage for Medicare. Creditable coverage is defined as group coverage based on current active employment.

Do I need Medicare to have full coverage?

Yes. Once you are no longer actively employed, Medicare will become the primary insurance. If you do not enroll in Medicare, you may not have full coverage. See Medicare “Who Pays First” guide for more details.

Secondary Insurance Options

You have the option to purchase secondary coverage to supplement your Medicare A and B. You will have the option to choose a Medicare Advantage Plan or Medicare Supplement Insurance and a Medicare Prescription Drug Plan.

Contact HTA to schedule a Roadmap to Medicare Appointment to discuss your secondary insurance options if you have not already done so.

Additional Information
Underwriting Considerations

Medicare Supplement Insurance has an Open Enrollment Period for the first 6 months that you are enrolled in Medicare Part B. During this time, you will be able to purchase ANY medicare supplement plan with no medical underwriting.

Unless you have a Guaranteed Issue circumstance, Medicare Supplement plans are medically underwritten after the first 6 months on Medicare Part B.

Medicare Advantage Plans and Medicare Prescription Drug Plans provide an Initial Election Period when you enroll in Medicare, a Special Election Period when you come off your group plan, and also allow you to change plans once a year during the Annual Election Period (October 15^th through December 7^th) without medical underwriting.

Additional Considerations

Spouse Under Age 65- If your spouse relies on your group health plan for benefits, please be mindful that if you come off your group plan, your spouse will have to go on COBRA, seek benefits through their respective employer, or purchase individual health insurance until they become Medicare eligible.

Important HSA Considerations– You cannot continue to contribute to your Health Savings Account (HSA) once you enroll in Medicare Part A. If you are enrolling in Medicare after age 65, your Part A effective date may be back dated up to 6 months. Please contact us to discuss the HSA maximum contribution rate for you circumstances. Click Here for Details and Rules.

This does not apply to Flexible Spending Accounts (FSA) or Health Reimbursement Accounts (HRA). Medicare does not have any restrictions on these types of accounts.