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Hello Toni:
I’m a human sources supervisor for a neighborhood oil and fuel firm and have a query about an worker who is popping 65. His state of affairs is a bit of completely different as a result of subsequent month he’ll start receiving chemotherapy for most cancers.
I’m unsure how one can advise him as a result of technically he’s working full-time. He has 5 months of pay from unused trip time that he can use whereas recuperating, which is able to preserve his standing as a full-time worker.
Our agency has over 100 staff and I’ve been advised there are guidelines based mostly on firm dimension. How can I guarantee that I’ve the proper reply to my questions on behalf of the staff of our firm?
– Katie, Tampa, Fla.
Hello Katie:
Your worker with most cancers is approaching his Medicare Preliminary Enrollment Interval, which begins three months earlier than his sixty fifth birthday month and ends three months after his sixty fifth birthday month.
Many People don’t enroll in Medicare when turning 65 as a result of they (or their partner) are “nonetheless working” for an employer with over 20 staff and have employer group medical health insurance, similar to your organization.
This rule can shield your still-working-full-time worker with well being points.
Now, readers, allow us to speak about who pays your declare first. This depends upon what number of staff are in your firm’s group well being plan. (See chart on pg. 21 of the Medicare & You handbook on variety of staff.)
– If you’re 65 or older and there are 20 or extra staff the place you (or your working partner) at present obtain advantages, the group medical health insurance pays first. (Please confirm there are 20 or extra staff enrolled within the employer group well being plan). (It might be to your benefit to delay enrolling in Medicare with out receiving a Half B penalty.)
– If there are fewer than 20 staff the place you (or your partner) at present work and obtain advantages, typically Medicare pays first. Your HR division (otherwise you) ought to confirm with the insurance coverage provider as to how the present medical health insurance plan coordinates with Medicare to find out whether or not you must enroll in Medicare Components A and/or B or ought to delay enrollment in a single or each.
Katie, under are a number of gadgets that may make your HR function job simpler:
– Confirm your staff’ choices by calling your organization’s medical health insurance plan to find how the plan coordinates with Medicare.
– Perceive that it might be to an worker’s benefit to delay Half B enrollment. See the Medicare & You handbook underneath “I’ve different well being protection. Ought to I Get Half B?” or Chapter 1 of my e-book Medicare Survival Information Superior version for extra clarification.
– Let staff who’re previous age 65 know they need to contact their native Social Safety workplace instantly to enroll in Medicare if their work standing modifications from full-time to part-time, laid-off or retired. They might want to file the Social Safety types to keep away from the “well-known” Medicare Half B penalty. They are going to be eligible for a particular enrollment interval and may enroll in retiree advantages similar to a Medicare Complement or Medicare Benefit plan. You will need to keep in mind that COBRA and retiree insurance coverage aren’t thought-about present employer insurance coverage, so don’t delay in enrolling in Medicare Components B and D (Medicare’s prescription drug plan).
Readers, there are particular Medicare guidelines concerning leaving employer advantages after turning 65. Studying when and how one can change Medicare plans and which Medicare Half D prescription drug plans most closely fits one’s well being state of affairs is very important for an worker similar to Katie’s, who has most cancers points.
Toni King is an creator and columnist on Medicare and medical health insurance points. She has spent almost 30 years as a high gross sales chief within the area. If in case you have a Medicare query, e-mail data@tonisays.com or name (832) 519-8664. Toni’s new e-book, “Maze of Medicare,” is now accessible on www.tonisays.com. “Maze of Medicare” is the primary explanatory e-book that features scripture and constructive quotes to assist relieve the stress and nervousness over transitioning to Medicare.
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