Stay on work insurance or start Medicare? - YouTube

Today's lesson is for the people like  you that are turning 65 and eligible  

for Medicare but you're going to keep working  or your spouse is going to keep working and  

you're covered under group insurance and you're  wondering should I sign up for Medicare now  

or can I wait till later? And this is  the number one question that we get  

with people calling in and people are generally  real concerned about this and what their real  

concern because they've read enough is  there are penalties if you get this wrong  

and this is the number one thing that they're  concerned about and they want our consulting  

and our advice like should I go ahead and  sign up for Medicare I don't think I need it  

but I might need it but I sure need it later  and I don't want to pay these penalties,  

I don't really understand them, but will I have  to pay these penalties what do you think? We  

even get people typing this in on the bottom of  the videos, so I'm going to work to giving you  

a framework for advice and my framework for  advice really doesn't replace a consultation  

because everybody's situation is different and  you really need to get some help with this.  

Now the thing that they ought to be more concerned  about is if you don't get this right and you  

delay in signing up for Medicare stay on your  group insurance and then you later want it  

and you haven't met all the rules and this works  out to be a bad decision of skipping Medicare  

or delaying Medicare you are going to  face a delay in actually getting Medicare,  

so there's two problems with the delay if you  don't have it right is one is you're going to pay  

a penalty and those penalties are for life I mean  once they start then they're going to go on for  

the rest of your life and then the second thing is  like say you all of a sudden need Medicare in like  

June or July and if you don't qualify  for a special enrollment period  

you're going to have to wait till January to March  to apply of the next year and then if you apply  

and are accepted January to March it doesn't start  till July 1st of the next year so you've had this  

big gap where you're now a Medicare age person,  your insurance has ended, and you have a delay  

in getting on to Medicare, big problem, so that  doesn't necessarily happen to that many people  

but it can happen to enough and then we have  people like that calling us in oh no what do I do  

and there are things we can do to try to work the  system to get you so if you're one of those people  

where you delayed way back when and now you're  discovering you got a problem give us a call and  

we'll we'll try to work through the situation with  you so now so the real thing to delay is I've got  

group insurance, I'm happy with it, it doesn't  cost me a lot and I'm going to keep on working  

I don't know how long or two more years or  three more years or an indefinite period of time  

happy with my group insurance don't pay a  lot and I really don't even want to mess  

with all this Medicare stuff but I got this  one little thing that I want to ask you which  

is the topic of today's video so it's what  we're trying to prevent are penalties later  

and a delay and so we've got work insurance and  then the first question we have for these people  

what about your spouse you know I  mean the first thing is your spouse  

older than you or is your spouse younger than  you because if your spouse is younger than you  

they're not eligible for Medicare now at some  point in the future and then the next question  

about the spouse is are they covered under your  group insurance and if the answer to that is yes  

and you need them to be covered let's just say  they're 62., you're turning 65, they're going  

to need health insurance for the next three  years and if you're going to keep working  

and you plan to keep working anyhow  and plan to stay on the group insurance  

then you're going to want to stay on that  group insurance because you need to cover  

them and a lot of group insurance will  not let you cover a dependent or a spouse  

even if you're still working if unless you're  enrolled in the group insurance yourself so we  

need to go to the spouse and many of spouses that  are three years younger or seven years younger  

they're still working they have their own group  insurance at their own place so we don't need to  

we don't need to worry about that we also have  people in that situation that are turning 65  

now but they've been retired for a while but  they're covered under their younger spouse's  

group insurance so they're wondering  should I stay on this covered under  

spouse's group insurance or should I sign up for  Medicare and get my own so people are all over  

the board in their places and I don't really  want to get into doing planning and a ton of  

examples today because I really want to just walk  you through the material so first thing we need  

to look at is yes you're keeping working yes you  have group insurance and then we need to find out  

is the spouse relying upon this group insurance  yes or no and then what are their other options  

to make it to 65 just like you are now to then get  on Medicare okay so we need to clear all that up  

once we have the answer to all those questions  now we need to just look at the work insurance  

we need to look at the group  insurance at work and we need to say  

first of all how good is this you know a lot of  people say how do you like oh it's good I love it  

and then they haven't been sick other than going  to the doctor and it covers the doctor's visits or  

they got some medicines but you know when we dig  a little deeper what's your deductible and a lot  

of group insurance now has a high deductible you  know three four five six thousand dollars and then  

it's not a hundred percent after that it's you  know 80/20 or 70/30 and so if you were to have  

a serious sickness come on you might be looking at  your group insurance and you might be out 10 grand  

and so that doesn't mean dump the group insurance  it's just we're going to want to look into the  

group insurance you're going to want to look into  your group insurance and just see how good is this  

group insurance and how good is it going to be if  I have a serious illness okay because you now have  

alternatives and that alternative is Medicare so  that now we're looking at do I really want to stay  

on the group insurance and and then besides the  benefits and the deductibles and copayments and  

all that kind of stuff the next thing is how much  do I pay personally for this group insurance do I  

you know do I pay for $500 a month  how much do I pay for my spouse  

you know if your spouse is covered on it and he  or she is about your same age then you know we're  

back on the spouse thing but you're just going  to want to look at your out-of-pocket money that  

you're kicking into this group insurance and we're  going to want to come up with a monthly number  

because it's probably not going to be  that expensive or as expensive as you  

think to get on Medicare I mean for part b you  got $148.50 a month is the standard premium  

but if you make a lot of income  then you're going to have irma  

on top of that and so all of these are not leading  to sign up for Medicare but we're just going to  

want to look at the whole situation and say how  much would it cost me to dump the group insurance  

then I'm going to save whatever I'm paying for  the group for either me or my spouse and me  

then so how much am I kicking out now and then  how much will I kick out for Medicare and then  

how much will a Supplement be how much will a  Medicare Advantage Plan be which a lot of times  

those are zero and we put all the money together  you may find out after we do this research that  

you're actually going to be better off coverage  wise and maybe about the same for money you're  

kicking out and you may say it's going to be a  good decision for me to dump the group insurance  

you know I can't make those in advance  but I'm just walking you through  

what we do with people to really make this first  decision do I want to sign up for Medicare at  

65 or do I want to delay now we're going to get  in do you have the option to delay and to delay  

means you're still working you're actively  working you're not a retiree pass 65 and  

your coverage that you have on the group  insurance is what Medicare calls creditable  

it's not credible it's creditable meaning  that Medicare has all their own rules  

and they require you to avoid these penalties  if you want to avoid these penalties later  

to prove to them when you later get onto  Medicare has the coverage so I from 65 to 68  

which I just turned yesterday those three  years or 36 months that I didn't have Medicare  

did I have creditable coverage yes or no  and if you didn't have creditable coverage  

then you're going to face penalties and  you're going to face that delay thing  

is you're not going to be able to get on it right  away and that's going to create another problem  

so what we want to do is we really want to look at  your group insurance now before you're 65 before  

you make that decision and say is it creditable  and it's pretty simple if you look at my chart  

here creditable coverage is really a group  health plan from an employer that employs more  

than 20 employees I just had a guy calling in a  couple days ago and we got to talk to him and his  

employer has 15 employees and it took us  a while to get to that and I said well  

you don't really have the option  of staying on that group insurance  

and I'm guessing your employer is going to  be thrilled when you go on Medicare because  

for you and your spouse they're  paying a tremendous amount of money,  

probably a couple grand a month, to cover you  and then you're paying a little part of that  

and you know and furthermore if  you've stayed on that your coverage  

is not going to be credible it's going to be over  here in the non-creditable because you you're on a  

group of plan and we we get lots of people later  on that come in and they've kind of thought they  

were all right maybe they're a professional like a  lawyer or a CPA and they were paying for all this  

so the first thing they're upset about you mean  to tell me that I could have dumped this insurance  

several years ago when I turned 65 and  saved this $2,000 a month and I could have  

changed and gone on Medicare and paid my Part B  and a little bit of IRMAA and bought a Supplement  

and you know I would have you know I would have  been paying $400 a month or $300 a month instead  

of $2,000 yep that's exactly what they didn't get  any consulting they just kept right on trucking  

leaving everything like it is and then now we  got to deal with the penalties and the delay  

and many times we're able to work through this  and do some consulting and fill out some forms and  

we can fix things for people but you know I don't  want you relying on that so the real thing of the  

creditable coverage is this coverage creditable  and to be creditable it needs to be a group health  

plan in a business where there's more than 20  employees now I'm going to go over some things  

that are non-creditable coverage  and one of the biggest ones is COBRA  

we have lots of people that come to us that  are like 67 they retired at 65 they didn't sign  

up for Medicare perhaps they're a highly paid  executive and when they retired at 65 or 66 or  

whatever the employer as part of their retirement  package said oh we're going to pay COBRA for both  

of you the husband and wife we're going to pay  that for you for the whole 18 months just as an  

adjustment for retirement so then they just keep  right on trucking they got this wonderful employer  

and then at the end of the 18 months they're  coming to us hey now I need to get on Medicare  

that COBRA doesn't count as a creditable  coverage even though it was group insurance  

they were retired doesn't count retiree  plans so there's a lot of places that  

offer retire well not as many as anymore a  lot of governments they have a retiree plan  

but Medicare most retiree plans require you  to sign up for Medicare anyhow I mean that's  

underneath the base of that and then they sit  on top of it but if you are not signed up for  

Medicare you can't later get on Medicare and use  your retiree plan as a way to get out of this.  

Marketplace plans we have people that were on  this thing with the government and maybe they're  

getting a subsidy on the marketplace they're  under 65 and then they just keep it somehow and  

then they come to us later or they're asking us in  advance can I just keep the marketplace coverage  

and the answer that well yeah maybe you can  but it's not going to count as creditable  

coverage so we really need to take a serious  look at getting on Medicare same with Tricare  

same with veterans benefits because we have many  people at 65 say oh I'm going to rely on the VA so  

and that's good and if you're going to  rely on the VA for the rest of your life  

and you know you qualify more power to you and  you know we'll even help you with that but if  

you later at 75 years old you say you know I think  i'd rather have private insurance now so I don't  

want to get on the regular Medicare and I want  to get a Supplement you're not going to be able  

to use the veterans as a as an excuse and then  the FEHB is the federal employees health benefit  

so there's more on this list I just simply  wanted to teach you that you need to in advance  

determine whether your solution for Medicare past  65 is going to be looked upon as creditable and  

for the most practical purposes that's  large groups large group insurance  

still working past 65. I'm Hans  Scheil, I thank you for listening.