Medicare & Employees
Six months before turning 65, employees should start thinking about their medicare plan options. Begin to learn about the differences between plans, medicare supplement vs medicare advantage plans (MAPD's).
Important Compliance Requirements: Groups with Medicare-Eligible
If your group clients have employees or dependents approaching or over the age of 65 or are eligible for Medicare due to a disability, it is important to note the following group size guidelines for Medicare enrollment.
Prescription Creditable Coverage letter to be shared with employees.
Important information about claim payments when eligible for Medicare.
When Medicare is the primary coverage, the plan reduces claim payments. Once a member is eligible for Medicare Part B coverage, the amount Medicare would have paid as the primary payer for covered services is calculated and the member’s benefits are reduced by this amount. This amount is not covered by the fully insured plan. Members not enrolled in Medicare Part B will be responsible for the costs that Medicare would have paid and, therefore, will incur a greater out-of-pocket expense.
Affected members will be responsible for the costs that Medicare would have paid and, therefore, will incur a greater out-of-pocket
expense. Affected members who wish to have Medicare Part B coverage before claim payments are reduced should enroll during the general enrollment period, which is January 1 through March
Medicare is the primary payer when:
· Member is eligible for Medicare due to age and the member’s group size is 19 or fewer employees
KBenefits Insurance Services
Individual Health Insurance
Medicare Plan Options
Christopher S. Kudryk
KBenefits specializes in health, dental, vision, life and medicare insurance for employers and individuals in NJ & NY.
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