1 WHY SHOULD I SIGN UP FOR MEDICARE

1
WHY SHOULD I
SIGN UP FOR
MEDICARE
PART D IF I AM
NOT ON ANY
PRESCRIPTIONS
NOW?
BY BETSY D. CHANDLER
WWW.MICINSURANCE.COM
PR OF ES S I ONA L IS M | EX PE R TIS E| PE RS ONA L S E R V I CE
This question is posed to our office frequently. There are a few reasons why you may wish to enroll in Medicare Part D
when you are eligible.
The first good reason to do so is that there is a penalty of 1% per month for not enrolling in a Medicare Part D plan upon
eligibility if you do not have credible coverage. Credible coverage is defined as prescription coverage which is equal to or
better than Medicare Part D. If you, or your spouse, are still working for a company and have prescription coverage
from that employer, that may count as credible coverage. Check with your employer to be sure. It is the employer’s responsibility to notify you whether or not your group coverage is credible or not. If you are late when enrolling the penalty
of 1% per month will be assessed to you when you do enroll in a Medicare Part D plan, and will follow you for the rest of
your life. The 1% is 1% of the national average of Medicare Part D plans. In 2013 the national average is $31.17, which
means 1% of that is $0.31 cents per months. If you waited a year, you would pay $0.31 x 12 months or $3.74 per month
extra for the rest of your life.
The next good reason to purchase Medicare Part D when you are eligible is that if you do not, you will have to wait until
the open enrollment period in order to do so, should you decide it would be beneficial to you. For example, let’s say
“Jake” turns 65 in January of 2013. He is no longer working, and has Medicare part A & B as primary, and has a Medicare
Supplement as secondary. He has only 2 prescriptions per month , which are both generic and cost him less than $10
each per month. He decides to pass on Medicare Part D inasmuch as his prescription costs are minimal. In June his doctor decides to put him on a prescription which will cost $150 a month. Jake wants to enroll in a plan immediately as he
can’t afford the $150 a month for the RX. Now, he is a late entrant into Part D, and cannot enroll until the open enrollment period which is October 15 through December 7th. His coverage will then be effective January 1 of the following
year, and he will pay the penalty for the year he was eligible but not enrolled in a plan. Furthermore, he will have to face
the cost of the $150 a month RX out of his pocket from June until January.
When do you need, or not need, Medicare Part D?
If you are over age 65, but have group health insurance which has credible coverage for Part D you do not need Part D.
(It may be in your best interest to do so, and you should analyze which scenario is best for you.) If you have elected a
Medicare Advantage plan, with prescription coverage you do not need Part D. If you have prescription
benefits available, and avail yourself of them, from the V.A. you do not need Part D. Many of our Veteran
clients tell me they want Part D in addition to the V.A. coverage for many reasons, and you can certainly
do that. V.A. prescription benefits do count as credible coverage though.
2
WHY SHOULD I
SIGN UP FOR
MEDICARE
PART D IF I AM
NOT ON ANY
PRESCRIPTIONS
NOW?
BY BETSY D. CHANDLER
WWW.MICINSURANCE.COM
PR OF ES S I ONA L IS M | EX PE R TIS E| PE RS ONA L S E R V I CE
If you are turning 65 and “aging in” to Medicare and do not have an employer sponsored health insurance plan and are
enrolling in Medicare and a Medicare Supplement, you need Part D. If you are coming off a group plan past the age of 65,
and enrolling in a Medicare supplement plan, you need Part D. If you are Medicare eligible, and do not have any other
prescription coverage, you need Part D.
Please do keep in mind that everyone’s situation is different. This column is intended to inform you about the importance of making important decisions about health insurance coverage at the appropriate time. It is not intended to give
specific advice. Please be sure to discuss your situation with a licensed insurance professional that specializes in this area
before making any decisions.
Betsy Chandler is a licensed insurance professionals with MIC Insurance Services, a health insurance services company. If you have questions relative
to this column or other related topics , we invite you to call us at (973)-492-2828.