Berks Barrister Fall 2018 - 14

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Medicare : Is it right for me?
By Debra R. Franklin, Esquire, and
Tony Montgomery

A

fter all these years of working, you're finally getting ready
to blow out those 65 candles and, perhaps, consider
retirement (or not). Either way, one of the things you
want to think about in the months before your landmark birthday
is Medicare coverage. But beware - there are lots of options and
choices out there. Making the best choice for you, your family,
and possibly your business is not necessarily easy or obvious.
With the myriad of websites, mailings, and unsolicited phone
calls that those approaching 65 receive, it's understandable
that some people just delay or ignore their Medicare eligibility
and coverages due to utter confusion and frustration. In our
experience, many Medicare insurance carriers and agents
purposely add to the confusion in order to position themselves
to gain your trust as being the one person who can guide you
through the Medicare maze. Please keep in mind that anyone
who is in a position to benefit financially from your choices
may not be completely objective or have your best interests as
their main priority. Also please keep in mind that when seeking
advice from friends and relatives who may already have exercised
their Medicare rights that they will only understand it as well
as it was originally explained to them, and as it pertains to their
individual situation. Everyone's situation is different, and there is
no universal right answer that applies across the board. That's why
it's critical that you start planning before you bake that birthday
cake, and work with someone who is not paid based on the
products you may choose. Below, we discuss several issues that you
should consider before deciding what to do about Medicare.

1. How do you decide if and when to enroll?
There are many factors that go into deciding whether or not
you should apply for your Medicare benefits immediately upon
14 | Berks Barrister

achieving eligibility, such as employment status, income, need for
spousal coverage, health, prescription drug usage and age.
a. First, what constitutes your Medicare eligibility? For
most it occurs when you turn age 65. You are entitled to
Medicare Parts A & B that would become effective the 1st of
the month that you turn 65. For example, if you are born July
25th, you are eligible for Medicare to begin July 1st of the year
you turn 65. If you were born on July 1st, then your Medicare
eligibility would be the first of the previous month or June 1st.
One may also become Medicare eligible if they have collected
Social Security Disability benefits for at least 24 months, or
upon being diagnosed with End Stage Renal Disease or ALS
(Lou Gehrig's Disease) without any age requirement.
b. Once you become eligible for Medicare through one of
the criteria listed above, must you enroll? The answer is no.
Although you may be entitled to Medicare, there is NO
requirement that you must exercise that option. You may
have heard that there is a late enrollment penalty for not
taking your Medicare when first eligible. Medicare Part A,
hospital insurance, has no penalty if you enroll into it after
your initial eligibility period, however, if you choose to begin
collecting your social security income benefits, then you
will be automatically enrolled. Normally, Medicare Part A
has no monthly premium as long as have worked and paid
into social security for 40 quarters (10 years) throughout
your lifetime. The other half of Medicare, Part B, medical
insurance, does have a late enrollment penalty which would be
10% for every calendar year from age 65 until you choose to
enroll .... Unless you have other credible insurance instead.
Most people don't realize that if they have credible insurance


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Berks Barrister Fall 2018

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