Ok, so “world” is a bit dramatic, but…. In the U.S. — Absolutely.
I’m going to head right to the “helping” part first and then you’ll see why. If you are in any of these roles:
- Human Resources – any role within and at any company anywhere;
- A financial advisor helping your client through job transitions or with retirement;
- A person that is over age 65 and considering signing up for employer-provided Cobra coverage;
- A person that knows a person that is over age 65 and considering signing up for employer provided Cobra coverage;;
- A benefits person that coaches people through “coverage”;
- Owner of a business that just wants things to go smoothly for your employees and your human resources department;
- That might complete the list! (likely not….)
Now, what should you be helping WITH?
It’s almost simple. Keep your ears peeled for (1) anyone talking about or considering signing up for Cobra (health insurance coverage that you can take with you when you leave the workplace due to retirement, being let go, etc.”. (2) AND – here’s the other key piece… they are OVER AGE 65.
(*Note: This entire post is going to generally apply to employer groups with more than 20 people, also)
Here’s what happens: HR prepares the Cobra paperwork for a 68 and 66 year old couple and delivers it to them in preparation for the separation of employer and employee/dependents. Note that I say 68 and 66 year olds.
Problem: No one explains to them what can happen as this coverage interacts with Medicare.
Many people that are ages 68 and 66 have not signed up for Medicare’s Part B due to the fact that they do, indeed, have employer coverage. And, that’s all good!
Where things can go wrong is when they never got Part B and are now offered the Cobra coverage from the employer. 99.9999% of the time they think this: “perfect, I can just keep my coverage for 18 months and all is well since I’ve had the coverage, I know how it works, etc”.
But, they really don’t know how it can work.
When a person is ELIGIBLE for Medicare Part B (remember, eligible just means that they passed age 65) and are on Cobra coverage — Medicare becomes the primary payor for this person in a claim situation. So, imagine that a large claim occurred or they scheduled surgery for a knee replacement? Well, everyone would bill MEDICARE first. Don’t believe us? See this document from the Medicare.gov website – And, it’s on page 7. (We use this document often!)
So, what does this really mean in reality? Well, remember the person didn’t enroll into Medicare. That’s where the problem can begin. And, continue.
Here’s our YouTube video that can explain things clearly about why you don’t want to be on Cobra health insurance without having Medicare in place.
After understanding how things work, we then want to talk through “well, if I get Medicare, do I even need to have Cobra?” *** Totally different conversation and it’s certainly step two after getting your Medicare all set up properly.
Please do not do this “Medicare stuff” alone. Don’t let your employee, your friend, your sibling or your client do this alone.
We’re an agency based in Michigan specializing in the “transition to Medicare”. It’s a really big deal to get this “stuff” right. We handle ONLY Medicare issues, teaching and enrollment into the proper products. Contact us – we work with people all over the country (we’ve worked virtually for years)
Just like you use a good orthopedic surgeon for that knee replacement, find a specialist with your health insurance 🙂
Joanne Giardini-Russell is a Medicare Nerd & the owner of Giardini Medicare, helping people throughout Metro Detroit and the country transition to Medicare successfully. Contact Joanne at firstname.lastname@example.org or by calling 248-871-7756.