Is this Person Required to Take Part B at 65?

[WCMason]

I wondered about that but just posted the link and ran.

May not be since it is high deductible. Check with group carrier.

This ..................

A prescription drug plan is deemed to be creditable if it:

1) Provides coverage for brand and generic prescriptions;
2) Provides reasonable access to retail providers and, optionally, for mail order coverage;
3) The plan is designed to pay on average at least 60% of participants’ prescription drug expenses; and
4) Satisfies at least one of the following:

a. The prescription drug coverage has no annual benefit maximum benefit or a maximum annual benefit payable by the plan of at least $25,000, or
b. The prescription drug coverage has an actuarial expectation that the amount payable by the plan will be at least $2,000 per Medicare eligible individual in 2006.
c. For entities that have integrated health coverage, the integrated health plan has no more than a $250 deductible per year, has no annual benefit maximum or a maximum annual benefit payable by the plan of at least $25,000 and has no less than a $1,000,000 lifetime combined benefit maximum.

(Released May 23, 2005 in the Creditable Coverage Guidance.)

The maximum deductible can change each year. The 2015 maximum initial deductible is $320. Please see The 2015 Medicare Part D Model Plan Parameters for a comparison of changes each year.

What is meant by Creditable Coverage and How do I know if I have Creditable Coverage?

You're right that it is best not to assume an employer plan--especially an HSA--has Rx coverage that meets Medicare's minimum standard. I have had people check and find out from their employer that the Rx coverage is not creditable. That means they have to take a Part D plan to avoid late enrollment penalties. That means they have to take at least Part A. And that means no more HSA contributions. And then maybe they should just get off the employer plan and embrace all that is Medicare. Worth confirming.

 

[kstein]

Good advice, I think she is leaning towards Medicare anyways just for the simplicity of it but is checking these things from her employer to see.

 

[yorkriver1]

During the multi-carrier meeting my FMO held yesterday, we were told by the BCBS rep. that if the enrolled persons on the group are fewer than 20, it is a good idea for a group with 20+ employees to put the carrier on notice of the size. Then the carrier knows that they must be primary payor for the Medicare age person. Otherwise, they may look to pay as secondary based on # enrolled.
Re: not enrolling in Medicare A, as mentioned. If the person is receiving Social Security payments, they can't waive A, to my knowledge. I imagine the person mentioned here isn't collecting SS income. Having Medicare A while on group coverage where the group is primary is a non issue usually. Only affects the HSA contribution eligibility. Good reminder WC, and an option for some who would like to continue contributing.

 

[TwoCents]

I'm sure it is cc since its an employer plan but I haven't seen the specifics of her employer plan yet.

That's a dangerous assumption.

 

[somarco]

Just to punch up 2cents post, the underlying health insurance plan may be creditable, but as #10 points out, the Rx coverage may not be.

 

[kstein]

Thanks for input she went med sup and Pdp. Kept dental vision w employer.