Is Medicare Part B Required to Stay on Supplemental?
My Mom is 85 yrs. old and has enjoyed full medical, dental, and vision benefits as a Prime Care Survival retiree with Edison International since she was 65. Under her coverage she has no deductibles or premiums of any kind. This is one of the best health coverages on the planet.
My Mom received letter from EIX Benefits that she must enroll in Medicare Part B to remain in an Edison sponsored health plan by Mar 31st,2015.
Upon further discussion with EIX reps. they said they were complying with Federal law, which one I ask them? And there still trying to figure that out.
My question is, does this situation have anything to do with the Affordable Care Act or Medicare ? I thought I heard President Obama say, ” if we liked our present health coverage we could KEEP it. Why would my Mom trade her no payment plan for Medicare Part B plan with all its payments, premiums, and penalties?
Answer
Generally someone needs to have Original Medicare to get supplemental coverage. Some insurances allow deferment of Part B without a penalty, but TRICARE requires Part B.
You can read through all the rules at Medicare.Gov (although we have reprinted them below for your connivence).
Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.
" href="http://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/should-you-get-part-b/should-i-get-part-b.html#1368" name="1368">Medicare Part B (Medical Insurance).
CollapseI have employer or union coverage.
If you or your spouse (or family member if you're disabled) are still working and you have insurance through that employer or union, contact your employer or union benefits administrator to find out how your insurance works with Medicare. This includes federal or state employment, but not military service (unless on active duty). It may be to your advantage to delay Part B enrollment.
Note
You can sign up for Part B without a penalty any time you have health coverage based on current employment. (COBRA and retiree health coverage don't count as current employer coverage.)
When employer/union coverage ends
Once your employment (or your employer/union coverage) ends, 3 things happen:
- You may be able to get COBRA coverage, which continues your health insurance through the employer's plan (in most cases for only 18 months) and probably at a higher cost to you.
- You have 8 months to sign up for Part B without a penalty, whether or not you choose COBRA. To sign up for Part B while you're employed or during the 8 months after employment ends, complete anApplication for Enrollment in Part B (CMS-40B) and a Request for Employment Information (CMS-L564). If you choose COBRA, don't wait until your COBRA ends to enroll in Part B. If you don't enroll in Part B during the 8 months after the employment ends:
- You may have to pay a penalty for as long as you have Part B.
- You won't be able to enroll until January 1–March 31, and you'll have to wait until July 1 of that year before your coverage begins. This may cause a gap in health care coverage.
- If you already have COBRA coverage when you enroll in Medicare, your COBRA will probably end. If you become eligible for COBRA coverage after you're already enrolled in Medicare, you must be allowed to take the COBRA coverage. It will always be secondary to Medicare (unless you have <a class="glossary" style="margin: 0px;padding: 0px;border-width: 0px 0px 1px;border-bottom-style: dotted;font-weight: normal;font-style: inherit;font-size: 13.8000001907349px;font-family: Arial;vertical-align: baseline;color: #4c4c4c;text-decoration: none;cursor: pointer !important" title="
Permanent kidney failure that requires a regular course of dialysis or a kidney transplant.
" href="http://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/should-you-get-part-b/should-i-get-part-b.html#1317" name="1317">End-Stage Renal Disease (ESRD)).Learn more about how Medicare works with other insurance.
CollapseI have TRICARE.
If you have <a class="glossary" style="margin: 0px;padding: 0px;border-width: 0px 0px 1px;border-bottom-style: dotted;font-weight: normal;font-style: inherit;font-size: 13.8000001907349px;font-family: Arial;vertical-align: baseline;color: #4c4c4c;text-decoration: none;cursor: pointer !important" title="
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
" href="http://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/should-you-get-part-b/should-i-get-part-b.html#1367" name="1367">Medicare Part A (Hospital Insurance) and <a class="glossary" style="margin: 0px;padding: 0px;border-width: 0px 0px 1px;border-bottom-style: dotted;font-weight: normal;font-style: inherit;font-size: 13.8000001907349px;font-family: Arial;vertical-align: baseline;color: #4c4c4c;text-decoration: none;cursor: pointer !important" title="
A health care program for active-duty and retired uniformed services members and their families.
" href="http://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/should-you-get-part-b/should-i-get-part-b.html#1438" name="1438">TRICARE, you must have Part B to keep your TRICARE coverage.
I'm an active-duty service member.
If you're an active-duty service member, or the spouse or dependent child of an active-duty service member:
- You don't have to enroll in Part B to keep your TRICARE coverage while the service member is on active duty.
- Before the active-duty service member retires, you must enroll in Part B to keep TRICARE without a break in coverage.
- You can get Part B during a special enrollment period if you have Medicare because you're 65 or older, or you're disabled.
- If you have <a class="glossary" style="margin: 0px;padding: 0px;border-width: 0px 0px 1px;border-bottom-style: dotted;font-weight: normal;font-style: inherit;font-size: 13.8000001907349px;font-family: Arial;vertical-align: baseline;color: #4c4c4c;text-decoration: none;cursor: pointer !important" title="
Permanent kidney failure that requires a regular course of dialysis or a kidney transplant.
" href="http://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/should-you-get-part-b/should-i-get-part-b.html#1317" name="1317">End-Stage Renal Disease (ESRD), you should enroll in Part A and Part B when you're first eligible.
I have Veterans' benefits.
If you have Veterans' benefits, enrolling in Medicare may provide you with additional service and location options. If you don’t keep Part B, you may have to wait to sign up later, and you may pay a late enrollment penalty.
I have CHAMPVA.
If you have <a class="glossary" style="margin: 0px;padding: 0px;border-width: 0px 0px 1px;border-bottom-style: dotted;font-weight: normal;font-style: inherit;font-size: 13.8000001907349px;font-family: Arial;vertical-align: baseline;color: #4c4c4c;text-decoration: none;cursor: pointer !important" title="
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
" href="http://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/should-you-get-part-b/should-i-get-part-b.html#1367" name="1367">Medicare Part A (Hospital Insurance) and <a class="glossary" style="margin: 0px;padding: 0px;border-width: 0px 0px 1px;border-bottom-style: dotted;font-weight: normal;font-style: inherit;font-size: 13.8000001907349px;font-family: Arial;vertical-align: baseline;color: #4c4c4c;text-decoration: none;cursor: pointer !important" title="
A health care benefit for dependents of qualifying veterans.
" href="http://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/should-you-get-part-b/should-i-get-part-b.html#5321" name="5321">CHAMPVA, you must have Part B to keep your CHAMPVA coverage.
I don't have any of these.
You should enroll in Part B when you're first eligible. If you don't sign up for Part B when you're first eligible, you may have to pay a late enrollment penalty for as long as you have Medicare. Learn more about when you can sign up for Parts A & B.