Skip to content

Roadmap to Medicare

Turning 65 Retiree

Customized Roadmap Report

Click on the image to download your 1 page Roadmap

Enrolling in Medicare

After reviewing ALL of the information on this webpage, click on Enroll Now for detailed enrollment instructions based on your situation.

Since Medicare is most likely your PRIMARY Insurance, and you may have penalties and deadlines for not enrolling in Medicare, you may want to…

Your Roadmap is based on…

  • You are approaching age 65
  • Your Primary Insured IS NOT (or WILL NOT be) actively working at the employer providing your benefits
  • You ARE (or WILL be) covered under the group health Retiree plan

Do I need Medicare to have full coverage?

Yes/Likely.  Once you turn 65, it is likely that your Retiree coverage will become secondary coverage and Medicare will become the primary insurance.  If you do not enroll in Medicare, you may not have full coverage.

  • Questions to ask your Retiree plan when you turn 65:
    • Will my benefits change now that I am turning age 65?
    • Will my premiums change?
    • Can my spouse get this benefit if I do not enroll?
    • Will benefits and/or premiums change for my spouse should my passing occur first?
    • Will the Retiree plan act as primary insurance or do I need to have Medicare A and B as primary insurance to my plan?

If you wish to defer enrollment in Medicare A and/or B, please confirm from your Retiree plan health insurance carrier (in writing recommended) that they will remain the primary payer or you could have significant gaps in your coverage.

Will I receive a penalty if I don’t enroll now?

Yes. You will receive a late enrollment penalty because your Retiree coverage is not considered creditable coverage to Medicare.  Creditable coverage is defined as group coverage based on current active employment.  Retiree plans are not based on active employment.  

What is my deadline to enroll?

Your Initial Enrollment Period (Turning 65) is 7 months surrounding your 65th birthday to enroll online.  Your effective date will be automatically assigned to you based on which month you enroll online. 

Secondary Insurance Options

Since your Retiree benefits are likely considered secondary insurance to Medicare, you MUST be enrolled in Medicare A and B to have full coverage.  You will have the option to keep your Retiree Plan as secondary or elect a Medicare Supplement and Medicare Prescription Drug Plan as secondary.

Underwriting Considerations

Medicare Supplement Insurance has an Open Enrollment Period for the first 6 months that you are enrolled in Medicare Part B.  During this time, you will be able to purchase ANY medicare supplement plan with no medical underwriting.

If you stay with your Retiree plan and decide to elect a Medicare Supplement later (when Retiree plan ends, but you have already been on Medicare for more than 6 months) you will have SOME plans available on a Guaranteed Issue basis.  There will be less options available that do not require you to answer medical questions to qualify.

Medicare Advantage Plans and Medicare Prescription Drug Plans provide an Initial Election Period when you enroll in Medicare, a Special Election Period when you come off your Retiree plan, and also allow you to change plans once a year during the Annual Election Period (October 15th through December 7th) without medical underwriting.

Additional Considerations

Effective Date Considerations- Reminder, when you apply for Medicare at age 65, you cannot choose a specific effective date for the benefits (and premiums) to start.  The only way to influence the effective date is by which month you enroll online.  Please contact us ASAP if you are trying to achieve a specific start date that is something other than the first of the month of your 65th birthday (possibly to coordinate with your group plan ending).

Important HSA Considerations– You cannot continue to contribute to your Health Savings Account (HSA) once you enroll in Medicare Part A.  If you are enrolling in Medicare after age 65, your Part A effective date may be back dated up to 6 months.  Please contact us to discuss the HSA maximum contribution rate for you circumstances.  Click Here for Details and Rules.

  • This does not apply to Flexible Spending Accounts (FSA) or Health Reimbursement Accounts (HRA).  Medicare does not have any restrictions on these types of accounts.

Contact Us

Our Address

347 N. Pottstown Pike
Suite 200
Exton, PA 19341

Contact Us
P: 610.430.6650
F: 610.430.6652

© Copyright HTA | Privacy Policy | Designed by Apis Productions