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The Medicare annual election period begins on October 15, 2019.You, our colleagues in the group benefits space, have differentstart and end dates that are heavily skewed towards the fall, aswell, so we share mutual headaches!

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Our firm handles only Medicare. While we may say "only" Medicare,it's an enormous task. We coach people from the time they reach age64.5 with questions like "Do you need or want Medicare coverage?How does it compare to your employer plan? How much will it costyou? Are you contributing to a health savings account? Should youenroll into Part A only?" And on and on.

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Related: As the U.S. workforce gets older, Medicareassistance is a must-have 

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Once the answer becomes "Yes, I want or need Medicare coverage"(regardless of age), our work pivots to educating that consumerabout pricing, coverage choices, timing of the process, how to workwith human resources to avoid Medicare penalties, and more.

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The aging workforce leads "Medicare people" like us to becomemore integrated with the employer benefits space, and we have moreinteraction with human resources these days. There's much moreconfusion as the average employee tries to navigate theintersections of Medicare eligibility and working past age 65.

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We'll provide some trigger topics for you this fall as well as acouple of resources to make your life easier. And, the resourcescan be passed along to your human resources friends, which willmake their life easier, as well. It's always nice to give themsomething of value, right?

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Employer plans and the health savingsaccounts 

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This one slips through the cracks rather often. I recall talkingwith two physicians, both age 69, who both enrolled for Part A ofMedicare at age 65 and had been fully funding their health savingsaccount ever since. A real no-no. Their financial advisor was onthe call with us, as well, and you know that he surely learnedsomething during the phone session. (My guess is that won't happenagain to his clients).

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Medicare Part A is not a high-deductible plan, which thusdisallows a person from contributing to a health savings account.However, there's more to that conversation in terms of which personis the employee, are they funding the family level, missing theover age 55 catch-up provision and more.  So, to avoidextra confusion in this short article, let's just say that theentire health savings account and Part A should be aconversation.

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What you can do? Simply say "This reallyrequires you to talk to other advisors as well, Mr. Smith, sinceyou are turning 65 and in an HSA compatibleplan." 

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Recently eligible for Medicare

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Let's say you have a person on an employer plan who recentlyturned 65. The person is not married, and has no other dependentson the plan with him. This employee will typically have nounderstanding that due to his Medicare eligibility, he can comparethat coverage to his employer group coverage.

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We often have calls with people who are very healthy, stillworking, like their employer coverage (they're healthy and notusing it, so of course it's great, right?), the employer iscontributing 80 percent towards the premium. Life is pretty good.We'll typically advise them to stay with the employer plan as it isin their best interest.

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On the flip side, let's say we have a person struggling with achronic illness and they can't go to a certain physician as he/sheis out of network with the employer plan. This person can comparecoverage, costs, networks or lack thereof, to Medicare'soptions.

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What you can do? Tread lightly here. Findpeople who can truly educate the consumer about theirchoices. We've seen people at age 89 stay with employer insurancebecause they thought they had to.

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Under 20employees 

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When an employer size is under 20, Medicare becomes primarycoverage for all employees age 65+ who are eligible for Medicare.We find that this one slips through the cracks too often. Theemployee (and/or their spouse) must enroll into Medicare Parts Aand B.

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We've seen cases where the employee was not made aware of thesituation, did not enroll into Medicare, and when the claims rolledin, they were denied. Not all plans will deny; however, some will.This is also an area where it's a bit gray in terms of who shouldhave told the employee that they needed to enroll into Medicare. Itcan become a finger-pointing routine and at the end of the day, theconsumer/employee is left holding the bag. Don't let that be yourclient. At the end of the day, we're all (as a group) responsibleto help them.

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What you can do? Find a good Medicare source toverify and triple check situations. For the most part, this onlyrequires a phone call.

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The examples above are just a few of the stickiest and mostcommon things that we see as we work with the employer space. Toavoid these problems, we must work together as an industry and relyon the experts around us.

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Wishing you luck and sanity this season!

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Joanne Giardini-Russell is a Medicare specialist and owner ofBoomerHealth Group in Brighton, Mich., an independent provider ofMedicare products nationally. Joanne may be contactedat [email protected].

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