A blog about Medicare. What you and your employees need to know

Don’t Let Medicare Spook You – A Success Story

Author: Lora Drummond

Medicare Transition Specialist

Posted: 10/26/2020

Don’t Let Medicare Spook You 

Have you ever felt the fear of thinking you made a mistake? It creates a lot of anxiety you want to resolve quickly. Here is an old success story worth retelling about a couple who needed their Medicare fear resolved! I’m sharing their real story so that when you get ‘spooked’ by Medicare or your decisions, you know where to get a confident resolution.

A Success Story

One of our Certified Medicare Planners® met with a couple who thought they had waited too long to enroll in Medicare. Mary was turning 65 in a few days and feared she wouldn’t be covered in time and would yield a perpetual penalty for enrolling past her birthdate. Their fears were resolved at the meeting, AND important questions led to a few positive surprises. While getting the particulars, the advisor soon realized not only was Mary eligible, but Ben also was approaching his 65th milestone. Ben had been on Medicare disability for years, and since he was already enrolled, he didn’t anticipate having to do anything when his birthday eligibility kicked in. 


Mary: Our advisor calmed Mary’s fears about penalties because Medicare provides three months before and three months after her 65th birthday month to enroll. So Mary was not late in enrolling at all! We showed her all of the plan options in her area to consider to make the most appropriate plan choice for her needs. We even helped her enroll!

Ben: Even though he qualified for Medicare Parts A & B under disability, his 65th birthday opened up ALL the Medicare plan options, including Medicare Supplements and other Medicare Advantage plans for consideration. He might save on costs, modify coverage based on his needs, and still qualified for his “no questions asked” eligibility. 

But there is more to Ben’s story…  


Medicare Disability

When he filed for disability, Ben’s HR team told him he could keep his group plan and enroll in Medicare Parts A & B since he qualified for work disability. However, what they failed to advise is that in Arizona, Ben could have enrolled in a Medicare Advantage plan instead, which would provide benefits similar to his group plan. 

Ben enrolled in Medicare and kept his employer plan, as suggested by the employer. However, Medicare began charging Ben a penalty for going without “creditable coverage” when he left his employer and went on disability.


Because in Medicare’s eyes, Ben should have enrolled in Part D when he went on disability. His HR team forgot to have him enroll in a drug plan when he was enrolling in Parts A & B. Medicare suggests you enroll in a drug plan also when leaving your employer plan (to avoid penalties).

But wait! Wasn’t Ben still enrolled on his group plan also?


The Grand Discovery

Ah… yes, but Social Security didn’t know Ben retained his union medical plan with Medicare disability. Therefore, because he had creditable drug coverage under the group plan, he was never without it. He just needed to prove that fact to Social Security and Medicare.

We supplied Ben with the forms to be completed by his employer to show his union coverage had been in effect since his disability filing. This step eliminated his penalty AND provided a refund for the penalties paid!

HR Superstars Need Medicare Partners Too!

Ben’s employer couldn’t have caught all the nuances in this scenario to guide him because, well… they are not licensed Medicare planners. And no one expects them to navigate all the complexities of Medicare. That’s why we are here! Your employees shouldn’t have to fear making decisions with Medicare. We strive to make Medicare @Work 123Easy for you and your employees.

An aging workforce can benefit from having ready access to partners trained to guide with Medicare so that open discussions can help them. Why not add this partnership to your team?

Consider working with a team of Certified Medicare Planners ® to guide Medicare discussions with your employees. 

With our partnership, you support these opportunities:

  • Save them from paying for more coverage than they need, 
  • Avoid Medicare pitfalls later when they are making an exit plan, 
  • Readies employees to transition to Medicare when it’s appropriate for them, and 
  • Creates a non-bias, carrier-agnostic relationship for providing expert support of ALL the Medicare plans in an area.

Best of all… our services are free to you and your employees

Call us to learn more about how we are helping other companies. 

We can help you lead the path for employees to uncover ‘grand discoveries’ and add to your list of things you do best. 


Create a compliant Medicare benefit support plan.

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Don't Let Medicare Spook You

By adding Medicare education to your benefits package you are adding unrealized total rewards and providing more choices for your employees. Having a Medicare transition team creates confidence in your ability to compliantly educate and transition eligible employees to Medicare while reducing costs for your employees and boosting your bottom line.

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Your Medicare Transition Partner
– Lora

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