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How Do I Know If I Need or Qualify for Medicare?


Lee: Let’s see. How do I know if I qualify or if I need Medicare?

Casey:  Oh, wow. So that is to me, one of the shocking things that people who are becoming Medicare eligible, whether that’s for a few different reasons we will go over in a second that just aren’t aware of it. And so we could give you a list a mile long of reasons and options, but I’m gonna give you the most common. So most people are gonna qualify for Medicare when they’re turning 65. That’s going to be the vast majority of people. When they turn 65, they’re going to be eligible for Medicare. The other one is if they’re on Social Security disability for 24 consecutive months. Okay. And so keep in mind that you might be a 40 year old. You might be a 50 year old. You might be a 55 or 60 year old and a social care disability for two years. Now you’re going into Medicare automatically. That’s just going to happen. Yep. Another one to keep in mind if you apply for Social Security disability and then turned down. And then let’s say you go get an attorney or you apply again and you get approved. They’re going to backdate that approval back to when you first applied. And so I’ve had clients walk in the door and say, hey, listen, for some reason I got this Medicare card in the mail. Like, when did you apply for Social Security? Well, it’s been a couple of years ago. Ta-Da! That’s why you got it. So that’s what. But the most common is when you’re turning 65. Now, keep in mind, if you’re still working, you’re still in an employer sponsored plan with at least 20 or more employees on that plan, and it’s considered creditable by the government. That means it’s at least as good as what Medicare would offer. Then you don’t have to do anything. So we have a bunch of clients, and one of the big employers in our area is a is a government site, right? It’s private contractor, but it’s a government site and tons and tons of our clients are eligible for a group employer plan. And they continue to work to 66, 67 or even sometimes 70 years.

Lee: Yep. 

Casey: They stay on that employer plan. They never sign up for Medicare during that period of time. Staying on their group plan. No penalty, no problem. They can apply for Medicare as soon as they become, decided they’re going to retire. And that’s okay. Now, if you’re on a small employer plan, that does not to me doesn’t offer health insurance where it’s 20 or less employees. Excuse me, 19 or less employees, then you got to sign up for Medicare. You have to do it and there’ll be a penalty. And unfortunately, we have people we meet once in a while that didn’t do it and that penalties for life. 

Lee: Yeah. 

Casey: And it stinks because it’s not a small amount of money. Didn’t we. We were talking about a meeting today. One of our agents. I think you said that someone who hasn’t had, Medicare prescription drug coverage for 15 years. 

Lee: Yep. 

Casey: That penalty is about 75 bucks a month for the rest of that person’s life. If they ever sign up for prescription drug plan.

Lee:  Yep. They had no idea. I’m healthy. I don’t take drugs. Why would I need this? And then. Sorry. Never talked to a broker.

Casey: Never asked for advice.

Lee:Yep. Exactly right.

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