Medicare Information
You're Not Alone
As you approach age 65, you may find yourself not knowing how to approach Medicare. But as a participant of The Alliance Health Plan, you’re not alone. We’ll help you understand your options and find the right plan for your needs and budget.
Medicare Details
Eligibility
When is my Medicare age-eligibility date?
Your Medicare eligibility date is the first day of the month in which you turn 65, unless your birthday falls on the 1st of the month. If your birthdate is the 1st day of a month, your Medicare eligibility date is the 1st day of the month prior to your 65th birthday.
Your Initial Enrollment Period (IEP) lasts for 7 months: the 3 months before your 65th birthday, your birthday month, and the 3 months after. You can apply directly through the Social Security Administration.
Enrollment
Am I required to enroll in Medicare?
As a member of The Alliance Health Plan, your Medicare enrollment at age 65 depends on your employer’s size.
- If your employer has less than 20 employees, your Alliance Health Plan medical coverage will change to the secondary payer of medical claims. For this reason, the Alliance Health Plan requires you to enroll in Medicare Part A and B on your age-eligibility date. Your Alliance Health Plan coverage will not end unless we receive a termination request from your employer or you otherwise become ineligible to participate on the plan.
- If your employer has 20+ employees, you won’t need to enroll in Medicare, and the Alliance plan will remain your primary payer of your medical claims.
Understanding these guidelines helps you make informed decisions and avoid penalties.
Dependents
Can my family remain enrolled in the Alliance Health Plan if I end my coverage?
The Alliance Health Plan is an employer group health plan, which means an eligible employee of an Alliance-affiliated employer must be enrolled in the Alliance Health Plan for a spouse and or child(ren) to be eligible for coverage on the plan. Alliance Benefits does not sell individual insurance policies. If you terminate your coverage on the Alliance Health Plan, your spouse and/or child(ren) will end.
Spouses and children may be eligible for temporary Coverage Extension.
Prescriptions
Am I required to enroll in a Medicare Part D drug plan for prescription coverage?
You are not required by the Alliance health plan to enroll in Medicare Part D. Prescription coverage on the Alliance Health Plan is Creditable by Medicare guidelines. You have the option with Medicare to postpone Part D enrollment while covered on a Creditable employer prescription plan, without a future penalty, as long as you enroll within their guidelines once you no longer have Creditable employer coverage. If you remain enrolled in the Alliance plan and enroll in Medicare Part D drug coverage, Part D will not pay Primary over an employer group prescription plan, so it may or may not be financially beneficial to pay for Part D while you have the Alliance employer group prescription coverage. We recommend you discuss any questions with a licensed Medicare agent.
Please read this notice carefully and keep it with your other important papers. This notice has information about your current prescription drug coverage with the Alliance and the Medicare Part D prescription drug coverage. It also explains the options you have under the Medicare prescription drug coverage and can help you decide whether or not you want to enroll. At the end of this notice is information about where you can get help to make decisions about your prescription drug coverage.
Contact Information
Health Savings Account (HSA)
How does Medicare impact my HSA?
Once you enroll in Medicare, you can no longer contribute to your Health Savings Account (HSA). However, you can still withdraw your existing funds tax-free for qualified medical expenses, including Medicare premiums.
Your HSA account is a bank savings account in your name. All contributions made to your HSA prior to being enrolled in Medicare still belong to you, and you own the account even after end of employment. After retirement, your HSA balance can be used toward your Medicare monthly premiums.
Contribution Rules
- You cannot contribute: You must stop making (or receiving) contributions to your HSA on the first day of the month your Medicare coverage begins.
- Retroactive penalty: If you delay enrolling in Medicare and claim Social Security, your Medicare Part A coverage can be made retroactive for up to six months. To avoid excess contribution penalties, you should stop funding your HSA at least six months before you plan to apply for Social Security.
- The Penalty: Making contributions while enrolled in Medicare subjects you to a 6% IRS penalty on the excess contributions.
Spending Existing Funds
- What you can pay for: You can use your HSA funds tax-free to pay for Medicare Part A, Part B, Part D, and Medicare Advantage premiums. You can also use them for copays, deductibles, and other qualified expenses.
- What you cannot pay for: You cannot use HSA funds to pay for Medicare Supplement (Medigap) policy premiums.
- Age 65 rule: Once you reach age 65, you can use HSA funds for non-medical expenses without the standard 20% penalty, though these withdrawals will be taxed as regular income.
Spousal Coverage
If your spouse is enrolled in Medicare but you are not and you carry family coverage, you can still contribute up to the maximum family limit. Your spouse can also continue to use their own HSA funds for their qualified expenses.
It is the participant’s responsibility to comply with IRS rules regarding their HSA. Alliance Benefits is not responsible for an ineligible employee’s contributions to an HSA or for tax penalties which may be incurred by the employee if their annual maximum contribution amount is exceeded.
Account Information
For more information, please read the document below.
Find Help
Who can I contact about Medicare?
For Medicare assistance, please call or email Michael Holmes directly.
Michael Holmes
Martin Insurance Group | Wholesure Partner
Email: [email protected]
Direct: 609-356-1557
Resources
Learn More About Medicare
Medicare and the Alliance Health Plan
Spouse Medicare and the Alliance Health Plan