How to Transition to Medicare Coverage

If you have a health plan through the Health Insurance Marketplace and will soon have Medicare eligibility, it’s not too soon to start planning for your coverage to switch.

If you have a Marketplace plan now, you can keep it until your Medicare coverage starts. Then, you can cancel the Marketplace plan without penalty.

When to apply for Medicare

Once Medicare eligibility begins, you’ll have a 7 month Initial Enrollment Period to sign up. For most people, this is 3 months before, the month of, and 3 months after their 65th birthday.

It’s important to sign up for Medicare when you’re first eligible because once your Medicare Part A coverage starts, you’ll have to pay full price for a Marketplace plan. This means you’ll no longer be eligible to use any premium tax credit or help with costs you might have been getting with your Marketplace plan. 

Also, if you enroll in Medicare after your Initial Enrollment Period, you may have to pay a late enrollment penalty. It’s important to coordinate the date your Marketplace coverage ends with the effective date of your Medicare enrollment, to make sure you don’t have a break in coverage.

Getting Help

Our insurance agency works with people all across the state of Texas to help transition people into Medicare coverage, as well as insuring people of all ages in this state for their health insurance options.  If you are a resident of Texas, we want to help you!  Please call Jim Lindeneau, at 832-445-0211, ext. 2# for more information.  

New Health Insurance Special Enrollment Period for Tax Season

The Centers for Medicare and Medicaid Services (CMS) announced a new Individual Health Insurance Marketplace Special Enrollment Opportunity beginning on March 15 through April 30. This Special Enrollment Opportunity is for individuals and families who did not have health coverage in 2014 and are subject to the fee or "shared responsibility payment" when they file their 2014 taxes in a Federally Facilitated Marketplace (FFM) states.

Who is Eligible
Clients who live in a FFM state are eligible for this Special Enrollment Opportunity if they:

• Are not currently enrolled in health coverage through the FFM for 2015,
• Attest that they paid the fee for not having health coverage in 2014, and
• Attest that they first became aware of, or understood the implications of, the penalty or shared responsibility payment after Feb. 15, 2015, when Open Enrollment ended, in connection with preparing their 2014 taxes.

State-based Exchanges (SBE) have the flexibility to determine whether they will establish a similar special enrollment period. Check specific SBE websites for additional information. 

What This Means
Eligible clients will have the opportunity to purchase an On-Exchange Individual Health Plan from March 15 through April 30.

• Enrollments made by the 15^th of the month will have coverage effective on the 1^stday of the following month.
• Enrollments made after the 15^th of the month will have coverage effective on the 1^st day of the second month.

The fee for not having health insurance increases to $325 per adult or 2% of income for 2015. Individuals taking advantage of this special enrollment period will still owe a fee for the months they were uninsured and did not receive an exemption in 2014 and 2015. This special enrollment period is designed to allow such individuals the opportunity to get covered for the remainder of the year and avoid additional fees for 2015.Our office will be open Sunday, March 15th for anyone who pre-schedules an appointment, to enroll for coverage.  The reason for this is because March 15th is the cutoff for an April 1 effective date.  Anyone who waits until April 16th or after, will have an effective date of either May 1 or June 1 (depending on the exact date of enrollment).  For anyone desiring an April 1 effective date, it is imperative to enroll no later than this Sunday, March 15th.  

TO SCHEDULE AN APPOINTMENT OR TO FIND OUT IF YOU ARE ELIGIBLE, PLEASE CALL DANA LINDENEAU AT 832-445-0211, EXT. 1#.