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Broker News | December 2017 | Vol. 12 No. 12
Broker News | December 2017 | Vol. 12 No. 12

Medicare Direct Pay Special Enrollment Period


With a new year coming, many retirement age individuals may take the opportunity to retire on December 31. This can mean big changes, including the need to acquire individual Medicare health insurance. Here are some important steps to help guide your clients through this process.

For Medicare eligible individuals, the first step to prepare for transition into a Medicare Direct Pay plan is to have both Medicare Parts A and B in place for the desired date the new Medicare plan will be effective. For those retiring on 12/31/17, the desired effective date would be 1/1/2018. In order to ensure that happens, you should advise your client to call the Social Security Administration at 1-800-772-1213. One thing to be aware of is that individuals retiring after age 65 may already have Medicare Part A in place.  

Once Medicare Parts A and B are in place, you can begin to consult with your client regarding plan selection.

In order to obtain coverage beginning 1/1/2018, the member’s application must be turned in to the Health Plan by 12/31. There are no retroactive enrollments allowed with Medicare Direct Pay plans. If the application is not submitted by 12/31, the retiree then has up to 60 days to complete an enrollment application for a plan. The coverage will begin on the 1st of the month following the application submission, but the retiree may be left without coverage in the meantime.

Once all of this is taken care of, your client can have peace of mind knowing that their health care coverage is in place for retirement.

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