Medicare Information for Small Businesses
As COSE helps Northeast Ohio small businesses navigate their health insurance benefits, we’ve encountered many questions related to Medicare information for small businesses. Many if not most businesses will need to address these questions and issues at some point, so we have taken the time to answer some common questions.
Q: What is Medicare?
A: A federal health plan that pays for medical services for qualified seniors, disabled persons, and those with end-state renal disease.
Q: Will my employees automatically be enrolled into Medicare or do they need to sign up?
A: Three months prior to an employee’s 65th birthday, he or she will receive a Medicare package that automatically enrolls them into Part A and Part B. If they do not receive a packet, they should contract Medicare directly. If they choose to opt out of Part B, they’ll have to return an enclosed letter. However, COSE strongly recommends that employees take Part B to avoid large out-of-pocket expenses.
Q: What are Part A and Part B?
A: Part A pays for inpatient hospital stays, skilled nursing facilities and some hospice and home health care services. Provided an employee or spouse has 40 or more quarters of Medicare-covered employment, there is no cost associated with Part A. Part B covers Medicare eligible physician services, outpatient services, certain home health services and durable medical equipment. It costs $96.40 per month this year, provided your current income does not exceed $82,000 (single) or $164,000 (married couple).
Q: If I’m still offering employees insurance, should they take Medicare or not?
A: COSE suggests employees turning 65 enroll in Medicare Part A and Part B. If they do not receive a packet, they should contact Medicare directly. If your company has fewer than 20 employees, Medicare is primary. This means Medicare pays claims first and the company’s insurance pays second. If the company has more than 20 employees, the company insurance pays first and Medicare pays second.
Q: Do employees need insurance in conjunction with Medicare?
A: It’s not necessary, but secondary insurance will help minimize out-of-pocket expenses.
Q: Do employees have to notify Medical Mutual of Ohio when they are turning 65?
A: Yes, employees should call Medical Mutual of Ohio’s customer service department when they receive their Medicare packet.
Q: Will employee coverage remain the same when they enroll in Medicare and stay in the company’s insurance plan?
A: As the employer, you need to make a plan selection for active employees turning 65. Your choices include Medifil and Medifil without Rx, which will change your employee’s coverage, and Medicare Carve Out, which, in most cases, will keep their coverage the same.
Q: What is Part D?
A: Medicare Part D is a prescription drug benefit plan available to all individuals turning 65 years of age.
Q: Do I need to elect a Part D plan?
A: No, however you are responsible for notifying your employees as to whether or not the plan elected is considered creditable by government standards associated with the Medicare Part D plan. Visit cms.hhs.gov/creditablecoverage for information on creditable plans. If not creditable, the employees need to purchase a Part D plan on their own so they don’t incur a monthly penalty.
Learn more at www.medicare.gov.
Or call COSE at (216) 592-2222 or e-mail memberservices@cose.org.