Maximizing Medicare

About to Turn 65? Here's How to Set a Health Care Path

Since 2015, Fred Torlish, owner of FWT Insurance Services, has been helping small businesses and individuals secure the best health insurance at reasonable costs. By building relationships with clients and analyzing their needs against the best the market offers, he has given them a solid foundation based on educated choices. 

The main service provided by FWT Insurance is helping clients approaching the age of 65 navigate the transition to Medicare. With the launch of Medicade’s Annual Election Period from October 1 through October 14, FWT conducts reviews with current clients as well as others already on Medicare to see if either their Medicare Advantage or Prescription plan will be suitable for the subsequent year. From October 15 to December 7, reviews continue and plan changes can be made if warranted. Medicare Supplemental plans can be reviewed at any time throughout the year.

Torlish breaks down what you need to know: 

Who is eligible for Medicare?

Anyone who turns 65 and has been employed and paid into Medicare taxes for at least 10 years, those over age 65 who are retiring from the workforce or those under 65 who have been on Social Security for at least 24 months are eligible for Medicare. 

There are two main components to Medicare. Medicare A covers services like inpatient hospitalization, inpatient rehabilitation and hospice care. People are usually automatically enrolled in Medicare A whether they continue working or retire at age 65. Medicare B, which is administered through Social Security, includes all outpatient medical events, including doctor and emergency room visits, tests and same-day hospital procedures. Medicare B is acquired by enrollment through Social Security.

When should people talk to you about Medicare?

Ideally, people would come to me when they are 64-and-a-half. At that time, I work with them to determine their current situation and do a cost and coverage analysis, taking into account their current employment—if they are at a corporate job, smaller company or self-employed—to see whether they should remain on active employer coverage or switch to a full Medicare program. 

If they are actively employed and are satisfied with the terms and premiums of their employer’s health plan and Medicare is classified as “secondary” through their or their spouse’s active employer coverage, there’s no need to sign up for Medicare B until they either become dissatisfied with their coverage or when it’s time for them to retire. Typically, people who are self-employed in small business or work for a smaller company are better off switching completely to Medicare B since Medicare is considered “primary” regarding their coverage. 

In addition, I send everyone the book Medicare & You, which is issued by the government and gives a complete overview of the process. 

What are the biggest challenges you see with people understanding Medicare?

There is a lack of awareness and education regarding Medicare. I like to get in front of human resource directors at small to midsized businesses to help them understand that they need to communicate how Medicare works better to their employees. 

Why should people contact you for assistance with Medicare? 

I’m an independent, non-captive agent, which means that I do not represent any one health insurance entity. I am contracted with all the major carriers along with a few of the minor carriers in New Jersey and in 14 other states. I also can contract in any of the other states upon request.

I can help people sign up for Medicare B online through Social Security—it’s an easy and efficient process—but it can take between six days to a month to take effect so it’s important to sign up 90 days before one becomes Medicare eligible and not wait until they turn 65. 

I sit down with people and provide them with every option that is available and empower them to make an informed decision based on what gives what gives them the most peace of mind. 

The Annual Election Period beginning in October is my most crucial time of year. For clients already on Medicare, I review their current Medicare and prescription plans to ascertain if they should remain status quo or transition to another product. Over the last eight years, I have saved people anywhere from $200 to $16,000 going into the subsequent year by doing these reviews. Knowledge can lead to incredible savings as well as peace of mind. 

Learn more at FWTInsurance.com/aboutus.html.

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