Frequently Asked Questions

First, check with your workplace to see if you have a Retiree Group Medicare plan option. If the answer is YES, you’ll want to meet with your employer or benefit administrator before doing anything else. These plans may offer richer benefits and cost you less than individual Medicare plans. However, you’ll still need to sign up for Original Medicare.

Do you have a Retiree Group Medicare option? (Review answer from the previous question.)

The ultimate goal is to keep you both covered. You should enroll in Medicare and shop for Blue Cross and Blue Shield of Texas plans to help pay the expenses Medicare won’t cover. If your spouse does not have insurance available through an employer, he or she should purchase an individual health plan on the Marketplace.

If you’re covered by your spouse’s employer group health plan and are turning 65, you’ll have two options:

1. Enroll in Medicare Part A only (or both A and B) and review Medicare Advantage and Medicare Supplement Insurance plans to help cover what Medicare doesn’t.

2. Delay Medicare enrollment until you are no longer covered by your spouse’s plan. You will not have to pay any late enrollment penalties because you will have had coverage during that time. You can enroll later during a Special Enrollment Period.

Before choosing one of these options, talk to the Human Resources department of your spouse’s employer to learn how your current insurance works with Medicare. Your decision may be based on cost. If your spouse’s employer does not contribute to the cost of insuring you, switching to a Medicare plan may save you money. When considering costs, be sure to factor in premiums, deductibles and copays.

It’s possible. If your income is limited, Medicare might pay for 75% or more of your drug costs including monthly prescription drug plan premiums, annual deductibles, coinsurance, and copays.

There are also four kinds of Medicare Savings Programs that may help pay Medicare Part A and Part B deductibles, coinsurance, and copays. Explore the benefits and limitations of these Medicare Savings Programs.

To learn if you qualify for Extra Help, Medicare’s low-income subsidy program, call Medicare at 1-800-MEDICARE (1-800-633-4227). Hearing or speech impaired call 1-877-486-2048, 24 hours a day, 7 days a week.

Or call the Social Security Administration at 1-800-772-1213. TTY 1-800-325-0778 8:00 a.m. to 7:00 p.m., Monday – Friday. You can also visit Social Security.

Most people should enroll in Medicare Part A (hospital coverage) during the Initial Enrollment Period. Learn more about the Initial Enrollment Period and other important dates.

If you would like to enroll in a Medicare Advantage plan or Medicare Supplement Insurance Plan from Blue Cross and Blue Shield of Texas, you will still need to enroll in both Parts A and B.

IMPORTANT: If you’re receiving Social Security benefits, you will be automatically enrolled in Medicare Part A at the start of your Initial Enrollment Period.

Some people may delay Medicare Parts A and B past age 65. Much depends on whether you’re still covered by an employer health plan, and how large your employer is. If you are covered by a High Deductible Health Plan and have a Health Savings Account, signing up for either Part A or Part B while still employed may prevent you from adding funds to your HSA, so make that decision carefully. For a detailed answer based on your circumstances, visit Medicare.gov and select the situation that applies to you.

If you haven’t already done so, get your personalized Medicare Timeline. This customized calendar will tell you exactly what to do – and when – as you approach age 65.

If you’re approaching Medicare age, you should talk to your employer or benefit administrator to understand how your health plan will work with Medicare.

Since Medicare Part A is free for most people, you might want to sign up for Part A when you turn 65 and Part B when you retire. However, signing up for either part of Original Medicare keeps you from adding funds to a health savings account, so make that decision carefully.

The size of your employer’s business and its group health plan will affect how Medicare works for you. And it will depend on if you’re turning 65, already 65, or under 65 with a disability.

For more details on these situations, review this section of the official Medicare site.

If you’re no longer covered under your employer’s health insurance plan, you should obtain new insurance. Blue Cross and Blue Shield of Texas may be able to provide you with another plan. We have a special section on our website that can provide the information you need.

If you purchased your Blue Cross and Blue Shield plan through the Health Insurance Marketplace, you can keep it until your Medicare coverage begins. In most cases it’s better for you to sign up for Medicare when you’re first eligible, so you avoid penalties and any increases in the cost of your Marketplace plan. You can find more details about this at Healthcare.gov.

IMPORTANT: Once your Medicare coverage is active, you will need to cancel your Marketplace coverage.

If you’re considering a Medicare Supplement Insurance Plan, here’s some good news. Although you can’t enroll in Medicare until your Initial Enrollment Period, you can enroll in a Blue Medicare Supplement^SM plan up to a year before you want coverage to be effective.