CDIS Blog
Still Working After 65? Here’s What to Know About Delaying Medicare
If you or your spouse have job-based insurance, you might delay Medicare — but it’s not without risk.
If you’re still working at 65 with employer insurance, you may not need Medicare right away. But delaying Medicare enrollment incorrectly can cause costly penalties or gaps.
When You Can Delay
You can delay enrolling in Medicare Part B (and sometimes Part A) if:
• You (or your spouse) are still working.
• You have active, creditable employer coverage.
• Your employer has 20+ employees.
This lets you keep employer insurance, skip Part B’s monthly premium, and sign up during an 8-month Special Enrollment Period (SEP) later. You might even enroll in Part A (often free) unless you have an HSA.
When You Shouldn’t Delay
• No job-based insurance — COBRA, retiree, and Marketplace plans don’t count.
• Employers with under 20 employees.
• If you rely on VA coverage, Medicare suggests still enrolling in Parts A & B.
If you delay Part B without proper coverage, you’ll face a 10% lifetime penalty for each year you wait. That’s why it’s critical to understand the rules if you plan to delay Part B enrollment while working, so you can avoid costly Medicare delayed enrollment penalties down the line.
HSA Users, Be Careful
Enrolling in any part of Medicare stops your ability to contribute to an HSA. If you want to keep contributing, don’t sign up for even free Part A. Stop contributions at least 6 months before enrolling to avoid IRS issues.
What to Do Next
1. Ask HR if your plan counts as creditable.
2. Get written proof.
3. Plan ahead for SEP.
4. Don’t assume you’ll be auto-enrolled — take action.
We’re Here to Help
Call us today at 1-855-890-2583 to talk with an Education Specialist about delaying Medicare Part B or to learn how to delay Medicare while working without penalties.
CDIS Blog
What Does a Dual-Eligible Special Needs Plan (D-SNP) Cover?
If you qualify for Medicare and Medicaid, a dual eligible special needs plan may offer the extra support and savings you need.
What is a D-SNP?
A D-SNP is a type of Medicare Advantage plan created specifically for people who have both Medicare and Medicaid. These plans coordinate your care, provide enhanced support, and tailor benefits for those who often face greater health or financial challenges.
Because D-SNPs bring both programs together under one umbrella, they’re sometimes called dual advantage plans or dual special needs plans. The goal is to make managing your healthcare simpler and more affordable.
What D-SNPs Typically Cover
• Full Medicare benefits (Parts A & B): Hospital stays, doctor visits, preventive services, skilled nursing, lab work, and durable medical equipment — just like other Medicare Advantage plans.
• Prescription drug coverage (Part D): D-SNPs include built-in Part D, often with no or minimal copays depending on your Medicaid level. Many also offer a broader drug list than standard Part D plans.
• Medicaid benefits (state-based): May include long-term care, personal support, transportation to medical visits, and home or community services — based on your state’s Medicaid rules.
• Routine extras: Many plans add dental cleanings, vision exams, hearing aids, and over-the-counter (OTC) allowances for items such as vitamins or pain relievers.
Care Coordination Makes a Difference
Many D-SNPs include a dedicated care coordinator or case manager who can reduce hospital stays and eliminate confusion. They can help explain how to use your benefits, schedule doctor visits and follow-ups, manage chronic conditions, and connect your Medicare and Medicaid services so nothing gets missed.
Why D-SNPs Matter
Navigating two government programs can be overwhelming. A D-SNP brings them together under one card and one team, simplifying life. If you’re eligible, you could enjoy stronger coverage, lower costs, and more confidence in your care.
We’re Here to Help
Call 1-855-890-2583 to connect with an Education Specialist about available D-SNPs in your area and find the right plan for your needs.
CDIS Blog
Understanding Medicare Enrollment Penalties
Medicare has a few important enrollment periods. Miss one, and you might pay more every month for life. The good news? You can avoid these Medicare enrollment penalties if you know how the rules work.
Medicare Part B Late Enrollment Penalty
What is it? If you don’t enroll in Medicare Part B (medical insurance) when you’re first eligible and don’t have other creditable coverage, you’ll face a monthly penalty. This is one of the most common reasons people end up paying more.
How much is it? 10% of the standard Part B premium for each full 12-month period you went without coverage. This penalty lasts for life.
• Example: Delay Part B by 2 years → 20% added to your premium permanently. That’s a serious penalty for not signing up at age 65.
• How to avoid it: Enroll during your Initial Enrollment Period (IEP) — a 7-month window around your 65th birthday. Or delay safely if you have active job-based coverage. Once that ends, you get an 8-month Special Enrollment Period (SEP) to avoid a penalty for signing up late.
Medicare Part D Late Enrollment Penalty
What is it? If you go more than 63 days without creditable drug coverage after you’re first eligible, you’ll pay a Medicare drug plan penalty when you finally sign up.
How much is it? 1% of the national base premium (about $34.70 in 2024), multiplied by the number of months you went without coverage. This penalty is added to your monthly premium — for life.
• Example: 10 months without drug coverage → 10% of $34.70 = $3.47/month, permanently.
• How to avoid it: Sign up for Part D during your IEP or keep other creditable drug coverage (like VA, Tricare, or employer plans). If you lose that coverage, you usually have 63 days to avoid the penalty.
Why This Matters
Penalties may seem small monthly but add up over time — and they last as long as you have Medicare. The key to avoiding them is simply knowing your deadlines so you don’t pay more than necessary for your coverage.
We’re Here to Help
Call 1-855-890-2583 to talk with an Education Specialist about avoiding Medicare enrollment penalties.
CDIS Blog
Original Medicare: What’s Covered and What Isn’t
Understanding the limits of Medicare can help you avoid costly surprises down the line.
Original Medicare consists of Part A (hospital insurance) and Part B (medical insurance). It’s the foundation of most people’s health coverage after 65 — often called Traditional Medicare — but it doesn’t pay for everything. Knowing what Medicare Part A covers, what Original Medicare covers, and what Traditional Medicare is helps you plan ahead and decide if you need additional protection, like a Medigap policy or a Medicare Advantage (MA) plan.
What Medicare DOES Cover
• Part A: Covers inpatient hospital stays, skilled nursing care after a qualifying hospital stay, hospice, and some home health care. Most people don’t pay a premium if they’ve paid Medicare taxes for 10+ years. This is the core of the question, “what does Medicare Part A cover?”
• Part B: Includes doctor visits, preventive services (like flu shots and mammograms), lab work, X-rays, durable medical equipment, mental health, and some home health. You’ll pay a monthly premium for Part B.
• Optional Part D prescription drug plan: Covers many generic and brand-name drugs, depending on the plan’s formulary. Purchased separately through a private insurer.
• Medicare Advantage (Part C, private alternative): These plans must cover everything in Parts A and B, often adding extras like vision, hearing, dental, and drug coverage. Networks and costs vary.
What Medicare DOESN’T Cover
• Long-term care: Custodial stays in a nursing home or assisted living aren’t covered. It’s one of the most common and expensive gaps in Original Medicare coverage.
• Most dental, vision, and hearing: Routine check-ups, glasses, and hearing aids aren’t covered unless tied to a medical procedure.
• Prescriptions (under Original Medicare): You’ll need a separate Part D plan or MA plan for drug coverage.
• Routine foot care and cosmetic procedures: Except when medically necessary, like diabetes-related foot exams.
• Overseas care: Medicare usually doesn’t pay for care outside the U.S., except in rare emergencies.
Why This Matters
If you’re asking, “What is Original Medicare?” or “What is Traditional Medicare?” Well, Traditional Medicare benefits offer a solid base, but major costs can still fall to you. If you rely on daily prescriptions, travel abroad, or want dental and vision included, it’s wise to explore add-ons. It also pays to learn how to sign up for Medicare Part A and B or how to apply for Medicare Part A only, depending on your needs and timing.
CDIS Blog
When Can You Change Your Medicare Supplement Plan?
Apply to switch Medigap coverage any time — but timing affects your options.
You can technically apply to switch at any point. However, changing your Medicare Supplement plan might involve more scrutiny. Insurers could deny coverage based on your health history, charge higher premiums for pre-existing conditions, or impose waiting periods.
When You Have Guaranteed Issue Rights
There are special cases — usually within 63 days — when insurers must accept your application:
• You’re in your Medigap Open Enrollment Period (first 6 months of Part B at 65).
• Your Medicare Advantage plan is ending, leaving your area, or you’re moving back to Original Medicare.
• You’ve lost other coverage, like a retiree or employer plan.
• Your Medigap company misled you or went bankrupt.
Steps To Safely Switch Plans
1. Apply for the new plan first — don’t cancel your current one until approved.
2. Wait for confirmation, then set your start date.
3. Cancel your old plan in writing to avoid double bills.
When To Consider Switching
• You want lower premiums.
• You’re paying for extras you don’t use.
• You moved to a state with different plan costs.
• Your health or finances have changed.
Why It Matters
Whether you’re wondering “how do I change my Medicare Supplement plan?,” “can you change your Medicare Supplement plan?,” or “can you switch Medicare Supplement plans easily?,” the answer is yes — but with caution. Approval isn’t guaranteed unless you’re in a protected switch.
