Frequently Asked Questions

Do I Need to Enroll in Medicare When I Am 65?

If you are already enrolled in Social Security benefits (people can enroll in Social Security as early as age 62 or earlier if disabled, although many people wait until their Full Retirement Age (FRA) which is age 66 for people born between 1943 and 1954) they will automatically be enrolled in Medicare A and B at age 65 and can optionally dis-enroll from Medicare Part B but not Medicare Part A.

If you are not yet collecting Social Security benefits (collecting can be delayed until age 70) then they can “manually” enroll in Medicare A and optionally B at age 65.

If you are wroking for a company with:

  • Fewer than 20 employees then they need to find out if the insurance company carrying their coverage requires both A and B (some require just A while others require both A and B.)
  • More than 20 employees then they do not need to enroll in Medicare at all if they don’t want to. Again, if they are enrolled in Social Security benefits and turn age 65 then enrollment will then be automatic.
What is Prescription Prior Authorization?

Prescription “Prior Authorization” is a drug benefit management tool used by Medicare Part D insurance companies that requires the doctor to show the plan that the drug is medically necessary in order for it to be covered by the plan.

How is my Social Security benefit calculated?

Social Security retirement benefits are computed using a worker’s average indexed monthly earnings (“AIME”), which summarizes up to 35 years of a worker’s indexed earnings history. Using earnings for the highest-paying 35 years, these figures are added together and then divided by the number of months in 35 years (35 years X 12 months = 420 months) to arrive at a person’s “AIME.”

If the worker does not have 35 years of income history, the Social Security Administration assigns each missing year an income value of $0. The “AIME” accounts for wages on which FICA taxes have been paid and adds a weighting factor for inflation and cost-of-living increases over those years.

What is the difference between Waiting Period vs Elimination Period in a Long Term Care insurance policy?

The Waiting Period is the time beginning when a contract is issued and ends when the contract owner can begin to receive benefits.

The Elimination Period is the period of time that begins at some point after the Waiting Period is over and when the contract owner incurs a benefit trigger event.

Here’s an example of both a Waiting Period and Elimination Period as they relate to a Long Term Care insurance policy:

If the Long Term Care insurance policy has a Waiting Period of 6 months, then the policy is unusable for 6 months from the date the policy issue date.

If this same Long Term Care insurance policy has an Elimination Period of 90 days, then assuming the policy has passed its 6 month Waiting Period, once a benefit trigger has occurred, benefits will begin after the 90 day Elimination Period has ended.

What are the chances that I will need Long Term Care?

According to industry professionals across the board, large percentages of Americans will need some form of Long Term Care when they are seniors:

  • 70% of seniors are expected to require some form of long term care
  • 40% of seniors are most likely going to require nursing home care

Learn more about Long Term Care insurance …