Is it possible to enroll in Part A, decline Part B and enroll in Part D?
DH will also be enrolled in my employer's coverage. (That will avoid future Part B late enrollment penalties)
Reason for asking this:
Part A cost will be zero, also our zip code has $0 Part D plan through Wellcare - which it seems may provide opportunities to lower our out of pocket drug costs compared to employer coverage.
Answer seems to be:
To join Part D plan, an individual must:
Have Medicare Part A (Hospital Insurance) or Part B (Medical Insurance).
Live in the service area of the plan you want to join.
Be a U.S. citizen or lawfully present in the U.S.
Complete an enrollment request during a valid election period.
Part D IEP for working individual
Mr. Hackerman’s 65th birthday was on March 23, 2020. He is currently working, and while he signed up for Medicare Part A benefits effective March 1, 2020, he declined enrollment in Part B, given his working status. He is eligible for Part D since he has Part A and lives in the Part D plan service area. Even though he did not enroll in Part B, his Part B IEP is still the three months before, the month of, and the three months following, his 65th birthday—that is, December 1, 2019, to June 30, 2020. His IEP for Part D is also December 1, 2019, to June 30, 2020
Your documentation seems to support that is possible from the Medicare side of things. The other consideration is your employer plan requirements. Some employer plans require Medicare eligible beneficiaries to enroll in Medicare. In that case, the employer plan may be structured such that Medicare is the primary payer (pays first), and the employer plan is secondary (pays what Medicare does not cover).
Ret2018 wrote: Sat Jan 11, 2025 8:31 am
Your documentation seems to support that is possible from the Medicare side of things. The other consideration is your employer plan requirements. Some employer plans require Medicare eligible beneficiaries to enroll in Medicare. In that case, the employer plan may be structured such that Medicare is the primary payer (pays first), and the employer plan is secondary (pays what Medicare does not cover).
You are absolutely correct! Thank you for bringing this up.
I work for a small employer we range between 18-22 employees.
The threshold is 20 employees - I do not understand how they are counted, especially if some are part time or choose to not enroll in employer insurance because they are enrolled in their spouse's insurance.
This document details how it is counted. It doesn't matter if they are enrolled in employer group health plan. There are a lot of details in how "the number of employees" is calculated based on weeks employed and hours employed. This becomes critical for small employer like mine.
Yes, you can be enrolled in Part D even if you only have Part A coverage. I'm living proof since I'm now undergoing the process of disenrolling from Part D after a EGWP Medicare Sponsor placed me into Part D -- my saga is mentioned here. viewtopic.php?p=8198151#p8198151
But be aware that if you enroll in Part D long after you were enrolled in Part A, you can face a Late Enrollment Penalty, unless you had creditable insurance drug coverage from the date you were enrolled in Part A to your enrollment in Part D.
kd2008 wrote: Fri Jan 10, 2025 4:47 pm
Is it possible to enroll in Part A, decline Part B and enroll in Part D?
DH will also be enrolled in my employer's coverage. (That will avoid future Part B late enrollment penalties)
Reason for asking this:
Part A cost will be zero, also our zip code has $0 Part D plan through Wellcare - which it seems may provide opportunities to lower our out of pocket drug costs compared to employer coverage.
Answer seems to be:
To join Part D plan, an individual must:
Have Medicare Part A (Hospital Insurance) or Part B (Medical Insurance).
Live in the service area of the plan you want to join.
Be a U.S. citizen or lawfully present in the U.S.
Complete an enrollment request during a valid election period.
Part D IEP for working individual
Mr. Hackerman’s 65th birthday was on March 23, 2020. He is currently working, and while he signed up for Medicare Part A benefits effective March 1, 2020, he declined enrollment in Part B, given his working status. He is eligible for Part D since he has Part A and lives in the Part D plan service area. Even though he did not enroll in Part B, his Part B IEP is still the three months before, the month of, and the three months following, his 65th birthday—that is, December 1, 2019, to June 30, 2020. His IEP for Part D is also December 1, 2019, to June 30, 2020
I have the Well Care zero premium part D and my experience, limited to my medications, is that Good RX pricing for my co-pays almost always beats the co pays that I would owe under my part D plan and Costco pharmacy pricing for members is often lower than Good RX. Another anomaly to be aware of is that GoodRX pricing can vary widely from pharmacy to pharmacy.
kd2008 wrote: Fri Jan 10, 2025 4:47 pm
Is it possible to enroll in Part A, decline Part B and enroll in Part D?
DH will also be enrolled in my employer's coverage. (That will avoid future Part B late enrollment penalties)
Reason for asking this:
Part A cost will be zero, also our zip code has $0 Part D plan through Wellcare - which it seems may provide opportunities to lower our out of pocket drug costs compared to employer coverage.
I have the Well Care zero premium part D and my experience, limited to my medications, is that Good RX pricing for my co-pays almost always beats the co pays that I would owe under my part D plan and Costco pharmacy pricing for members is often lower than Good RX. Another anomaly to be aware of is that GoodRX pricing can vary widely from pharmacy to pharmacy.
GOOD LUCK as you begin your adventure !!!
Appreciate you sharing your experience. Definitely helpful. We have priced all his medications on the Medicare website.
It came to $60/yr with Wellcare plan. How accurate did you find the pricing tool of Medicare website?
Currently, we get it through Amazon Rx pass that costs $60/yr. Added benefit is that any additional prescriptions of generics will not increase our cost if Amazon Rx carries it.
Part D would be useful if any high dollar prescription is needed as the max out of pocket is $2000.
Always to good to have options than not, especially for containing health care costs.
kd2008 wrote: Sat Jan 11, 2025 12:49 pm
How accurate did you find the pricing tool of Medicare website?
I have had the same Wellcare plan for 7 years, it has been OK and I am in very few meds so I have not looked at alternatives on the Medicare site for a few years now. ... Inertia is a powerful force.
