TUCSON, ARIZONA -  I got a call yesterday from a woman told me she will turn 65 at the end of March and needs to figure out her Medicare coverage. We talked for a few minutes and I remembered to ask her a very important question. “Are you a retired teacher, or state, or county employee?”  Sure enough, she is a retired teacher.

At that point I told her she probably doesn’t need my help.  This is because the Arizona State Retirement System (ASRS) has very good Medicare-related plans. This woman seemed to be leaning towards a Medicare Advantage plan and I told her the ASRS Advantage plan is very, very good. She will pay around $100 per month for the ASRS Advantage plan, but that cost is worth it because the ASRS plan has much lower co-pays than $0 premium Medicare Advantage plans that are available to the general public.

I also told this woman that state retirees get vision and dental coverage, benefits that are not included in Medicare. I instructed her to go to the ASRS office at 7660 E Broadway (just west of Pantano) and talk to a counselor so she completely understands her Medicare choices and supplemental benefits.

Then I asked her if she had received her Medicare card. She said she had not.

Yikes! If her birthday is at the end of March, that means her Medicare begins on March 1st.  I said to her, “You are not collecting Social Security yet, are you?”  She said she is waiting until she turns 66 to collect Social Security so she gets the full amount due her.

Because this woman is not collecting Social Security as she turns 65, she must tell Social Security she wants her Medicare. And because March is only three weeks away, she needs to move quickly. So here’s what I told her to do.

She could enroll in Medicare online, but that might not be the quickest way to do it. I suggested she go to the local Social Security Office (3500 N Campbell Ave, just south of Prince Road). She can go without an appointment and sign up in-person for Medicare.  She should bring a copy of her birth certificate and a picture id. (She could call Social Security to make an appointment, 1-800-772-1213, but the first available appointment date might be two weeks from now.)

After she has signed up for Medicare, she needs to go to the Arizona State Retirement System (ASRS) office at  7660 E Broadway Boulevard to enroll in the ASRS Medicare Advantage plan. But she can’t get enrolled in the ASRS Advantage plan until she is in the Medicare system.

I have spoken with several retired teachers who were not aware of their Arizona State Retirement System benefits. I guess they don’t pay attention to things they receive in the mail because they are sent a detailed book that explains their Medicare-related health insurance options.  Perhaps the front page of the book needs to say, “Read this important information about your retiree health care coverage before your Medicare begins!

This is my week to tell people they don’t need my services.  I talked to three people who have the state Medicare retiree plan because they are retired teachers. They thought they were paying too much for their Medicare Advantage plan (about $100 per month), and they had issues with referrals that come with an HMO.  I went through their evidence of coverage book and concluded that their plan is awesome, and I told them so.

The plan I was looking at is a Medicare Advantage plan, but it’s not like the ones I enroll people in.  Here are just a few of the awesome benefits:  Hospital co-pay: $100 (that’s it!); Part B drugs (like chemotherapy): 0% co-pay; Radiation therapy: 0% co-pay. Part D coverage: no donut hole!!

As an insurance agent I’m not supposed to mention benefits, but I am describing a plan I do not sell. And it is a plan that other insurance agents should not move people out of to put them into a $0 premium Medicare Advantage plan they sell.

Some people don’t need Medicare.

Yesterday I got a call from a man who turns 65 in November. He told me his wife is still working and her employer is a big company, which is a very important factor. This man has his Medicare card and will start paying his Part B premium next month.  I told him to find out how much his wife is paying to have him on her insurance and to find out if the insurance is good coverage. But because her employer is a national, large company, the health insurance is probably pretty good – and he may not need his Medicare.

If a person is covered by employer health insurance after they turn 65, they don’t need to enroll in Medicare Part B and pay the premium. The company must have more than 20 employees. However, people who work for small-to-medium size companies (with over 20 employees) often have lousy and expensive health insurance, so they might be better off using their Medicare.

I told this potential customer to investigate his health insurance, how good it is, and how much it costs. I also told him he could use Medicare as secondary insurance to (possibly) cover deductibles and co-pays. But I had to admit I have not dealt with this, so I referred him to the Medicare.gov website.  I told him he could also call 1-800-MEDICARE to learn more about how Medicare co-ordinates with other health insurance.