2. Medicare traps and limitations
(Whether or not receiving benefits from HP
Advice and reference info from
(Updated Apr 24,
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Dependent coverage coordination.
Unlike group plans for employees and retirees, which cover
dependents, a Medicare plan covers one individual. There is no
family coverage under Medicare. This complicates the transition
from a group employee or retiree plan to Medicare since you and
your spouse/partner probably don't have the same age and
Coordinating with dependent coverage
There are limitations and traps
related to pre-existing conditions, and when changing
between employer-provided, retiree, Advantage, and Supplemental
There are several
expensive traps in Medicare -- one of which could cost you for
- Lifetime costs for missing deadlines.
- Premium depends on the last tax return available to Medicare,
which may be a lot higher than your actual income.
- In-network vs. out-of-network.
- Physically in a hospital but not technically "admitted" -- a
potentially very expensive trap.
- The deductible, coinsurance, and drug coverage differences
between the various alternatives.
For background and
discussion of these traps, watch HPAA's 2014
Key pages on the official
Medicare website covering limitations and traps:
- Supplemental (Medigap) plans:
"Choosing a Medigap Policy" Especially note the section on
Guaranteed Issue -- pages 21-24.
"8 things to know about Medigap policies"
"Guaranteed issue rights. Rights you have in certain situations
when insurance companies are required by law to sell or offer
you a Medigap policy even if you have health problems (called
- Advantage plans:
"13 things to know about Medicare Advantage Plans"
- Changing plans:
"Medigap [Supplemental] & Medicare Advantage Plans"
- Comparing open-market plans:
You can compare quality and performance of Medicare plans on the
official Medicare website:
If you have found an especially
helpful page on the official Medicare site, please pass the
word via an email to
3. Compare plans