Northeast Wisconsin
  • Northeast Wisconsin
  • May 2018
Written by 

The birthday gift of health insurance

We all look forward to birthdays, especially when we are younger. You never forget starting school at age five, getting a driver’s license at 16, and voting for the first time after your 18th birthday. Each birthday brings new opportunities to learn, grow and take charge of our lives as we prepare for our future.

Birthdays at ages 26 and 65, or an early retirement age, can have a big impact on our health insurance.

Up to age 26, dependents may stay on their parents’ health insurance plan. You can be married and living on your own, but remain on your parents’ plan. Once your 26th birthdate month comes along, you have a special enrollment period (SEP) to get your own health insurance.

When making that transition, you should get expert help to learn about monthly premiums, provider networks, drug formularies, health savings accounts, direct primary care and out-of-pocket expenses.

Buying health insurance is another example of how we can take charge of our lives for good health, protection against risk and saving money.

The next big birthday for health insurance is becoming eligible for Medicare at age 65.

The 1st of the month of your 65th birthday is the day you can or must transition to Medicare. The decision to enroll into Medicare can be different for everyone.

If you are working and have a qualified employer group health insurance plan, you do not need to enroll into Medicare, but once you stop working you have to take Medicare Part A and B or face a penalty. There are several exceptions to this, so you should work with an expert to make sure you get enrolled at the right time and avoid potential penalties.

Early retirees can really be any age, but are more likely starting at age 59½ when you can draw retirement funds without penalty, or age 62 when you can first apply for Social Security benefits. Whatever your age before 65, your household income may impact your health insurance premium due to tax credits.

Early retirees with incomes below $47,000 for an individual, and $64,000 for a couple, receive advanced premium tax credits that lower the monthly premium. Strategies to stay below these income levels can be successful, but take some advanced planning and consultation with your insurance broker and accountant.

Getting help with insurance gives you peace of mind, and allows you to truly enjoy your 26th, 65th and all the birthdays in between.

John Ulness

John Ulness is co-owner of Ulness Health Insurance & Wellness in Appleton. He helps people in Wisconsin understand their health insurance options to control costs and enroll. He can be reached at 1-800-386-0876 or [email protected]

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