You might know Highmark Inc. (and its health insurance subsidiaries and affiliates collectively) as among the ten largest health insurers in the U.S. You might know Highmark as the fourth-largest Blue Cross and Blue Shield-affiliated organization in the country. You might even know that Highmark Inc. and its affiliates serve 5 million members and hundreds of thousands of additional members through the BlueCard® program. But do you know how deep our company’s roots actually go?
The mission of Highmark Inc. is to be the leading health and wellness company in the communities we serve. In carrying out this mission, we strive to preserve the tradition and reputation that we’ve built upon our high ethical standards. In fact, in all we do, we’re adamant that we don’t lose sight of one basic principle of integrity – “We care not just for the end result but also for how it’s obtained.”
For over 75 years, Highmark has provided affordable health insurance plans in our region, and our nation. In fact, the history of the company begins during the Great Depression of the 1930s with the genesis of the Blue Cross and Blue Shield movement. It was during that time that Highmark’s predecessor companies were established to help Pennsylvania residents pay for health care.
To ensure the availability of funds to pay for hospital and medical services, respectively, a hospital association based in Pittsburgh sponsored the formation of an organization later known as Blue Cross of Western PA (now Highmark Blue Cross Blue Shield). The Pennsylvania Medical Society backed the founding of Pennsylvania Blue Shield (now Highmark Blue Shield) and then in 1996, the two Blue plans were consolidated, forming Highmark Inc. Highmark is now one of the largest health insurers in the U.S.
Blue Cross and Blue Shield were unique organizations from the outset — nonprofit corporations structured along traditional business lines. Without shareholders to satisfy, margins were held in reserve, applied to subsidize the cost of coverage for poor health risks, or reinvested in the business.
Leading the way
As independent organizations from the mid-1930s to the mid-1990s, Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield introduced several innovations, including a children’s health insurance program that became the model for the national CHIP program and a dedicated program for seniors that predated Medicare, which helped to ensure access to health care services for the widest possible cross section of the community.
Experience the Highmark Difference
It’s never too soon to learn how Medicare works (especially if you’re helping a parent or friend to sign up for it). But if you’re going to be turning 65 soon or are already there, you’ll want to understand when and how to enroll in order to avoid any penalties or gaps in health care coverage.
There are four main parts of Medicare: Parts A, B, C and D. Parts A and B are also known as Original Medicare. Part C is known as Medicare Advantage, and Medicare Part D consists of prescription coverage.
Signing Up for Medicare at Age 65
You may be automatically signed up for Medicare Part A and Part B if you’re already getting Social Security benefits when you turn 65. If not, you can sign up through the U.S. Social Security Administration anytime during the seven-month period that begins three months before the month of your 65th birthday and ends three months after the month of your 65th birthday.
If you don’t enroll in Original Medicare when you’re first eligible, you can sign up between Jan. 1 and March 31 each year. Regardless of when in that date span you sign up, your coverage will begin July 1.
If you enroll later, you may have to pay a higher Part B premium for not signing up on time. The increased premiums would last as long as you’re on Medicare, so enrolling in Medicare sooner rather than later is best.
If you don’t sign up for Medicare because you’re employed and still covered by your employer’s health plan or covered by your spouse’s plan, you can sign up as soon as you know you’ll be leaving, or during the eight-month period that begins the month after your employment or coverage ends; whichever happens first. You’ll usually be able to avoid a penalty for late enrollment in this case.
If You’re 65 and Still Working, Do You Need Medicare?
Many people, for many reasons, decide to delay retirement beyond the age of 65. If you plan to stay in the workforce, depending on where you work, you’ll need to understand a few things about Medicare.
- If you work for a company with more than 20 employees, you’ll want to enroll in Medicare Part A as soon as you’re eligible three months before your 65th It’s free, and you’ve earned it. You probably don’t want to enroll in Part B until you retire, though, since you’ll have to pay the premiums. But when you do retire, remember that you have only eight months from the day you leave work to enroll in Part B.
- If you work for a company with fewer than 20 employees, consider enrolling in Parts A and B as soon as you’re eligible three months before your 65th birthday; your small company’s insurance plan won’t pay for anything that Medicare will cover after the age of 65. In fact, if you decline to enroll in Part A and/or Part B, and your insurance company discovers you’ve had services that should have been covered by Medicare Part A or Part B, your insurance company will pursue you for a reimbursement of the costs.
- If you get a new job after turning 65, consider whether you should use that as an opportunity to change health plans. If you’re married and your retiree plan from the previous employer covers an under-65 spouse, you might want to keep the plan. You can’t re-enroll in certain retiree plans once you end your coverage. If you’re married, and you lose your new job, your spouse could be without coverage until age 65.
- If you’re self-employed and don’t have a retiree plan, sign up for Medicare Parts A and B as soon as you can. The costs may be tax deductible as a business expense.
- If your current health insurance plan covers prescription drugs and it’s at least as good as what you’d get through Medicare Part D (they call this “creditable coverage”), consider delaying getting Part D coverage until you retire. If your current plan is creditable, you won’t have to pay any penalty when you enroll in a Part D plan within two months of losing your employer coverage.
Whether you plan to retire at 65 or continue to work, be sure to find out all of the Medicare options that are available to you so that you are covered when you need it.