barnum-medicare

HSA and Medicare: How to Avoid a Costly Contribution Mistake

Wed, 30 Sep 2026 16:00:02 GMT

How Medicare Enrollment Can Create Consequences for Your HSA Contributions

Many Americans spend years building savings in a Health Savings Account (HSA), one of the most tax-advantaged ways to save for health care expenses. HSA funds can be used for many qualified medical expenses, including deductibles, copays, coinsurance, prescription medications and certain medical equipment… even when you are on Medicare. That is why HSAs can be such an important part of your retirement planning.

But when Medicare enters the picture, the rules can lead to unexpected tax consequences.

Where Medicare Can Create a Problem with HSAs

Some people continue working after age 65 and remain covered by an employer-sponsored HSA-eligible high-deductible health plan (HDHP). That's allowed. Simply turning 65 or becoming eligible for Medicare doesn't automatically prevent you from contributing to an HSA. The issue begins when you are actually enrolled in Medicare. Once you're enrolled in Medicare Part A and/or B, you generally can no longer contribute to an HSA.

The confusion is that Medicare enrollment doesn't always happen when people expect it to.

One way this can happen is through Social Security benefits. If you're already receiving Social Security benefits when you become eligible for Medicare, you're generally automatically enrolled in Medicare Part A and Part B. While Part B can generally be declined, premium-free Part A usually takes effect automatically. Once Part A coverage begins, you're no longer eligible to contribute to an HSA, even if you're still working and covered by your employer's HSA-eligible health plan.

That means someone could continue making HSA contributions through payroll, or continue receiving employer contributions, without realizing that Medicare coverage has kicked in and made them ineligible to make those contributions.

A second issue can arise when someone delays Medicare while continuing to work and contribute to an HSA. When that person later applies for premium-free Medicare Part A after age 65, their Part A coverage can generally be retroactive for up to six months, but not earlier than the month they first became eligible for Medicare.

This creates a potential HSA problem because a person can't make HSA contributions for months in which they're covered by Medicare. If Part A is applied retroactively, HSA contributions made for those retroactively covered months may become excess contributions, even though the person wasn't aware at the time that Medicare coverage would later reach back to those months.

For example, someone who works past 65, keeps an HSA-eligible employer plan and delays Medicare might continue contributing to an HSA. If they later enroll in Medicare and receive six months of retroactive Part A coverage, some of those recent HSA contributions may no longer be allowable.

That's why it's important for people who work past 65 to coordinate the timing of Medicare enrollment, Social Security benefits, and HSA contributions.

The Potential Tax Consequences

The IRS generally imposes a 6% excise tax on these “excess” HSA contributions that aren't corrected as permitted under IRS rules. The tax can apply for each tax year the excess remains in the account.

In some cases, an individual may be able to avoid the 6% excise tax by withdrawing the excess contribution, along with any earnings attributable to it, by the applicable tax-return deadline and properly reporting the correction.

Because the tax treatment depends on the circumstances and timing, anyone who discovers a possible excess contribution should consider contacting the HSA custodian and a qualified tax professional.

How to Avoid HSA Contribution Problems

If you're approaching Medicare eligibility, planning to enroll in Medicare, or applying for Social Security benefits after age 65, review your HSA contribution strategy ahead of time. The correct time to stop contributing isn't the same for everyone.

For example, if you enroll in Medicare during your Initial Enrollment Period, you generally need to make your last HSA contribution for the month before your Medicare Part A coverage begins. Special rules can apply if your birthday is on the first day of a month.

If you delay Medicare and later enroll in premium-free Part A, Medicare recommends accounting for the possibility that Part A coverage will be retroactive. If you enroll six or more months after turning 65, that generally means stopping HSA contributions six months before the month you apply for Medicare or Social Security benefits.

Because enrollment dates and individual circumstances can vary, confirm the effective date of your Medicare coverage before determining your final HSA contribution.

Your HSA Can Still Be Valuable After Medicare

Enrolling in Medicare means you can no longer make HSA contributions, but it doesn't mean you can't use the money already in your account. You can continue pulling from your HSA after enrolling in Medicare, and withdrawals for qualified medical expenses can generally remain tax-free. HSA funds can therefore continue to be a valuable resource for health care expenses throughout retirement.

The key is planning ahead. Understanding when Medicare coverage begins, and when HSA contributions must stop, can help you preserve the tax advantages you've worked to build.

Medicare Scam Calls and Fake Agents Are Getting Harder to Spot

Wed, 16 Sep 2026 16:00:05 GMT

Who's Really on the Other End of That Medicare Call?

The phone rings. The voice on the other end says your name, your age, and your address. It sounds official. It may even sound friendly. And within a minute, you are being asked to confirm your Medicare number. What do you do?

Complaints about Medicare-related scam calls have climbed sharply over the past year. Reports to the Better Business Bureau indicate that these kinds of calls remain a major concern for people Medicare. Some have even described getting dozens of these calls in a single day. Enrollment season tends to make it worse, because legitimate outreach picks up at the same time criminals do.

Here is how these calls tend to sound, and how to protect yourself.

The Three Pitches You Are Most Likely to Hear

Many Medicare scam calls follow similar scripts. Once you recognize a few key patterns, the calls lose a lot of their power.

"You qualify for extra benefits"

A recorded voice says it is reaching out to make sure you receive unclaimed Medicare benefits. The recording asks whether you have Part A and Part B, then transfers you to a live person. The real goal is either to get your personal information or to switch you to a plan you did not ask for.

"Your card is expiring"

The caller warns that your Medicare card is about to expire, or that your coverage could be interrupted unless you verify a few details. Fear and urgency are the strategy here. If you hand over your Medicare number or Social Security number, criminals can use it to steal your identity or bill you for services you never received.

"Something free is on the way"

Free braces. Free hearing aids. Free gift cards or a free smartphone. The offered gift is bait. One woman in Texas received a large box of orthopedic braces she never ordered, and later learned Medicare had been billed more than $700 for them. Her secondary insurer was charged as well, and additional claims were filed for supplies she never requested.

Fraudulent claims can also leave inaccurate information in your medical records, including diagnoses for conditions you do not have.

Fake Agents Are Part of the Problem

Not every scammer sounds like a robot. Some present themselves as licensed insurance agents. They may reference a well-known carrier, quote a plan name, or offer to walk you through your options right now over the phone.

A few things a real agent will not do:

Pressure you to decide something during a first call
Refuse to give you a full name, license number, or office phone number
Ask you to pay by gift card, wire transfer, or a payment app
Tell you that you must act today or lose your coverage
Show up at your door uninvited to sell you a plan

Verifying an agent is simpler than most people expect. Ask for their name and license number, then hang up and call the agency's main office number yourself. You can also check the license with your state Department of Insurance. Anyone who is legitimate will not mind you doing this; they know you need to be careful.

Habits That Keep You Safe

Treat unexpected Medicare calls with skepticism, even friendly ones
Never give your Medicare number, Social Security number, or bank details to someone who called you
Remember that Medicare generally reaches out by mail first and does not call to ask for your Medicare number or banking information
Hang up on anyone who pressures you or claims your coverage is at risk
Read your Medicare Summary Notices and Explanation of Benefits statements and look for charges you do not recognize
Report anything unfamiliar right away

Hanging up may feel rude, but it is the single most effective thing you can do.

If You Think You Already Shared Something You Shouldn't Have

Act quickly, but do not panic. Write down what you shared and when. Review your recent statements. Then report it. You can contact the Senior Medicare Patrol program in your state, call 1-800-MEDICARE, or file a report with the Federal Trade Commission at ReportFraud.ftc.gov.

The Easiest Defense Is a Person You Already Know

Scam calls work because they catch people on their own and unsure. Having a licensed agent you already trust means you have someone in your corner. You have a number you can call to ask whether an offer is real before you respond to it. If you have questions about a call you received, or you want a second set of eyes on your current coverage, reach out to our office. We are here to help you!

What Medicare Really Covers for GLP-1 Drugs in 2026

Wed, 02 Sep 2026 16:00:03 GMT

A Plain-English Guide to the New $50 Copay Program and How to Get Started

For years, Medicare generally has not covered medications when they are prescribed solely for weight loss. Federal law currently excludes drugs used for weight loss from the standard Part D benefit. However, a new, limited exception to the rule became available on July 1, 2026.

Through a temporary program called the Medicare GLP-1 Bridge program, certain people with Medicare drug coverage may now be able to get select GLP-1 medications intended for weight management for a $50 copay per one-month supply. The Bridge program does not eliminate the underlying Part D exclusion for weight-loss drugs. Instead, it provides a separate, temporary pathway for eligible Medicare beneficiaries.

Read on to learn what the program covers, who could qualify, and how the process works.

Medicare Part D’s Existing GLP-1 Coverage

Before looking at the new Bridge program, it helps to understand GLP-1 coverage up to this point.

Medicare Part D can cover certain GLP-1 medications when they are prescribed for a medically accepted condition other than weight loss. Depending on the particular drug, those conditions may include:

Type 2 diabetes
Certain cardiovascular risks
Moderate-to-severe obstructive sleep apnea
Certain cases of metabolic dysfunction-associated steatohepatitis (MASH), a serious form of fatty liver disease

If your doctor prescribes a GLP-1 for one of these approved conditions, or something other than weight loss, your Medicare Part D plan may cover it. Which specific drugs are covered and what requirements apply depend on your particular plan.

The New Medicare GLP-1 Bridge Program

The Medicare GLP-1 Bridge program is a temporary program scheduled to run from July 1, 2026, through December 31, 2027. It gives eligible people with Medicare drug coverage access to certain GLP-1 medications for the purpose of weight management for a flat $50 copay per one-month supply. The program is available nationwide, including in U.S. territories.

One important note is that the Bridge program operates outside the regular Part D benefit. Medicare pays participating pharmacies through a central processor rather than having your Part D plan pay for the medication. This means your Part D plan does not have to opt into the Bridge program for you to participate.

Which Drugs Are Covered as of August 2026?

As of August 2026, the Medicare GLP-1 Bridge includes these medications when prescribed to reduce excess body weight and maintain weight reduction:

Foundayo — tablet
Wegovy — injection or tablet
Zepbound — KwikPen only (not single-dose vials or pens)

Because the Bridge program is evolving, Medicare may update covered products over the duration of the program.

What About Ozempic and Mounjaro?

The names of these medications are familiar to many people, so you may wonder if they're covered. The answer is no: Ozempic and Mounjaro are not covered through the Medicare GLP-1 Bridge program. Instead, they remain subject to regular Medicare Part D coverage rules and are most often prescribed to treat type 2 diabetes. Wegovy and Zepbound, on the other hand, are versions approved specifically for chronic weight management.

So, if you take a GLP-1 medication for a condition that can be covered under Part D, continue working with your health care provider and Medicare drug plan or Medicare Advantage plan regarding coverage. If, however, you are seeking a pathway to weight management, then the Bridge program may be worth pursuing. The first step is to find out if you're eligible.

Who Qualifies for the GLP-1 Bridge?

To participate, you must be 18 or older, have Medicare drug coverage, and meet one of Medicare's clinical eligibility standards when starting treatment.

You may qualify if you have:

A body mass index (BMI) of 35 or higher
A BMI of 30 or higher plus heart failure with preserved ejection fraction, uncontrolled high blood pressure, or chronic kidney disease at stage 3a or higher
A BMI of 27 or higher plus prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease

You may also qualify for coverage of a GLP-1 drug if you started taking a GLP-1 drug prior to the start of the Bridge program and you met the eligibility conditions when you started taking the drug, even though you may not qualify now. For example, if you started taking a GLP-1 drug in January 2025 and at that time your BMI was 35, you may qualify for the Bridge program even if your current BMI is 25.

Medicare has additional clinical definitions and requirements for these conditions. Your health care provider will determine whether you meet the program's criteria.

You generally aren't eligible for the Bridge program if you already get GLP-1 drugs through your Part D coverage or if you have certain conditions for which GLP-1 treatment may be covered through regular Part D rules, including:

Type 2 diabetes
Moderate-to-severe obstructive sleep apnea
Certain fatty liver disease

Having one of these conditions may make you ineligible for the Bridge program even if your particular Medicare drug plan doesn't currently cover the medication. In that situation, regular Part D coverage and exception rules may apply.

You must also have qualifying Medicare drug coverage. That can include:

A standalone Medicare Part D plan
A Medicare Advantage plan with drug coverage
A Special Needs Plan with drug coverage
Certain employer or union Medicare drug plans
The LI NET program

How Do You Get Started?

The process starts with your health care provider rather than your Medicare drug plan.

Talk with your health care provider. Ask whether one of the covered medications is medically appropriate for you and whether you meet Medicare's BMI and health-condition requirements.
If they agree, your provider will send a prescription to your pharmacy. The medication must be prescribed as part of a treatment plan that includes diet and physical activity.
The first fill may take extra time. The pharmacy's initial claim may trigger a prior-authorization request to your provider. Once the required prior authorization is submitted, CMS says an approval or denial will generally be communicated within 72 hours.
Watch for a letter from Medicare. If your prior authorization is approved, Medicare will send you a letter confirming coverage through the Bridge program.
Be prepared to provide your Medicare information at the pharmacy. Your pharmacy may need your Medicare Number or, in some circumstances, the last four digits of your Social Security Number to process the claim.

Once approved, the prior authorization generally remains valid through December 31, 2027, including for refills and dose changes. A new authorization may be required if you change to a different GLP-1 medication covered by the Bridge.

How Does the $50 Copay Work?

The $50 copay works differently from what you normally pay for medications covered by your Part D plan because Bridge program medications are paid for outside your regular Part D benefit.

For medications you receive through the Bridge program:

You pay a flat $50 copay for a one-month supply
The $50 does not count toward your Part D deductible or annual out-of-pocket limit
It will not appear on your Part D Explanation of Benefits or your Medicare Summary Notice
Extra Help does not reduce the $50 copay
The Medicare Prescription Payment Plan cannot be used to spread the $50 cost across monthly payments

Those differences are especially important to understand if you receive Extra Help or are tracking your prescription drug spending toward your Part D out-of-pocket limit.

Your Next Step

If you think you might qualify for the Medicare GLP-1 Bridge, start by talking with your health care provider. Your provider can help determine whether one of the covered medications is appropriate for you and whether you meet Medicare's eligibility requirements.

The GLP-1 Bridge is currently scheduled to end December 31, 2027, so it's also worth discussing how your treatment and coverage options could change after the program period ends.

If you have questions about your current Medicare drug coverage, we're happy to help you understand how your plan works and where the GLP-1 Bridge program may fit in.

This article is accurate as of August 2026. The GLP-1 Bridge program keeps evolving, so it is good to keep an eye out for ongoing updates.

It's Time to Prepare for Medicare Annual Enrollment

Tue, 01 Sep 2026 16:58:42 GMT

Plan Ahead for the Best Results

As we head into fall, it's time to think about an important Medicare milestone: the Annual Enrollment Period. If you're on Medicare, this is your chance to review your coverage and make changes if your needs have shifted, or if there will be changes to your current plan that you don’t like.

Key Dates for Annual Enrollment in 2026

October 1, 2026: Plan details for 2027 go live. You can start comparing Medicare Advantage (Part C) and prescription drug (Part D) options in your area, though you can't make changes yet.

October 15 – December 7, 2026: Enrollment is officially open. This is when you can:

Join a Medicare Advantage or Part D plan
Switch to a different plan
Drop coverage or switch back to Original Medicare

January 1, 2027: Any changes you made take effect. Make sure you review your new plan documents so you understand your coverage and costs.

What About Medigap?

If you have a Medicare Supplement (Medigap) plan, it works differently. The rules for joining or switching a Medigap plan are more complicated than those for Medicare Advantage and Part D plans. Reach out to us to discuss your options.

How to Get Ready Now

Between now and October, set aside some time to prepare.

Gather recent medical bills and receipts
Make or update your complete list of current medications and doses
List the doctors and hospitals you have used most over the past year
Check your current plan's summary of coverage
Watch for your Annual Notice of Changes (ANOC) from your health insurance company (usually arrives in late September)—this tells you what's changing in your coverage, costs, provider and pharmacy network, and benefits for 2027
Schedule a review session with our team starting October 1—slots fill up fast

The more organized you are, the easier it will be to make confident choices.

Let's Plan Ahead

Whether you want to stick with what you have or explore new options, we can help you understand your current plan, see what else is available, and make sure your doctors and prescriptions and other benefits are covered. Schedule now to meet with us starting October 1st.

If you have questions now about the process and what to expect, reach out anytime. We're here to help make the process as straightforward and successful as possible.

Have you heard of the Donut Hole?

Thu, 11 Sep 2025 17:04:06 GMT

Many times, people have heard of "the donut hole" when it comes to Medicare; but what is it?

Turning 65, Now what

Thu, 04 Sep 2025 17:50:30 GMT

What People Approaching 65 Need to Know.

If you are one of the 10,000 people per day that are Medicare eligible there are decisions you must make. Take a look to see where you should start.

Which bucket do you fall in?

Have questions about your specific situation, call us, we can help 203.513.6263