Early retirees, under age 65, can be among the most expensive members to cover under a group health plan. Some of these individuals qualify for Medicare through Social Security Disability Insurance (SSDI), yet remain on their employer plan because they haven’t been made aware of, or guided through, the SSDI and Medicare enrollment process. LaborFirst can help plan sponsors identify pre-65 members who could be eligible for Medicare and support them through the process.
By optimizing the number of pre-65 retirees and their dependents using Medicare as their primary coverage, plan sponsors can significantly reduce healthcare expenses while ensuring members receive the benefits they are entitled to. Medicare Maximization is available through our HealthActive solution, designed for active employees and early retirees. The savings can be substantial: transitioning eligible individuals to Medicare saves plan sponsors an average of $87,500 per person over five years or roughly $17,500 per member, per year.
LaborFirst handles the process from start to finish. Our approach includes:
Discovery
We identify members who may qualify for Medicare through SSDI eligibility, long-term disability (LTD), COBRA, or with certain medical conditions.
Representation
We provide personal outreach and expert representation to guide members through the SSDI application and appeals process, ensuring successful Medicare enrollment.
Implementation
Once members receive SSDI approval, we guide them through the Medicare enrollment process to ensure a smooth transition without gaps in coverage.
Recovery
LaborFirst partners with insurers and TPAs to rebill past claims (up to 12 months) to Medicare, recovering overpaid expenses for plan sponsors.
Using eligibility and claims data, we conduct annual outreach campaigns and offer Health Risk Assessments (HRAs) to screen for potential SSDI eligibility. Members who meet initial criteria receive personalized follow-up, and if they choose to proceed, LaborFirst provides one-on-one support every step of the way, including help with online SSDI applications and coordination of required medical documentation.
LaborFirst’s Medicare Maximization service delivers value on both sides. Plan sponsors can reduce long-term financial liabilities and stabilize future healthcare costs and members become eligible for early SSDI payments, improving financial security, and access to Medicare coverage, reducing out-of-pocket healthcare costs.
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