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How To Apply For Medicare In Nc

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Original Medicare For North Carolina Beneficiaries

Medicare 101

Original Medicare is the federal health program run by the Centers for Medicare & Medicaid Services , and it is available in North Carolina and nationwide. Original Medicare consists of Medicare Part A and Medicare Part B . In North Carolina as elsewhere, youâre usually eligible for Medicare if:

  • Youâre 65 or older, and
  • Youâre a US citizen or a legal permanent resident of at least five continuous years, or
  • You receive disability benefits, or have amyotrophic lateral sclerosis .

If you have end-stage renal disease , you might qualify for Medicare before you turn 65, but you need to enroll with the Social Security Administration â youâre not likely to be enrolled automatically when you become eligible.

For an overview of Medicare, see our âWhat is Medicare?â video.

How To Enroll In A Medicare Part D Plan

  • Enroll in either Part A or Part B first.
  • Find insurance providers that sell Part D plans in your area.
  • Learn more about the plans available in your area by exploring them online or calling the provider directly.
  • Find the plan that has the health care benefits you want and enroll with the plan providervia phone, online or with an agent.
  • North Carolina Department Of Insurance

    The North Carolina Department of Insurance is responsible for regulating the states health insurance industry and ensuring consumers get fair coverage. The Department supports the Seniors Health Insurance Information Program , which provides free health insurance counseling to seniors, and Senior Medicare Patrol , which helps seniors avoid, detect and report Medicare fraud.

    Contact information: Website | 408-1212

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    Open Enrollment For Medicare Members

    All Medicare members currently enrolled in the Base PPO Plan administered by Blue Cross NC will be automatically enrolled into the Humana® Group Medicare Advantage Base Plan * effective January 1, 2023. If you want to change plans or need to make changes regarding your dependents, you will need to take action during Open Enrollment, which will be held

    All members currently enrolled in the Humana Medicare Advantage Plan * will REMAIN on that plan for 2023. If you want to change plans or need to make changes regarding your dependents, you will need to take action during Open Enrollment. If you are covering non-Medicare dependents on the Enhanced PPO Plan you will be required to take action during Open Enrollment to re-elect that dependent coverage.

    If you have non-Medicare Primary dependents on your plan, they have different options: the Enhanced PPO Plan and the Base PPO Plan . If they are currently enrolled in the Enhanced PPO Plan , they will be moved to the Base PPO Plan for the 2023 benefit year. You will need to take action during Open Enrollment if your non-Medicare Primary dependents want to be enrolled in the Enhanced PPO Plan for the 2023 benefit year. More information regarding these plan options can be found here.

    Please note: Although the 80/20 and 70/30 plan names have changed, they are the same plans offered previous to State Health Plan members.

    What Is The North Carolina Medicare Savings Program

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    The Medicare Savings Program is a national program that can help certain Medicare members afford premiums, deductibles, coinsurance, and copayments. To qualify for one of the programs, youll have to meet certain income and resource limits. Resources refer to other financial gains you may have that are not considered income, such as stocks, bonds, and any money you have in a savings account.

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    Helpful Resources For North Carolina Medicare Beneficiaries And Their Caregivers

    Do you have questions about Medicare eligibility in North Carolina or need help selecting the best options for your specific situation? These resources provide free assistance and information.

    • You can contact North Carolinas Seniors Health Insurance Information Program with questions related to Medicare enrollment in North Carolina. Visit the website or call 855-408-1212.
    • North Carolinas Senior Medicare Patrol Program strives to reduce Medicare error, fraud, and abuse by educating Medicare beneficiaries and their caregivers about Medicare benefits, statements, explanations of benefits, etc.

    Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

    About our health insurance quote forms and phone lines

    We do not sell insurance products, but this form will connect you with partners of healthinsurance.org who do sell insurance products. You may submit your information through this form, or call to speak directly with licensed enrollers who will provide advice specific to your situation. Read about your data and privacy.

    If you have questions or comments on this service, please contact us.

    How Do I Enroll In Medicare

    Automatic Enrollment:

    If you are already receiving Social Security benefits, Railroad Retirement benefits, or Federal Retiree benefits, your enrollment in Medicare is automatic. Your Medicare card should arrive in the mail shortly before your 65th birthday. Check the card when you receive it to verify that you are entitled to both Medicare Parts A and B.

    Initial Enrollment Period:

    If you are not eligible for Automatic Enrollment, contact the Social Security Administration at 800-772-1213 or enroll online at www.socialsecurity.gov, or visit the nearest Social Security office to enroll in Medicare Part A and Medicare Part B. You have a seven month window in which to enroll in Medicare without incurring a penalty. If youre not automatically enrolled in premium-free Part A, you can sign up for it once your Initial Enrollment Period starts. Your Part A coverage will start six months back from the date you apply for Medicare, but no earlier than the first month you were eligible for Medicare. However, you can only sign up for Part B during the times listed below.

    Medicare coverage starts based on when you sign up and which sign-up period, youre in:

    Generally, when you turn 65. This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.

    If you qualify for Premium-free Part A: Your Part A coverage starts the month you turn 65.

    New: January 1, 2023

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    What Is The Best Medicare Plan In North Carolina

    At this point, youre probably wondering which of the options weve discussed is best for you. There is not one best Medicare plan in North Carolina, because everyones needs are different, Thats why there are so many options. While a Medicare Advantage plan may be best for you, your spouse or friend may be better off with a Medicare Supplement plan. Whats more, once you select the type of plan you want, youll have to choose from the hundreds available in North Carolina state!

    Our agents can come to meet with you at no cost and help you figure out if youre eligible for cost savings and help you pick the best plan for you. Plus, we have licensed agents that work with most of the major carriers in North Carolina. That means they can sort through them all with you to help you figure out which one truly works best for your needs. To get started, complete this Medicare Plan Finder form or give us a call at 833-GET-ENROLLED .

    Medicare Enrollment Guide For Providers & Suppliers

    2021 How to use Medicare Plan Finder, step-by-step

    Use this guide if any of the following apply:

    • Youre a health care provider who wants to bill Medicare for your services and also have the ability to order and certify.
    • You dont want to bill Medicare for your services, but you do want enroll in Medicare solely to order and certify.
    • You wish to provide services to beneficiaries but do not want to bill Medicare for your services.
    • You want to enroll as a supplier who does not dispense or furnish durable medical equipment, prosthetics, orthotics and supplies .

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    Medicare In North Carolina

    Summary:

    If you live in North Carolina and are nearing age 65, you may be wondering if you are eligible for Medicare, what health services Medicare covers, and how it works. Understanding your Medicare coverage and options in North Carolina can help you make an informed decision about how you receive your Medicare benefits.

    Medicare Eligibility In North Carolina

    Your search for affordable Health, Medicare and Life insurance starts here.

    Call us 24/7 at or Find an Agent near you.

    Some may think that Medicare eligibility in North Carolina is complicated. However, understanding the qualifications for Medicare is the easy part. Making a decision about your NC Medicare options is where it can get difficult. HealthMarkets can help guide you through the systemat no charge to youso that you can get the right plan for your budget and your needs.

    Are you ready to find Medicare plans now? Get your free FitScore® and begin shopping online.

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    How Do I Enroll In A Prescription Drug Plan

    The Medicare Prescription Drug Plans are sold by private insurance companies approved by Medicare. All people new to Medicare have a seven-month window to enroll in a PDP three months before, the month of and three months after their Medicare becomes effective. The month you enroll affects the PDPs effective date. All people with Medicare are eligible to enroll in a PDP however, unless you are new to Medicare or are entitled to a Special Enrollment Period, you must enroll or change plans during the Open Enrollment Period for Medicare Advantage and Medicare Part D, Oct. 15 through Dec. 7. There is a monthly premium for these plans.

    For assistance with Part D plan comparisons and enrollments, please call our team of Medicare specialists at 1-855-408-1212 or you may log onto MyMedicare.gov to shop for prescription drug plans available in your area.

    If you have limited income and assets/resources, assistance is available to help pay premiums, deductibles and co-payments. You may be entitled to Extra Help through the Social Security Administration. To apply for this benefit contact SHIIP at 1-855-408-1212 or the Social Security Administration at 800-772-1213 or www.socialsecurity.gov.

    How Does North Carolina Medicare Enrollment Work

    United Healthcare Medicare Crossover Form

    If you start receiving your Social Security or Railroad Retirement Board benefits at least four months before you turn 65, youll be enrolled in Medicare automatically. Otherwise, you must fill out an application online or contact your local Social Security office. You can enroll in Medicare during the following periods:

    • Initial enrollment: Your Initial Enrollment Period starts three months before your 65th birthday and ends three months after your 65th birthday. If youve never had Medicare, you can enroll during this period. If you started receiving Medicare when you were younger, you can also make changes to your plan.
    • General enrollment: Choose this enrollment period if you missed your IEP. The Medicare General Enrollment Period is Jan. 1 to March 31. You can choose Original Medicare, Medicare Advantage, Medigap, or Part D.
    • Medicare Advantage open enrollment: You can make changes to your Medicare Part C, also known as Medicare Advantage, from Jan. 1 to March 31.
    • Open enrollment: You can join, switch plans, or drop your coverage from Oct. 15 to Dec. 7 each year.
    • Special Enrollment Periods : You may qualify for a SEP if you lose your coverage or have changes to your eligibility outside the regular enrollment periods.

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    When You Plan To Retire And Are 65 Or Older

    It is recommended to talk with your HBR or Human Resources Department ahead of your retirement to plan your steps and submit your retirement paperwork at least 120 days prior to your planned retirement date.

    Medicare Primary members have several options for health plan coverage. These options include the following plans:

    • Humana Group Medicare Advantage Base Plan
    • Humana Group Medicare Advantage Enhanced Plan

    In order for a retiree to be eligible for the Humana Group Medicare Advantage Plans, the retiree must be enrolled in Medicare Parts A and B.

    To enroll in Medicare, please contact the Social Security Administration at or www.socialsecurity.gov.

    If you are eligible for State Health Plan benefits under the State Retirement Systems, then you will be auto-enrolled into either the Humana Group Medicare Advantage Base Plan or the Base PPO Plan . The plan will be dependent upon when your retirement paperwork is processed and approved by the State Retirement Systems. Please see the table below.

    Who Is Eligible For Medicare

    Medicare is a nationwide program created in 1965 to provide health insurance coverage for Americans aged 65 and older. Medicare is run by the federal government, specifically the Centers for Medicare and Medicaid Services.

    Medicare was later expanded and now also covers people younger than 65 who have permanent disabilities, as well as those diagnosed with end-stage renal disease and amyotrophic lateral sclerosis . Learn more about Medicare.

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    What Is The Cost Of Medicare In North Carolina

    Your Medicare costs will depend on your employment history. If you worked and paid your Medicare employment taxes for a minimum of 39 quarters, you can get premium-free Part A, which means you will not pay a premium for your Medicare hospital coverage. Unfortunately, if you worked and paid Medicare employment taxes for only 30 to 39 quarters, you will face a Part A premium of $240 in 2019. However, if you did not work and pay Medicare taxes for a minimum of 30 quarters, your Part A premium will be $437 per month in 2019. The 2019 Part A deductible for hospital stays is $341 per day for the first 90 days, and then $682 per day.

    Most people will pay a monthly premium for Part B, medical coverage. The standard Part B premium in 2019 is $135.50 per month, and the standard deductible is $185. Some people with high income may be asked to pay more.

    Become A Medicare Provider Or Supplier

    Welcome to NC Medicaid Managed Care (30)

    Ready to become a Medicare provider or supplier? This guide will help you enroll in three steps.

    Do not use this guide if

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    How To Apply For Medicare

    If youre approaching 65, its essential to find out how and when to apply for Medicare. While it may seem overwhelming, enrolling in Medicare can be simple with access to the correct information.

    At Health Plans of NC, we help North Carolina residents find the right Medicare plan for their health needs and budget. We can help with your enrollment questions and talk you through the entire Medicare application process. Get in touch with one of our local North Carolina Medicare agents today to find out more.

    Understand Medicare In North Carolina

    Medicare, the United States federal medical insurance program, provides coverage for more than 1 million people in North Carolina who qualify for Medicare. You can get Medicare if youre 65 or older or have a qualifying disability.

    Your disability typically qualifies if youve received at least 24 Social Security or Railroad Retirement Board disability insurance payments. You can also enroll in Medicare Advantage Plans if you have End-Stage Renal Disease or amyotrophic lateral sclerosis .

    Most people have premium-free Part A but, if you have to buy it, the cost can reach up to $499 per month in 2022. Part B costs $170.10 per month but can be more if you have higher income. There are 69 Medicare Advantage Plans in the state that are an alternative to Original Medicare. Learn more about your Medicare options in North Carolina.

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    What Do I Submit With The Claim

    Follow the instructions for the type of claim you’re filing . Generally, youll need to submit these items:

    • The completed claim form )
    • The itemized bill from your doctor, supplier, or other health care provider
    • A letter explaining in detail your reason for submitting the claim, like your provider or supplier isnt able to file the claim, your provider or supplier refuses to file the claim, and/or your provider or supplier isnt enrolled in Medicare
    • Any supporting documents related to your claim

    How To: Enroll In Medicare Part A And Part B

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    Some people are automatically enrolled in Medicare Part A and Part B. Some people are not.

    You’ll be automatically enrolled in Medicare Part A and Part B if:

    • You’re receiving Social Security or Railroad Retirement Board benefits when you turn 65 or
    • You’re eligible for Medicare because of a disability or medical condition.

    You must enroll yourself in Medicare Part A and B if:

    • You’re not receiving Social Security benefits when you become eligible for Medicare.

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    How Do I Change My Medicare Coverage

    Your Medicare choices are not set in stone after the first time you enroll. You can make changes to your Medicare coverage during a few special Medicare enrollment periods.

    • The Medicare Annual Enrollment Period , October 15 December 7
    • The Medicare Advantage Open Enrollment Period, January 1 March 31
    • The Medicare Special Enrollment Period for qualifying life events dates vary based on qualifying event

    Learn how to make changes to your Medicare coverage during these three time periods:

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