Get Important News & Updates
Sign up for email and/or text notices of Medicaid and other FSSA news, reminders, and other important information. When registering your email, check the category on the drop-down list to receive notices of Medicaid updates check other areas of interest on the drop-down list to receive notices for other types of FSSA updates.
How Does The Lis/extra Help Program Work
Enrollees in this program usually DO NOT have to pay:
- Premiums for their prescription drug coverage
- Deductibles for their prescription drug coverage
- The Part D late enrollment penalty
- Full copays or coinsurance
- More than $9.20 for the prescription drugs their plan covers
Program members also get a quarterly Special Enrollment Period to join or switch Medicare Part D plans. Over the course of a year, someone on Medicare who is receiving Extra Help could potentially save about $5,000!
Documents You Need To Apply For Medicare
To begin the application process, youll need to ensure you have the following documentation to prove identity:
- A copy of your birth certificate
- Your drivers license or state I.D. card
- Proof of U.S. citizenship or proof of legal residency
You may need additional documents as well. Make sure to have on hand:
- Your Social Security card
- W-2 forms if still active in employment
- Military discharge documents if you previously served in the U.S. military before 1968
- Information about current health insurance types and coverage dates
If you are already enrolled in Part A and have chosen to delay enrollment in Part B, you will need to complete additional forms .
You May Like: Does Medicare Pay For Entyvio
Creating A Mymedicaregov Account
Youll need a MyMedicare.gov online account to start using all the digital services. If you dont already have an account, follow these steps to make one:
Thats it. You now have a MyMedicare account and can log in using your chosen username and password.
General Eligibility For Medicare
Medicare eligibility goes hand-in-hand with Social Security eligibility.
Individuals in the below-listed categories can get Medicare coverage.
- Persons age 65 or older eligibility begins four months before their 65th birthday
- Disabled persons 64 and under can qualify if receiving disability benefits from Social Security or the RRB for 24 months
- Persons with end-stage renal disease can get premium-free Medicare Part A. Eligibility based on End-Stage Renal Disease requires current dialysis treatment, a kidney transplant, and filing an application for Medicare.
Recommended Reading: Can I Enroll In Medicare Online
When Can You Enroll In Medicare
You can apply for Medicare during three distinct enrollment periods: your Initial Enrollment Period, the General Enrollment Period and a Special Enrollment Period when youre getting off your employers health coverage.
Medicare Enrollment Dates
|Change to a 5-star Medicare Advantage or Part D prescription drug plan.|
Who Do I Call For Medicare Questions
Using MyMedicare.gov can take some getting used to it, but this user-friendly online portal is designed to save you time performing various everyday tasks.
If you have any questions about using MyMedicare.gov that arent answered above, you can call the MyMedicare.gov technical advice line at 1-833-906-0981 or 1-833-906-0981 for TTY users. Alternatively, once youve logged on, you can chat to the MyMedicare.gov support team using the Live Chat feature.
If you wish to learn more about private Medicare Advantage plans and to compare plans that may be available where you live, you can call to speak with a licensed insurance agent.
$0 premium Medicare Advantage plans may be available in your area.
Find $0 Medicare Advantage plans in your area
Or call 1-800-557-6059TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!
About the author
Zia Sherrell is a digital health journalist with over a decade of healthcare experience, a bachelors degree in science from the University of Leeds and a masters degree in public health from the University of Manchester. Her work has appeared in Netdoctor, Medical News Today, Healthline, Business Insider, Cosmopolitan, Yahoo, Harper’s Bazaar, Men’s Health and more.
When shes not typing madly, Zia enjoys traveling and chasing after her dogs.
Medicare has neither reviewed nor endorsed this information.
Don’t Miss: Should I Enroll In Medicare If I Have Employer Insurance
How Do I Check My Medicare Enrollment Status
You can use MyMedicare to check your Medicare plan enrollment information so youll always know which types of coverage you have at your disposal.
Youll be able to view information about your Medicare insurance, other types of insurance and supplement or subsidy coverage.
Some of the information includes your Medicare plan name, plan type, quality ratings and your plan period.
When Do I Sign Up For Medicare Advantage
Before you sign up for Medicare Advantage, make sure you weigh the pros and cons of Medicare Advantage vs. Medicare Supplements. If you choose to sign up for Medicare Advantage, you can do so during your IEP.
If you missed your IEP, you can join during the Medicare Annual Enrollment Period. For those currently enrolled in a Medicare Advantage plan, you also have another opportunity to make changes during the Medicare Advantage Open Enrollment Period.
Don’t Miss: Does Medicare Pay For Eyeglasses For Diabetics
End User Point And Click Agreement
You, your employees, and agents are authorized to use CPT only as contained in the following authorized materials internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services . You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.
Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA Web site, .
Applicable FARS/DFARS restrictions apply to government use.
U.S. Government Rights
What Are The Two Enrollment Methods
If youre already getting Social Security or Railroad Retirement Board benefits, you dont need to enroll in Medicare. Youll automatically get Original Medicare as of the first day of the month you turn 65.
Those who are automatically enrolled will receive a Welcome to Medicare packet, which will include your Medicare card, three months before turning 65.
If you want a Medicare Supplement Insurance policy.
If you decide you dont want Part B, you must return the Medicare card. If you keep the card, you keep Part B coverage and you will be charged the monthly premium.
Note that if you live in Puerto Rico, you will only receive Medicare Part A automatically. You need to call Social Security at 772-1213 or TTY 325-0778 to apply for Part B if you want it.
You will not get Medicare automatically if you are not already receiving benefits from Social Security or the Railroad Retirement Board, even if youre close to age 65. You need to apply for Part A and Part B if you want them using one of the methods mentioned here, even if youre eligible for premium-free Part A.
The government expects you to know when to enroll. Be sure to apply for Part B during your Initial Enrollment Period unless you have current employment-based insurance coverage elsewhere. If you dont apply and sign up later, you will have to pay a Part B late enrollment penalty for as long as youre enrolled in Part B.
You May Like: Does Medicare Cover Cosmetic Surgery
Claim Status Request And Response
Providers have a number of options to obtain claim status information from Medicare Administrative Contractors :
Providers can enter data via the Interactive Voice Response telephone systems operated by the MACs.
Providers can submit claim status inquiries via the Medicare Administrative Contractors provider Internet-based portals.
Some providers can enter claim status queries via direct data entry screens.
Providers can send a Health Care Claim Status Request electronically and receive a Health Care Claim Status Response back from Medicare.
The electronic 276/277 process is recommended since many providers are able to automatically generate and submit 276 queries as needed, eliminating the need for manual entry of individual queries or calls to a contractor to obtain this information. Submission of 276 queries and issuance of 276 responses should be less expensive for both providers and for Medicare. In addition, the 277 response is designed to enable automatic posting of the status information to patient accounts, again eliminating the need for manual data entry by provider staff members. If unsure whether your software is able to automatically generate 276 queries or to automatically post 277 responses, you should contact your software vendor or billing service.
When Do I Get My Medicare Card
In most circumstances, youll get a Medicare I.D. card several weeks after your initial application. However, waiting times can be up to 90 days. If you are automatically enrolled in Medicare because you already get Social Security benefits, you will receive your I.D. card two months before turning 65.
Recommended Reading: Does Medicare Offer Dental Plans
What Do I Need To Know About Advance Designation
You should be aware of another type of representation called Advance Designation. This relates to the Strengthening Protections for Social Security Beneficiaries Act of 2018, which was signed into law on April 13, 2018.
Advance Designation allows capable adult and emancipated minor applicants and beneficiaries of Social Security, Supplemental Security Income, and Special Veterans Benefits to choose one or more individuals to serve as their representative payee in the future, if the need arises.
To help protect whats important to you, we now offer the option to choose a representative payee in advance. In the event that you can no longer make your own decisions, you and your family will have peace of mind knowing you already chose someone you trust to manage your benefits. If you need a representative payee to assist with the management of your benefits, we will first consider your advance designees, but we must still fully evaluate them and determine their suitability at that time.
You can submit your advance designation request when you apply for benefits or after you are already receiving benefits. You may do so through your personal account, by telephone, or in person.
How Often Should You Check Medicare Eligibility
Its important to check your patients Medicare eligibility throughout their course of treatment. Working with an information technology company like ABILITY can help reduce the time spent completing these frequent Medicare status checks. At the very minimum, you should check Medicare status:
- The first time the patient reaches out to you for medical service
- Before any submission of a home health request for anticipated payment
- Before any submission of a hospice notice of election
- Before every claim submission
Don’t Miss: How Much Medicare Is Taken Out Of Social Security Check
How Quickly Does Medicare Coverage Start
When and how you enroll for a Medicare plan may affect the start date of your coverage.
Medicare enrollment can be done online, in person, or over the phone through Social Security. Your benefits may not start until 3 months after applying, so its important to apply 3 months before your 65th birthday to start receiving coverage that day.
If you already collect Social Security income benefits or Railroad Retirement Benefits, you will automatically be enrolled in Medicare when you turn 65.
Is Mymedicaregov Legitimate
MyMedicare.gov is managed by the federal government. Its free and secure and can be accessed 24 hours per day. Best of all, it takes only a minute to create an account.
There are a number of things you can do on MyMedicare.gov, such as checking your Medicare claims and reviewing your Part B deductible information.
Don’t Miss: Does Medicare Cover Private Home Care
When Does My Coverage Start
When and how you enroll for a Medicare plan impacts when your coverage begins. Your benefits may not start until three months after you apply.
If you have not received an acceptance letter 45 to 90 days after submitting your application, call the Social Security Administration or check online. You will need your Medicare application number to do so.
Once your coverage begins, you do not need to reapply each year for Medicare benefits.
However, you will have an opportunity to change plans or adjust your coverage during the open enrollment period, which runs from Oct. 15 to Dec. 7 each year.
Free Medicare Help
Information You Need To Apply
Before applying, be ready to provide information about yourself, your medical condition, and your work. We recommend you print and review the . It will help you gather the information you need to complete the application.
Information About You
- Your date and place of birth and Social Security number.
- The name, Social Security number, and date of birth or age of your current spouse and any former spouse. You should also know the dates and places of marriage and dates of divorce or death .
- Names and dates of birth of children not yet 18 years of age.
- Your bank or other and the account number.
Information About Your Medical Condition
- Name, address, and phone number of someone we can contact who knows about your medical conditions and can help with your application.
- Detailed information about your medical illnesses, injuries, or conditions:
- Names, addresses, phone numbers, patient ID numbers, and dates of treatment for all doctors, hospitals, and clinics.
- Names of medicines you are taking and who prescribed them.
- Names and dates of medical tests you have had and who ordered them.
Information About Your Work:
- Award letters, pay stubs, settlement agreements, or other .
We accept photocopies of W-2 forms, self-employment tax returns, or medical documents, but we must see the original of most other documents, such as your birth certificate.
Do not delay applying for benefits because you do not have all the documents. We will help you get them.
You May Like: What Is The Annual Deductible For Medicare
Will My Client Be Notified If Their Extra Help Status Changes
If your clients Extra Help status changes, they should receive a notification from CMS or the SSA via mail. The color of the notice will vary, depending on the purpose the notice serves.
Medicare Extra Help Status Cheat Sheet
|Used to get Extra Help automatically but no longer automatically qualifies||Yes|
How To Check Application Status For Medicare Advantage Or Part D
Medicare Advantage Part C is the alternative to original Medicare, and provides the benefits of both parts A and B. A person may check the status of their Advantage plan application by contacting the private company that offers it. When a company accepts an application, it sends the beneficiary a Medicare Advantage Plan ID card in the mail.
Medicare Part D is prescription drug coverage. As with Advantage plans, someone may contact the private company that offers the plan to check their application status. Accepted applicants receive a Part D card in the mail.
Recommended Reading: Which Medicare Plans Cover Silver Sneakers
Do I Need Medicare Part B
We always advise our clients to contact their employer or union benefits administrator before delaying Part A and Part B to learn more about how their insurance works with Medicare. Employer coverage may require that you enroll in both Part A and Part B to receive full coverage.
Common reasons beneficiaries delay Part B include:
Apply For Benefits Online
You should apply for disability benefits as soon as you become disabled. Follow these easy steps to apply online for disability:
- To start your application, go to our Apply for Benefits page, and read and agree to the Terms of Service. Click Next.
- On that page, review the Getting Ready section to make sure you have the information you need to apply.
- Select Start A New Application.
- We will ask a few questions about who is filling out the application.
- You will then sign into your mySocial Security account, or you will be prompted to create one.
- Complete the application.
You can use the online application to apply for disability benefits if you:
- Are age 18 or older.
- Are not currently receiving benefits on your own Social Security record.
- Are unable to work because of a medical condition that is expected to last at least 12 months or result in death and
- Have not been denied for disability in the last 60 days.
Note: If your application was recently denied, our application is a starting point to request a review of the determination we made.
You may be able to file online for SSI at the same time that you file for SSDI benefits. Once you complete the online process above, a Social Security representative will contact you if we need additional information.
Don’t Miss: Will Medicare Pay For Handicap Bathroom