Tuesday, May 21, 2024

How To Fill Out Medicare Part B Application

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If Youre Not Receiving Social Security Retirement Benefits

How to Fill Out CMS-40b Form and CMS-L564 Form

If youre not already receiving Social security retirement benefits and youre approaching age 65, then you can sign up for Medicare during your initial enrollment period. This is a 7 month window that starts 3 months before, includes the month of your birthday, and ends 3 months after your birthday month. If your birthday falls on the 1st of the month, then your Medicare will begin one month prior to your birthday month.

You can apply online for Medicare Part A and Part B. Or, you can fax or mail in the required forms instead of applying online. Once you apply for Part B, you will also be enrolled in Part A. If a Social Security office is open, then you can apply in person. You also have the option to call and set up a phone appointment.

Its important to know that if you miss your initial enrollment for Part B then you could face a late enrollment penalty.

Retirement Or Disability Benefits

If you applied for retirement or disability benefits from Social Security or through the Railroad Retirement Board, this also serves as your Medicare application. If youre

under age 65 and disabled, you will be automatically enrolled in Medicare 24 months after you begin drawing disability benefits.

How To Cancel Medicare Part B

The Part B cancellation process begins with downloading and printing Form CMS 1763, but dont fill it out yet. Youll need to complete the form during an interview with a representative of the Social Security Administration by phone or in person.

Due to the COVID-19 pandemic, all Social Security Administration offices are currently closed. The SSA is still answering phone calls, and you can access many services on its website. See the latest COVID-19 updates.

You can schedule an in-person or over-the-phone interview by contacting the SSA. If you prefer an in-person interview, use the Social Security Office Locator to find your nearest location. During your interview, fill out Form CMS 1763 as directed by the representative. If youve already received your Medicare card, youll need to return it during your in-person interview or mail it back after your phone interview.

What happens next depends on why youre canceling your Part B coverage.

Also Check: What Age Do You Register For Medicare

When To Use The Application For Enrollment

You should use the CMS-40B Form to apply for Medicare Part B, but only if you already are a Medicare Program Part A participant.

People usually apply for Medicare Part B when their Initial Enrollment Period starts. The IEP begins three months before the applicants 65th birthday, lasts for a month after the birthday, and then ends three months afterward. Thus, the overall IEP is seven months long. Please note that if you choose not to apply for Medicare enrollment during your IEP but decide to do so later, you will have to pay a fine.

There is also a General Enrollment Period , which lasts annually from the 1st of January until the 31st of March. Those willing to apply for enrollment during their GEP may also use the CMS-40B Form to sign up.

Other CMS Forms

Check some other CMS forms readily available for editing in our tool. Moreover, do not forget that you can upload, fill out, and edit any PDF document at FormsPal.

How Do You Fill Out Form Cms

Medicare Part B Extended Patient Signature...

Form CMS-L564 has two sections that must both be filled out. You should complete section A, andthe employer will fill out section B.

Youll need the following information for section A:

  • Name and address of your employer
  • Your Social Security Number or your spouses SSN, if they were the employee whose health insurance you were covered by
  • Section B must be filled out by the employer. Once they fill out section B of the form, you can submit the completed form.

    After you and the employer both complete part A and part B of Form CMS-L564, you can submit the form along with your Application for Enrollment in Medicare .

    Form CMS-40B is your actual Medicare Part B application and requires the following information:

  • Your Medicare number
  • Name, address and phone number
  • Address and signature of a witness
  • You should submit your Form CMS-L564 and Form CMS-40B together at the same time. You may deliver the forms to your local Social Security office by mail or in person.

    Important note: if you do not already have Medicare Part A, you shouldnt complete the CMS-40B form. You should contact Social Security directly by calling 1-800-MEDICARE TTY: 1-877-486-2048.

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    Medicaid Or Medicare Savings Programs

    Medicare beneficiaries with limited income or very high medical costs may be eligible to receive assistance from the Medicaid program. There are also Medicare Savings Programs for other limited-income beneficiaries that may help pay for Medicare premiums, deductibles, and coinsurance. There are specified income and resources limits for both programs. Contact your local county Department of Social Services or SHIIP to apply for one of these programs.

    When Can You Apply For Medicare Part B

    You should only apply to enroll in Medicare part B if youre already enrolled in Medicare part A. If you havent enrolled in part A, youll need to contact the SSA to begin the process. Medicare part A is free to enroll in once you turn 65, so most people do so shortly after their 65th birthday. Part B, however, requires you to pay premiums like traditional health insurance.

    You have a few options for when to apply for enrollment in Medicare Part B.

    • The Initial Enrollment Period . This starts three months before the month you turn 65, and ends three months after the month you turn 65. This is when most people apply for Medicare Part A, and when many also elect to enroll in Part B.
    • The General Enrollment Period . If you didnt enroll during your IEP, you can enroll during this period. It takes place every year between January 1 and March 31. Opting for this path could lead to higher premiums, however.
    • The Special Enrollment Period . This only applies if youre currently receiving group health benefits from an employer or if those benefits ended within the last eight months.

    Usually, you dont pay a late enrollment penalty if you sign up during the SEP. To prove your eligibility for an SEP, youll need to include Form CMS-L564 in your application. This form provides information about your or your spouses employment-sponsored group health plan.

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    How Do I Apply For Medicare Extra Help

    Medicare Extra Help is a program to help Medicare members with limited incomes pay the costs of Medicare Part D. Youll need to be enrolled in both original Medicare and Part D to apply.

    You can apply for the Extra Help program using your My Social Security account. The Extra Help application can be completed online.

    Youll need to provide some recent information about your income, such as:

    • pay stubs
    • Social Security or Railroad Retirement benefits statements
    • investment account statements

    Explore Your Other Medicare Coverage Options

    How to start Medicare when losing employer coverage – How to sign up for Medicare Part B

    Once you are enrolled in Original Medicare, you can explore additional coverage options.

    You can decide to:

    • Add a Medigap supplement insurance policy.
    • Add a Part D prescription drug plan.
    • Switch to a Medicare Advantage plan also known as Part C to replace your Original Medicare coverage.

    Medicare Part D, Medigap and Medicare Advantage are all administered by private insurance companies that contract with CMS.

    You can apply for these benefits online.

    Use the Medicare Plan Finder tool to explore and compare plans in your area.

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    Employer Or Military Retiree Coverage

    If you or your spouse has an Employer Group Health Plan as retiree health coverage from an employer or the military , you may not need additional insurance. Review the EGHPs costs and benefits and contact your employer benefits representative or SHIIP to learn how your coverage works with Medicare.

    How Much Does Medicare Cost

    Original Medicare

    Original Medicare is divided into Part A and Part B .

    • Part A helps pay for inpatient hospital care, some skilled nursing care, home health care and hospice care.
    • Part B helps pay for doctor services, outpatient hospital care, durable medical equipment, home health care not covered by Part A, and other services. Medicare was never intended to pay 100% of medical bills. Its purpose is to help pay a portion of medical expenses. Medicare beneficiaries also pay a portion of their medical expenses, which includes deductibles, copayments, and services not covered by Medicare. The amounts of deductibles and copayments change at the beginning of each year.

    Part A – Monthly Premium

    If you are eligible, Part A is free because you or your spouse paid Medicare taxes while you were working. You earn Social Security “credits” as you work and pay taxes. For each year that you work, you earn 4 credits.

    $471 $499

    You are 65 or older, and you receive or are eligible to receive full benefits fr om Social Security or the Railroad Retirement Board

    You are under 65, and you have received Social Security disability benefits for 24 months You are under 65, and you have received Railroad Retirement disability benefits and you meet Social Security disability requirements You or your spouse had Medicare-covered government employment You are under 65 and have End-Stage Renal Disease

    Read Also: How To Qualify For Medicare In Ga

    How Do I Apply For Medicare Advantage

    Medicare Advantage plans provide the same benefits as Original Medicare, and many plans may offer additional benefits that Original Medicare doesnt cover.

    If you are eligible for Original Medicare, you may also be eligible for a Medicare Advantage plan. To find out more about your eligibility and to compare plans that are available where you live, call to speak with a licensed insurance agent today.

    You can also compare plans online for free, with no obligation to enroll.

    Find Medicare Advantage plans in your area

    Do I Need An Application Form For Signing Up For Medicare Advantage

    How to Help Your Clients Sign Up For Medicare Part B

    If youd like, you may be able enroll in Medicare Advantage as an alternative way to get your Original Medicare, Part A and Part B, benefits. Medicare Advantage plans are offered by private health insurance companies that contract with Medicare to deliver your Medicare Part A and Part B benefits with the exception of hospice care, which is still covered under Part A. Many Medicare Advantage plans include benefits beyond Part A and Part B coverage as well for example, some plans offer prescription drug coverage, routine vision care, and/or wellness programs.

    There are several types of Medicare Advantage plans, although not every type of plan may be available where you live. Examples of plan types include Health Maintenance Organization plans, Preferred Provider Organization plans, Private Fee-for-Service plans, Special Needs Plans , and Medical Savings Account plans.

    To qualify for a Medicare Advantage plan, you need to be enrolled in Medicare Part A and Part B live within the plans service area and, in many cases, not have end-stage renal disease . You can generally sign up for Medicare Advantage only during certain election periods.

    You can compare Medicare Advantage plans available where you live just click Find Plans or Compare Plans on this page. Note that you need to continue paying your Medicare Part B premium, along with any premium the plan may charge.

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    Medicare Part D Forms

    Most Part D prior authorization forms are available online for you to download, print, and take to your doctor to sign. You can usually find the form on the carriers site, or you can contact the insurance company to ask them to email you the form. You may need to fill out a Coverage Determination Request Form if your medication requires prior authorization or step therapy.

    If You Delayed Medicare Because You Were Still Working

    If you delayed enrolling in Medicare Parts A and B because you were still working, then you can enroll online for both Part A and Part B.

    There are also two forms you need to fill out and send in to Social Security. This shows that you were covered under employer or other creditable insurance. As long as you can provide proof of coverage then you wont have any penalty for not signing up when you were first eligible at 65.

    Read Also: How Old Do You Have To Be For Medicare

    Canceling Part B Because You Got A Job With Insurance

    If you have had Part B for a while but no longer need it because youve rejoined the workforce with access to employer-sponsored health insurance, congratulations! But before you drop Part B, find out if your jobs coverage is primary or secondary to Medicare.

    A primary payer health plan pays before Medicare. That means your employer-provided health plan will cover its share of your health care costs first, and if theres anything left over that Medicare covers, Medicare will pay what remains.

    Conversely, a secondary payer health plan covers only costs left over after Medicare covers its share.

    If your health plan at work is a primary payer, thats great. Feel free to drop your Part B coverage if you wish. The Part B premiums might not be worth any additional coverage you receive. But if you have secondary-payer insurance at work, its usually better to keep Part B, or you could get stuck paying Medicares share of your health care expenses.

    Talk to your human resources department at work to find out if your employer-sponsored plan is primary or secondary to Medicare. Generally, businesses with 20 or fewer employees have secondary payer plans, while larger companies have primary payer plans.

    Medicare Part D Prescription Drug Coverage

    Medicare Part B – Apply For Medicare Part B – Deciding To Sign Up For Medicare Part B

    2022 Part D premiums:

    • The average premium for stand-alone Medicare Part D coverage is about $43/month in 2022. There continue to be a wide range of Part D plan options available. Premiums for Part D plans start as low as about $7/month in 2022. On the higher end, plans can have premiums of up to $100/month or more, so there is a great deal of variation in price and benefits across the available plans.
    • High-income enrollees pay a higher Part D premium. The threshold for high-income began to be indexed as of 2020. The income threshold for 2022 is $91,000 for a single person and $182,000 for a couple . In 2022, the additional premium for high-income enrollees ranges from $12.40/month to $77.90/month.

    Part D deductible:

    Part D out-of-pocket costs after deductible:

    • Not to exceed 25% of the cost of brand-name and generic costs.
    • There is no longer a donut hole in terms of the maximum amount that enrollees can be charged when they fill prescriptions. But the donut hole still exists in terms of how insurers design their coverage , how total drug costs are counted, and who covers the bulk of the cost of the drugs .
    • After a beneficiarys costs reach the catastrophic coverage threshold , additional out-of-pocket costs are capped at the greater of 5% of the cost of the drug or a copay of $3.95 for generics and $9.85 for brand-name drugs.

    Learn more about Medicare Part D.

    Also Check: When Do I Enroll In Medicare Part B

    Ways To Begin A Social Security Disability Application

    Many people opt to apply for disability benefits online. It is faster than mail, by phone, or in person at a local Social Security office.

    Before you start your application for disability benefits, consider which of the three methods works best for you. Then, get to know what information youll need for the application.

    First, you could choose to apply for disability online at Social Securitys website. At the same time, you will need to create or log into your my Social Security account to complete the online application.

    Second, you could apply in person by first calling Social Security at 1772-1213 and setting up an in-person appointment at your local Social Security office.

    Reach a special toll-free line for hearing impaired callers at TTY 1-800-325-0778.

    Youll need to bring several documents and other pieces of information in order to make the most out of that in-person appointment.

    Lastly, you can apply by phone first calling the Social Security phone number, and setting an appointment for a telephone interview.

    Either by phone or in person, Social Security will send you a Disability Starter Kit to prepare you for your disability claims interview.

    The interview itself take about an hour to complete. Even if you apply online, you will need either an in-person appointment at your local Social Security office or a phone appointment with a representative to review your case.

    Signing Up For A Medicare Part D Plan

    Medicare Part D drug coverage is optional and available to anyone with Medicare Part A and Part B.

    Two Ways to Get Medicare Prescription Drug Coverage

  • With a standalone Part D plan
  • Through a Medicare Advantage plan that includes prescription drug coverage
  • In both cases, you must already be enrolled in Original Medicare.

    You can explore and compare available Part D plans on the Medicare website.

    You can also call your local State Health Insurance Assistance Program for free help.

    Once you find a plan that meets your needs, there are a few ways to sign up.

    Four Ways to Sign Up for a Part D Drug Plan

  • Go online and use the Medicare Plan Finder. You can enroll in a plan by clicking the Enroll button next to the plans name.
  • Contact the insurance company that offers the Part D plan. You can visit the companys website or call the phone number listed on the Medicare Plan Finder page.
  • Request and fill out a paper application from the insurance company.
  • To sign up for a Medicare Part D plan, you will need your Medicare number and the date your Part A and Part B coverage started. You can find this information on your Medicare card or on MyMedicare.gov.

    Other Information You Need to Provide

    • Your primary mailing address
    • Whether you had or have other drug coverage
    • How you want to pay your premiums

    Coverage usually begins the first day of the month after enrollment.

    If you switch plans during the open enrollment period , your new coverage will start Jan. 1.

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