Medicare Other Insurance And How We Can Help
Did you know you can enroll in Medicare even if you have other kinds of insurance such as Medicaid, VA benefits, and employer-sponsored health insurance? That said, some of these types of insurance work better with Medicare than others. In some cases, they may affect your ability to enroll in Medicare.
To find out how to choose the right Medicare coverage and understand how it will interact with health insurance you may already have, call the number below. A licensed Medicare expert can answer your Medicare eligibility questionsand help you enroll.
What If Your Medicare Card Didnt Arrive
If youre expecting to receive a Medicare card but havent yet received one three months before your 65th birthday, the first thing to do is to not worry. Medicare sends out hundreds of thousands of cards per year without issue. Its possible for the card to be delayed or for there to be an error. To confirm whether a Medicare card is heading your way, check with your local Social Security office to make sure that youre enrolled.
Medicare Eligibility By Disability
Most Medicare recipients under the age of 65 reach eligibility during their 25th month receiving Social Security disability benefits. If you qualify for Medicare because of a disability, your Initial Enrollment Period will begin during the 22nd month you receive these benefitsthree months before youre eligible for coverage.
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Moderna Booster Update: How Much Does It Protect Against Omicron And For How Long
Research shows that mRNA vaccine boosters can defend against the omicron variant. However, one new study finds that protection decreases after 10 weeks.
The Moderna booster shot is 50 micrograms, or half of a full 100 microgram dose of the vaccine.
New research from Denmark and the UK this week demonstrates that mRNA boosters — like Moderna’s and Pfizer’s — offer significant protection against the new omicron variant of COVID-19. However, data from the UK on Friday indicates that booster protection starts to decrease notably after 10 weeks.
In a technical briefing released Friday, the UK Health Security Agency announced that the Oxford/AstraZeneca, Pfizer/BioNTech and Moderna vaccines all protect against omicron less than they did against delta, and that protection from boosters wanes in time. Booster effectiveness generally decreased from 60% to 70% protection at two to four weeks after the shot, down to 35% to 45% at 10 weeks, depending on the combination of vaccines administered.
The UK report also adds weight to the hope that omicron infections are less severe than with the delta variant, noting that the risk of hospitalization from omicron is about three-fifths of that from delta.
Moderna also indicated a potential double dose of the booster, 100 micrograms versus 50 micrograms, would increase omicron-neutralizing antibodies “approximately 83-fold higher than pre-boost levels.”
The Democratic Senates Proposal
Since his election campaign, President Biden has talked of lowering the Medicare age to 60. Now, Senate Democrats are furthering his agenda, proposing expansion for Original Medicare to include hearing benefits in addition to a non-specific, reduced eligibility age.
The proposal for the upcoming fiscal year will be in the works this fall. These expansions are part of a larger budget reconciliation bill that involves a $1.75 trillion budget and banks on future economic growth.
The Medicare expansions are one item on a list of proposed policies in areas including health care, climate, and education.
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How Do I Get Full Medicare Benefits
If youve worked at least 10 years while paying Medicare taxes, there is no monthly premium for your Medicare Part A benefits. But if you havent worked, or worked less than 10 years, you may qualify for premium-free Part A when your spouse turns 62, if she or he has worked at least 10 years while paying Medicare taxes. However, to be eligible for Medicare, you need to be 65 years old. You also need to be an American citizen or legal permanent resident of at least five continuous years.
So, to summarize with an example:
- Bob is 65 years old. Hes on Medicare, but he pays a monthly premium for his Medicare Part A benefits. He only worked for seven years and no longer works.
- His wife, Mary, has worked for over 30 years.
Signing Up For Premium
You can sign up for Part A any time after you turn 65. Your Part A coverage starts 6 months back from when you sign up or when you apply for benefits from Social Security . Coverage cant start earlier than the month you turned 65.
After your Initial Enrollment Period ends, you can only sign up for Part B and Premium-Part A during one of the other enrollment periods.
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Are You Eligible For Premium
- You get retirement benefits from Social Security or the Railroad Retirement Board
- You are eligible to get benefits Social Security or Railroad benefits, but have not filed for them yet
- You or your spouse had Medicare-covered government employment
If you do not fit any of these criteria, you will have to buy Part A. In that case, your Initial Enrollment Period does not change, but your coverage start dates will:
If you sign up for Part A or Part B
Your coverage starts
Within three months before your birthday month
The first day of your birthday month, or the first day of the previous month if your birthday is on the first of the month
Your birthday month
One month after you sign up
One month after your birthday month
Two months after you sign up
Two months after your birthday month
Three months after you sign up
Three months after your birthday month
Three months after you sign up
If you do not within three months after your birthday, you will have to wait until the next General Enrollment Period.
Sign Up: Within 8 Months After You Or Your Spouse Stopped Working
Avoid the penalty & gap in coverageIf you miss this 8-month Special Enrollment Period, youll have to wait to sign up and go months without coverage. You might also pay a monthly penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?
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When Is The Initial Enrollment Period
Most people become eligible for Medicare the year they turn 65. You will have a seven-month period when you can enroll in Medicare. This is known as yourInitial Enrollment Period . It starts three months before your birthday month, includes your birthday month, and ends three months after your birthday month.
For example, if your birthday is June 6, your IEP would start on March 1 and end on September 30.
Most seniors are automatically enrolled in Medicare. You will be automatically enrolled if you have received social security benefits for at least four months before you turn 65. Your coverage will begin on the first day of your birthday month .
If you have received social security benefits for less than four months before you turn 65, you wont be automatically enrolled. This means you will have to sign up.
The best time to sign up is still during your Initial Enrollment Period.
Enrolling In Medicare After Turning 65
Retirees who sign up for Medicare after turning 65 will have to wait a month or more for coverage to begin.
If you sign up for free Part A and/or Part B:
- The month you turn 65, you will receive Medicare a month after signing up.
- One month after turning 65, you will receive Medicare two months after signing up.
- Two months after turning 65, you will receive Medicare three months after signing up.
- Three months after turning 65, you will receive Medicare three months after signing up.
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Delaying Medicare Due To Work: Special Enrollment Period
If you didn’t enroll in Medicare because you were still working, and you were covered under a group health plan based on employment, you have a Special Enrollment Period during which you can sign up for Part A and/or Part B. While you or your spouse are still working and you’re still covered under a group health plan, you can sign up anytime.
After your or your spouse’s employment ends, your Special Enrollment Period lasts eight months, starting the month after the employment or group health plan ends . However, you have only two months after the employment or group health plan ends to sign up for a Medicare Advantage plan or Part D prescription drug plan . You can enroll in a Medicare Advantage plan starting three months before your Medicare Part B enrollment is due to take effect up to the day before your Part B coverage startsbut again, enrollment must take place within two months of your employment or group health plan ending.
Judy’s last day of work is July 1 and her group health plan ends July 31. She has eight months, until April 30, to sign up for Part B without a penalty. But if she wants to join a Medicare Advantage plan, she needs to do so by September 30 . Instead, on June 15, Judy signs up for Part B coverage to begin on August 1, so that she won’t have a gap in coverage. She has only until July 31 to add a Medicare Advantage plan . Her Medicare Advantage plan will start August 1.
Preparing As The Eligibility Age Nears
If a person already receives benefits from the Social Security Administration, the Administration will automatically enroll them in Medicare parts A and B.
The person will receive a âWelcome to Medicareâ packet 3 months before their 65th birthday, with instructions on how to sign up.
A person does not have to be retired to receive Medicare. If a person is not currently receiving Social Security benefits, they can apply for Medicare benefits as early as 3 months before their 65th birthday.
For example, if a person turns 65 years of age in April, they can apply for Medicare benefits in January of the same year.
Applying for Medicare benefits as early as possible may help the Social Security office process the paperwork in time for the personâs 65th birthday.
People who apply too late may face a premium 10% higher than that of those who apply on time. This premium would apply for double the time a person has been eligible but did not apply.
A person can apply for Medicare during their birth month or up to 3 months after their birth month without having to pay penalties for Medicare coverage.
However, their benefits will not begin until the Centers for Medicare and Medicaid Services process their request.
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What If You Still Work
There are three timeframes to understand. The first, the trial work period, is a nine-month period during which you can test your ability to work and still receive full benefits. The nine months don’t have to be consecutive. The trial period continues until you have worked for nine months within a 60-month period.
Once those nine months are used up, you move into the next time framethe extended period of eligibility. For the next 36 months, you can still receive benefits in any month you aren’t earning “substantial gainful activity.”
Finally, you can still receive free Medicare Part A benefits and pay the premium for Part B for at least 93 months after the nine-month trial periodif you still qualify as disabled. If you want to continue receiving Part B benefits, you have to request them in writing.
If you’re disabled, you may incur extra expenses that those without disabilities do not. Expenses such as paid transportation to work, mental health counseling, prescription drugs, and other qualified expenses might be deducted from your monthly income before the determination of benefits, which mayallow you to earn more and still qualify for benefits.
What Are The Four Parts Of Medicare
Medicare consists of four parts: Medicare Part A, which is your hospital insurance, Medicare Part B, which is your regular medical insurance, Medicare Part C , which is an alternate way to receive benefits, and Medicare Part D, which covers prescription drugs.
- Part A covers inpatient care at the hospital as well as nursing facilities. Most people would get this for free if they paid into Medicare through working for at least ten years, and enrollment is usually automatic.
- Part B is the coverage of medical supplies and services that are necessary to treat you. These include outpatient care, preventative services, rehabilitation, ambulatory services, and medical equipment. To receive Part Bs benefits, you must enroll and pay a premium, which we will discuss below.
- Part C is a combination of parts A and B, but usually administered privately and often covers additional items.
- Part D is your prescriptions. Part Ds monthly costs are based on your income and are on top of the Part B premium costs. These range from $0 extra to an additional $77.10 per month. You can find these brackets here.
For now, lets talk about the principal Medicare premium: Part B, and how it is calculated.
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What Does The Moderna Booster Shot Do
As the vaccine’s effectiveness decreases over time, a COVID-19 booster shot — whether from Moderna, Pfizer or Johnson & Johnson — recharges your body’s immune response and guards against a breakthrough infection.
Recent studies of the Pfizer and AstraZeneca vaccines show that their effectiveness can begin to wane after six months. Moderna said early data suggests that those who received the Moderna vaccine in 2020 are showing a higher rate of breakthrough COVID-19 infections than those vaccinated this year, suggesting the need for a booster to maintain high levels of protection.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
Should You Wait Until 65 To Sign Up For Medicare
If you wait to sign up right before your 65th birthday , you may go for months without coverage.
Initial Enrollment Period
Your Initial Enrollment Period will last for 7 months. This Initial Enrollment Period begins 3 months before the month of your 65th birthday and ends 3 months after your birthday month. If you fail to enroll before your birthday month, your coverage will be delayed by a month or more.
General Enrollment Period
Youll have the option to sign up during the General Enrollment Period which falls between January 1 and March 31 every year if you didnt sign up during the Initial Enrollment Period. But youll potentially be charged a late enrollment penalty. Your premiums for Part B will be permanently increased by 10% for each year that you neglected to sign up for Part B and your monthly premiums for Part A will temporarily increase by 10%. As a rule, most people dont pay premiums for Part A, but then again, most people dont delay signing up for Part A. Your coverage will start on July 1, three months after the General Enrollment Period ends.
You may be able to avoid the late enrollment penalty and having to wait for the General Enrollment Period if you qualify for a Special Enrollment Period.
Special Enrollment Period
Its important to check with your insurer or HR department to make sure that your coverage is sufficient to postpone Medicare enrollment.
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What Other Programs Have Been Scrapped From The Reconciliation Bill
In order to cut the price tag for the package in half, many publically popular items had to be cut.
In addition to the expansion of Medicare to include dental and vision, the measure to lower the eligibility age to sixty was also cut. Lowing the eligibility age could have provided coverage to 1.6 million people between sixty and sixty-four who are currently uninsured.
The Kaiser Family Foundation also reported that if the age was decreased, more than 11 million workers between sixty and sixty-four who rely on their employer-based insurance would be able to opt-in to Medicare. This change could reduce costs for businesses and organizations who could then provide other benefits to older and younger workers alike.
A group of lawmakers had proposed a measure that would have allowed the federal government to negotiate with pharmaceutical companies to bring down the cost of prescription drugs.
Right now, the pharmaceutical industry is doing everything they can to make sure that 1 out of 4 Americans continues to be unable to afford the prescriptions their doctors write. Does that sound acceptable to you at all?
These costs can be a major burden for those on Medicare. Currently, almost three-quarters of those on Medicare have purchased a Part D plan to help keep the cost of prescriptions down. The negotiating power could have helped limit the number of seniors who felt it necessary to purchase additional coverage.