Saturday, March 23, 2024

What Medicare Do I Have

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Do You Need To Renew Medicare Every Year

Can I Have Medicare and Employer Health Coverage?

A short answer to this question is no. If youre enrolled in Original Medicare or a Medicare Advantage plan, your plan will renew automatically.

However, there are some exceptions and enrollment information you may not be aware of. Lets explore some of the renewal and enrollment details of common Medicare plans.

Do I Automatically Get Medicare When I Turn 65

Some people automatically get Medicare at age 65, but those numbers have declined as the Medicare and Social Security ages have continued to drift apart.

Most people who automatically get Medicare at age 65 do so because they have been receiving Social Security benefits for at least four months before turning 65. Traditionally, Medicare premiums are deducted from your Social Security check. For the longest time, you could retire with full Social Security benefits at 65 and start on Medicare at the same time.

You are still automatically enrolled in Medicare Part A and Part B at 65 if youre drawing Social Security, but not as many people draw Social Security that early these days because of changes to the eligibility age for full Social Security benefits.

In 2000, the Social Security Amendments of 1983 began pushing back the standard age for full Social Security benefits. The progressive changes are nearing their conclusion: Beginning in 2022, the standard age for full benefits will be 67 for anyone born after 1960.

Besides the Medicare eligibility age of 65, what remains unchanged is that you can opt to begin drawing partial Social Security benefits as early as age 62. So, if you opt for accepting partial Social Security benefits before age 65, you are automatically enrolled in Medicare.

A smaller group of people also automatically get Medicare at age 65: people who receive Railroad Board benefits for at least four months before 65.

Is Medicare Part A Free

Typically, most people dont pay for Part A if they have paid Medicare taxes for a certain amount of time while working. However, if you dont qualify for premium-free Part A, it can be purchased for a monthly premium. This amount may vary each year and is based on how long you or your spouse worked and paid Medicare taxes.

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Covered Services In Medicare Advantage Plans

With a Medicare Advantage Plan, you may have coverage for things Original Medicare doesn’t cover, like fitness programs and some vision, hearing, and dental services . Plans can also choose to cover even more benefits. For example, some plans may offer coverage for services like transportation to doctor visits, over-the-counter drugs, and services that promote your health and wellness. Plans can also tailor their benefit packages to offer these benefits to certain chronically-ill enrollees. These packages will provide benefits customized to treat specific conditions. Check with the plan before you enroll to see what benefits it offers, if you might qualify, and if there are any limitations. Learn more about what Medicare Advantage Plans cover.

How Do Medicare Advantage Plans Work

Medicare Planning

A Medicare Advantage is another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. If you join a Medicare Advantage Plan, you’ll still have Medicare but you’ll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare.

These “bundled” plans include

, and usually Medicare drug coverage .

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How Do You Get Another Medicare Card

My card is lost or damaged Log into your secure Medicare account to print or order an official copy of your Medicare card. You can also call 1-800-MEDICARE to order a replacement card to be sent in the mail. TTY users can call 1-877-486-2048.

If you get Railroad Retirement Board benefits, you can call 1-877-722-5772 to get a replacement card. TTY users can call 1-312-751-4701.

My name changed Your Medicare card shows the name you have on file with Social Security. Get details from Social Security if you legally changed your name.

Protect your identity

Requirements To Continue Your Calpers Health Coverage

Before you turn 65, you must meet these requirements to continue your CalPERS health coverage:

  • Apply for Medicare by contacting the Social Security Administration . If you qualify for Medicare Part A at no cost because either you or your qualified spouse worked for 40 quarters in Social Security/Medicare-covered employment, you must also enroll in Medicare Part B as soon as you’re first eligible.

    When you enroll in Medicare Part A and Part B two to three months prior to your 65th birth month, CalPERS will work with the CMS to obtain your Medicare information and automatically transfer you from a CalPERS Basic health plan to a CalPERS Medicare health plan. If CalPERS is unable to obtain your Medicare information from CMS, you’ll need to complete and submit the Certification of Medicare Status form to CalPERS with copies of supporting documentation for manual processing.

  • If you’re ineligible for Medicare Part A at no cost, or if you’re deferring enrollment in Medicare Part B due to current working status and covered under an employer group health plan, you must complete the Ineligibility of Medicare Certification form.

    Submit the Ineligibility of Medicare Certification form to CalPERS with copies of supporting documentation prior to your 65th birth month to prevent cancellation of your CalPERS health coverage. You may remain in a Basic health plan if you’re ineligible for Medicare.

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    Do You Pay For Medicare After Retirement

    Budgeting for Medicare after retirementYoull need to pay monthly premiums, copayments, coinsurance, and deductibles. You can pay for premiums and other Medicare costs in several ways. While you could budget and save for healthcare throughout your life, other programs can help: Paying with Social Security.

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    Medicare: What You Need to Know

    We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

    MedicareInsurance.com, DBA of Health Insurance Associates LLC, is privately owned and operated. MedicareInsurance.com is a non-government asset for people on Medicare, providing resources in easy to understand format. The government Medicare site is www.medicare.gov.

    This website and its contents are for informational purposes only and should not be a substitute for experienced medical advice. We recommend consulting with your medical provider regarding diagnosis or treatment, including choices about changes to medication, treatments, diets, daily routines, or exercise.

    This communications purpose is insurance solicitation. A licensed insurance agent/producer or insurance company will contact you. Medicare Supplement insurance plans are not linked with or sanctioned by the U.S. government or the federal Medicare program.

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    Do You Have To Switch To Medicare From Your Employers Plan

    Some laws prohibit employers with over 20 employees from requiring Medicare-eligible employees to sign up for Medicare and drop the employer plan. But those laws do not apply to places that employ fewer than 20 people.

    At those companies with under 20 employees, the employer can decide, but its usually beneficial for those Medicare-eligible employees to enroll in Medicare.

    Theres no need to double up on coverage, especially if you are paying multiple premiums. You can compare what you are paying for group health coverage and what your benefits look like under that plan versus what you would pay under Medicare. You might even find that signing up for Medicare at 65 may make the most financial sense in any situation reviewed above.

    Not Checking Your Doctors For 2023

    If you have a Medicare Advantage plan, you generally must get medical care from doctors within that plan’s network and a plan’s network can change at any time. Before you decide to stick with the plan you’re in, make sure your preferred medical providers are still in the plan’s network in 2023.

    This may require some legwork on your part, since websites and provider directories aren’t always up to date.

    “I was just at a client, and said their doctor wasn’t in-network, and it took us calling the provider and looking up a different site on the network side,” said Evan Tunis, president of Florida Healthcare Insurance. “The best thing I would advise is to call the doctor’s office and just confirm with them.”

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    What Are The Circumstances That May Require Me To Renew Medicare Coverage

    So long as you pay your monthly premium and continue to collect Social Security, you will never need to renew your Original Medicare plan. Parts A and B are provided by the federal government and are not subject to the changes that may affect private insurers.

    Conversely, Medicare Advantage and Medicare Part D are offered by private insurers and therefore come with the same caveats youd expect from any insurance plan.

    The most common reason for needing to re-enroll in your plan is if your plan becomes unavailable in your area. This is most commonly due to a move but can also occur if a plan changes its service area. An insurance company might also decide to stop offering a specific plan. Finally, the government might stop offering a Medicare Advantage or Medicare Part D plan due to a low star ranking.

    Regardless of the reason, plan members affected by these changes are typically eligible for a Special Enrollment Period, allowing them to sign up for a different plan outside of typical enrollment periods.

    Can I Start Medicare Before My 65th Birthday

    Original Medicare

    You will have a Medicare initial enrollment period. If you sign up for Medicare Part A and Part B during the first three months of your initial enrollment period, your coverage will start on the first day of the month you turn 65.

    For example, say your birthday is August 31. Your initial enrollment period will begin three months prior to your birthday month, or in this case, May. If you sign up in May, June, or July, your coverage will start on August 1.

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    Medicare Part D Your Prescription Drug Plan

    Like Medicare Advantage, Part D plans are offered by private insurance companies that are approved by Medicare. Prescription drug benefits are often included as part of Medicare Advantage plans. However, if you choose to enroll in Original Medicare, you can add prescription drug coverage to your Original Medicare coverage. You can do this by purchasing a stand-alone Part D plan from a private insurer.

    • What Medicare Part D covers: Part D covers prescription drugs. Every Medicare prescription drug plan has a list of drugs that it agrees to cover. This list is known as a formulary. When you research a plan, check your list of medications against the prescription drugs in your plans formulary.
    • What Medicare Part D costs: Depending on the Part D plan you choose, you usually pay a monthly premium and sometimes a deductible. If your income exceeds a certain amount, youre also responsible for an extra monthly charge. Its called a Part D Income Related Monthly Adjustment Amount , and its on top of your premium. In addition, youre responsible for out-of-pocket costs for your drugs. But keep in mind each plan varies in the cost of premiums, the prices of drugs and the list of drugs covered.

    To learn more about Medicare Part D plans, go to “Unpacking Part D.

    How Do You Sign Up For Medicare

    Before you need to worry about a renewal, you need to apply for Medicare in the first place!

    Luckily, this is relatively easy: for Original Medicare , residents of the United States and its territories are automatically enrolled upon becoming eligible, provided theyre receiving Social Security benefits. If youre not receiving Social Security, youll need to sign up manually by contacting the Social Security Administration.

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    General Coverage And Enrollment

    Q: How do I find out about changes in services covered by Medicare?A: Throughout the year, the Centers for Medicare & Medicaid Services sends out updates about additional covered services or changes to existing covered services. These notifications are called National Coverage Determinations . View the NCDs for the current plan year .

    Q: Whats the difference between Medicaid and Medicare? A: Medicare is a federal program that provides health coverage to people age 65 and older, and to people with certain disabilities, such as end-stage renal disease. Medicaid is a public program that provides health coverage to people with low incomes.Q: If I sign up for a Kaiser Permanente Medicare health plan, will I lose my Medicare coverage? A: No. You wont lose Part A and Part B coverage. When you become a member, Kaiser Permanente will provide your Medicare benefits to you. Keep in mind that to sign up for a Kaiser Permanente Medicare health plan, youll need to be enrolled in Medicare Part B. Q: Can I be dropped from a Kaiser Permanente Medicare health plan? A: You can’t be disenrolled because of your health. Your membership can be ended for other reasons, which may include, but are not limited to:

    • Failing to pay your Kaiser Permanente premium, if your plan has one
    • Living outside a Kaiser Permanente service area for 90 days to 12 months
    • Moving permanently out of a Kaiser Permanente service area
    • Not staying enrolled in Medicare

    Medicare Part A: Hospital Insurance

    You still have time to enroll in a healthcare plan: Part 3

    Medicare Part A covers the costs of hospitalization. When you enroll in Medicare, you receive Part A automatically. For most people, there is no monthly cost, but there is a $1,556 deductible in 2022.

    Services covered under Part A may include surgeries, inpatient care in hospitals, skilled nursing facilities, hospice care, home healthcare services, and inpatient care in a religious non-medical healthcare institution.

    This sounds straightforward, but it’s not. For example, Part A covers in-home hospice care but does not cover a stay in a hospice facility.

    Additionally, if you’re hospitalized, a deductible applies, and if you stay for more than 60 days, you have to pay a portion of each day’s expenses. If you’re admitted to the hospital multiple times during the year, you may need to pay a deductible each time.

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    Costly Mistakes To Avoid With Medicare Open Enrollment

    Millions of retirees are in the thick of Medicare open enrollment, which runs from October 15 to December 7, but many find the process challenging.

    Some don’t understand the difference between Original Medicare and Medicare Advantage many are overwhelmed by Medicare advertising and only 4 in 10 people review their plan options each year, according to a July 2022 report from health care consulting firm Sage Growth Partners.

    This leads to Medicare open enrollment misses, including not confirming that your providers are in-network for the next plan year and not comparing your Medicare Part D prescription drug coverage with other available options.

    Below are 5 of the most common Medicare open enrollment mistakes.

    Common Services That Medicare Does And Doesnt Cover

    Heres general info about what Medicare does or doesnt cover for common health care needs. Visit medicare.gov/coverage for more detail. Also, check a Medicare health plans Summary of Benefits to learn whats covered.

    Medicare has some coverage for acupuncture and it is limited to treatment of chronic low back pain. Some Medicare Advantage plans have benefits that help pay for acupuncture services beyond Medicare such as treatment of chronic pain in other parts of the body, headaches and nausea.

    Assisted living is housing where people get help with daily activities like personal care or housekeeping. Medicare doesnt cover costs to live in an assisted living facility or a nursing home.

    Medicare Part A may cover care in a skilled nursing facility if it is medically necessary. This is usually short term for recovery from an illness or injury.

    The federal Medicaid program can help pay costs for nursing homes or services to help with daily living activities.

    Medicare Part B covers outpatient surgery to correct cataracts. It also pays for corrective lenses if an intraocular lens was implanted. Coverage is one pair of standard frame eyeglasses or contact lenses as needed after the surgery.

    Medicare Part B covers a chiropractors manual alignment of the spine when one or more bones are out of position. Medicare doesnt cover other chiropractic tests or services like X-rays, massage therapy or acupuncture.

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    Enrolling Through A Spouse Under 65

    If you’re currently ineligible for Medicare Part A without cost in your own right, you may be or become eligible through a current, former, or deceased spouse’s work history. If you’re eligible through a spouse, you may apply when your spouse is first eligible to receive Social Security benefits, generally at age 62. Contact the Social Security Administration at 325-0778 or TTY 325-0778 to clarify your Medicare eligibility through a spouse.

    Continue Learning About Medicare

    The Best Medicare Plan for You

    Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.

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    We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

    MedicareInsurance.com, DBA of Health Insurance Associates LLC, is privately owned and operated. MedicareInsurance.com is a non-government asset for people on Medicare, providing resources in easy to understand format. The government Medicare site is www.medicare.gov.

    This website and its contents are for informational purposes only and should not be a substitute for experienced medical advice. We recommend consulting with your medical provider regarding diagnosis or treatment, including choices about changes to medication, treatments, diets, daily routines, or exercise.

    This communications purpose is insurance solicitation. A licensed insurance agent/producer or insurance company will contact you. Medicare Supplement insurance plans are not linked with or sanctioned by the U.S. government or the federal Medicare program.

    MULTIPLAN_GHHK5LLEN_2023

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