Tuesday, August 2, 2022

When Can Someone Enroll In Medicare

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Initial Coverage Election Period

Optima Health – Medicare Eligibility

Another Medicare enrollment period is the Initial Coverage Election Period. The ICEP is your first opportunity to choose a Medicare Advantage plan instead of Original Medicare.

During the ICEP, you can also sign up for prescription drug coverage.

If you enroll in Part B when you turn 65, your ICEP is the same as your IEP. When you join later, your ICEP is the three months before your Part B coverage takes effect.

  • If youre newly eligible for Medicare because you turned 65, you can sign up for a Medicare Advantage Plan or Prescription Plan.
  • When on Medicare because of a disability, you can select a Medicare Advantage Plan or Medicare Drug Plan. Medicare coverage begins 24 months after SS or RRB disability benefits.
  • If youre already eligible for Medicare because of a disability and you turned 65, you can sign up for a Medicare Advantage Plan or a Prescription Drug Plan.
  • You can also switch from your current Medicare Advantage or Prescription Drug Plan to another plan.
  • Additionally, you can drop a Medicare Advantage or Prescription Drug Plan altogether. If you sign up for a Medicare Advantage Plan during this time, you can drop that plan during the next 12 months and return to Original Medicare.

What Are The Assets And How Are They Calculated

SSI is pretty strict in their definition of assets. Assets are pretty much anything that you own that has a measurable cash surrender value. The only exceptions in their consideration are home and car ownership.

They will not count the home you live in, or a car that you own. Everything else is fair game. That means that if you have any investments, retirement savings, or money in the bank, they will count those as assets and those assets will be added.

These are about the only assets that are not considered by SSI.

If you have life insurance, that also has a cash surrender value and can be counted as well. If you are collecting alimony or child support, that also is often counted as income.

If you reach the point of needing SSI but are concerned about being over their limits, think about ways that you may be able to manage your assets.

Al and I have always maintained separate bank accounts specifically so that if I needed some of the asset-based supports, it would be less complicated to apply.

That will also help us if Al needs to apply for support in the future, as joint bank accounts are considered in their full amount for each person on the account.

You do need to prove the existence of every asset you have, and in many cases, SSI has an annual recertification process where you reconfirm that you still meet the asset limits.

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How Much Does Part B Cost

The Social Security Act sets out the Medicare premiums, deductibles, and copays each year.

An individualâs income determines what they will pay for their Medicare Part B monthly premium. For individuals with an income below $88,000, the standard premium is $148.50 in 2021, with an annual deductible of $203.

According to the Centers for Medicare and Medicaid Services, about 7% of Medicare Part B beneficiaries will pay a higher income adjusted premium.

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Have You Or Your Spouse Worked For At Least 10 Years At Jobs Where You Paid Medicare Taxes

Generally, youre first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65.

Avoid the penalty If you dont sign up when youre first eligible, 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?

Sign Up: Within 8 Months After The Active Duty Service Member Retires

5 Tips For Navigating Medicare Open Enrollment
  • Most people dont have to pay a premium for Part A . So, you might want to sign up for Part A when you turn 65, even if the active duty service member is still working.
  • Youll pay a monthly premium for Part B , so you might want to wait to sign up for Part B.

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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Who Is Eligible For Medicare Advantage Plans

Youll automatically qualify for Medicare Advantage once you qualify for Part A and Part B coverage. Advantage plans are sold by private companies and are designed to cover some of the out-of-pocket costs Original Medicare does not cover.

4 Medicare Advantage Eligibility Requirements

  • You must be a U.S. citizen, a U.S. national or lawfully present in the U.S.
  • You must be enrolled in Medicare Parts A and B.
  • You must live in the chosen Medicare Advantage plan providers service area.
  • You must not have end-stage renal disease .
  • While regular Medicare Advantage does not cover ESRD, you may qualify for a Medicare Special Needs Plan . SNPs are special types of Advantage plans specifically designed for a particular condition or financial situation.

    You can keep your Medicare Advantage plan if you purchased it before developing ESRD. You can also buy an Advantage plan after being medically determined to no longer have ESRD usually from a successful kidney transplant.

    Don’t Leave Your Health to Chance

    Reasons Why You Might Wait

    If youre turning 65 but continuing to work and covered under your employers plan , delaying enrollment in Medicare Part B might be the best option. Heres a more detailed overview of everything you need to know about delaying your Medicare Part B enrollment.

    If your employer has at least 20 employees and covers you under a group health plan, you can delay your enrollment in Medicare Part B while you continue to be covered under the group plan. Youll want to check with your HR department to make sure that your plan is considered a group health plan under IRS rules. Assuming it is, you can wait to enroll in Medicare Part B which means you get to avoid the Part B premiums until you stop working or your employer stops offering the coverage .

    At that point, youll get an eight-month window during which you can sign up for Part B without a late enrollment penalty. Youll also be able to access your one-time guaranteed-issue window for enrolling in a Medigap plan at that point . Keep in mind that the employer-sponsored coverage has to be from a current employer COBRA or retiree benefits wont count. And if youre covered under a small-group plan from an employer with fewer than 20 employees, you need to enroll in Medicare when youre first eligible, as Medicare will be your primary coverage in that case.

    CMS has a helpful fact sheet that you can use to pinpoint your situation and decide whether it makes sense to delay your enrollment in Medicare.

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    Avoid Late Penalties By Signing Up During This Time

    If you become eligible for Medicare because you turn 65, you have a window of time during which to apply for coverage. This is called the initial enrollment period: It begins three months before the month in which you turn 65 and ends three months after, for a total of seven months. If you miss the initial enrollment period, you may have to pay lifetime penalties if you enroll later. Heres more information on the initial enrollment period and why its important.

    Can You Get Medicare At Age 60

    Understanding the Medicare Population and Consumer Affordability

    You cant enroll in Medicare before age 65 unless you have a permanent disability. If youre under age 65 and have a disability, youll automatically get Part A and Part B after 24 months of Social Security Disability Insurance or RRB disability benefits.

    The rules are more generous if you have permanent kidney failure or ALS. With either of these disabilities, you can qualify for Medicare right away without the typical 2-year SSDI waiting period. If you have ESRD, you have the option of joining a Medicare Advantage plan if you want, and any Part B late penalties are often waived.

    Some leaders and lawmakers previously have proposed lowering the Medicare eligibility age for the general population, but that hasnt come to pass. In his 2022 budget, President Joe Biden proposed giving people age 60 and older the option to enroll in Medicare. In 2021, more than 150 House Democrats suggested lowering the Medicare age to 60 or 55. A bill introduced to Congress in April 2021 aimed to give certain qualified individuals between the ages of 50 and 64 the option to enroll in Medicare.

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    If You Are Under Age 65 And Disabled:

    If you are under age 65 and disabled, and have been entitled to disability benefits under Social Security or the Railroad Retirement Board for 24 months, you will be automatically entitled to Medicare Part A and Part B beginning the 25th month of disability benefit entitlement. You will not need to do anything to enroll in Medicare. Your Medicare card will be mailed to you about 3 months before your Medicare entitlement date. , you get your Medicare benefits the first month you get disability benefits from Social Security or the Railroad Retirement Board.) For more information about enrollment, call the Social Security Administration at 1-800-772-1213 or visit the Social Security web site. See also Social Security’s Medicare FAQs.

    For more information, see Medicare.gov

    Do Husband And Wife Pay Separate Medicare Premiums

    You and your spouse pay separate premiums for Medicare benefits under Medicare Part B, and Medicare Part D if you sign up for it. If one or both of you choose to enroll in a Medicare Advantage plan, you will continue to pay separately the Medicare Part B premium and possibly a separate plan premium.

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    Full Retirement Age By Year

    Full retirement age is the age you begin to receive full Social Security benefits. If you start to draw your Social Security benefits before reaching your full retirement age, the payment you receive will be less.

    An easy way to think about full benefits and retirement age is this,

    • Social Security will reduce your payments if you choose to receive your benefit before full retirement age. The percentage of reduced amount is highest at age 62 and decreases until you reach full retirement age.
    • If you choose to receive Social Security payments when you reach full retirement, you will get the total amount.
    • Suppose you choose not to receive Social Security payments when you reach full retirement and delay your benefit. In that case, you can increase the amount of your payment by earning delayed retirement credits.

    If youre not sure when you reach full retirement age, our table provides the years and months you need to know for full retirement.

    Turning 65 What You Need To Know About Signing Up For Medicare

    What is Medicare Part A?

      The first of the 78 million baby boomers turned 65 on January 1, 2011, and some 10,000 boomers a day will reportedly reach that milestone between now and 2030. If you are about to turn 65, then it is time to think about Medicare. You become eligible for Medicare at age 65, and delaying your enrollment can result in penalties, so it is important to act right away.

      There are a number of different options to consider when signing up for Medicare. Medicare consists of four major programs: Part A covers hospital stays, Part B covers physician fees, Part C permits Medicare beneficiaries to receive their medical care from among a number of delivery options, and Part D covers prescription medications. In addition, Medigap policies offer additional coverage to individuals enrolled in Parts A and B.

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      Medicare enrollment begins three months before your 65th birthday and continues for 7 months. If you are currently receiving Social Security benefits, you don’t need to do anything. You will be automatically enrolled in Medicare Parts A and B effective the month you turn 65. If you do not receive Social Security benefits, then you will need to sign up for Medicare by calling the Social Security Administration at 800-772-1213 or online at . It is best to do it as early as possible so your coverage begins as soon as you turn 65.

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      Can I Sign Up For Medicare Plans Online

      Enrolling in Medicare coverage options online is generally easy and quick. More and more people are signing up online, according to an eHealth study. During 2018, about 16% of people in the study enrolled in Medicare coverage options online. Thatâs up from only 10% in 2017. In other words, about 60% more people in the study used eHealthâs online enrollment tool to sign up in 2018 than in 2017.

      Itâs interesting to note that online enrollment was even higher during âQ4.â Q4 means the 4th quarter of the year, October through December. Thatâs when Medicareâs Fall Open Enrollment happens for Medicare Advantage and Medicare prescription drug plans. Fall Open Enrollment goes from October 15 â December 7 every year.

      Sign Up: Within 8 Months After Your Family Member Stops Working

      • If you have Medicare due to a disability or ALS , youll already have Part A .
      • Youll pay a monthly premium for Part B , so you may want to wait to sign up for Part B.

      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 until you turn 65. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?

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      Automatic Enrollment For Original Medicare

      You are automatically enrolled in Original Medicare if you are actively receiving Social Security benefits when you become eligible.

      This occurs when you turn 65 years old or have a qualifying disability and have been on Social Security disability insurance for 24 months. In these cases, your premiums will be deducted from your Social Security check.

      Pros:

      • Whether you are on Original Medicare or a Medicare Advantage plan, everyone has to pay Part B premiums . Medicare Advantage plans, with some exceptions, charge their own monthly premiums. From this vantage point, Original Medicare is the cheapest option, at least when it comes to having access to Medicare.
      • Automatic enrollment means you will be enrolled on time. You will be able to avoid late penalties for Part A or Part B, some that could last as long as you have Medicare.

      Cons:

      • Enrollment in a Part D prescription drug plan is not automatic, and you still need to take steps to sign up for a plan if you want one. Part D late penalties could apply if you sign up too late.
      • If you want a Medicare Advantage plan instead, you need to be proactive. Pay attention to the Medicare calendar. If you do not change to a Medicare Advantage plan during your initial enrollment period, you will have to wait until the annual open enrollment period .

      What If Ive Worked But Not Long Enough

      From Prospect to Enrollment with Futurity Force

      You can still get Medicare Part A coverage, even if you dont fully meet the work requirement of 40 credits. Heres what youll pay in 2022:

      • If you have 30 to 39 credits, your Part A premium will cost $274 per month.
      • If you have fewer than 30 credits, your Part A premium will cost $499 per month.
      • If youre able to continue working and you accumulate 40 work credits, you wont have to pay the monthly premium for Part A coverage.

      Part A is the only part of Medicare that requires a specific amount of work history. You can enroll in Medicare parts B, C, and D without a work history.

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      Do I Need Medicare If I Am Covered By My Spouse’s Insurance

      If you have insurance through a spouse’s employer, you may also be able to delay Medicare past age 65. However, this depends on the rules the employer has for covered dependents of Medicare age. Some employers may require covered dependents to enroll in Medicare at age 65 in order to remain on the employer plan. In this case, you’ll need to talk directly with the employer’s benefits administrator to learn about what you can do about Medicare enrollment.

      I Am Turning 65 Next Year When Can I Sign Up For Medicare

      If you are eligible for Medicare, your initial enrollment period for Part A and Part B begins three months before the month of your 65th birthday and ends three months after it. For example, if your 65th birthday is in June, your enrollment period will extend from March 1 through September 30. If you join during one of the 3 months before you turn 65, coverage will begin the first day of the month you turn 65. If you join during the month you turn 65, your coverage will begin the first day of the month after you turn 65. If you join in the month after you turn 65, coverage will begin 2 months later, and if you join 2 or 3 months after you turn 65, coverage will begin 3 months later. A recent change in law limits these gaps in coverage. Starting in 2023, if you enroll in Medicare during the first 3 months after your turn 65, coverage will begin the first day of the month following the month you enroll.

      Once you have Part A and Part B, you are then also eligible to enroll in a Medicare Advantage plan and/or a Part D plan. If you are already receiving Social Security benefits when you turn 65, you will automatically be enrolled in Part A and Part B. If you are not already receiving Social Security benefits and you want to enroll in Medicare, you should contact Social Security.

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