When Is My Medicare Initial Enrollment Period
For most people, enrolling in Medicare Part A is automatic. However, there are several instances where you may have to manually enroll in Medicare Part A and/or Part B during your Initial Enrollment Period , the seven-month period that begins three months before you turn 65, includes the month of your 65th birthday, and ends three months later.
Some situations where you would enroll in Medicare during your initial enrollment include:
Can You Appoint A Representative
You may appoint another person to serve as your representative in the appeal. Your representative may be anyone you choose, including your doctor, a family member, friend, or an attorney.
The easiest way to appoint a representative is to complete and submit the Appointment of a Representative form . Just follow the instructions included with the form.
Your second option is to submit a written request that includes the following information:
- Your name, Medicare ID number, address, and phone number
- A statement that you are appointing someone else as your representative AND that you authorize the release of your personal and identifiable health information to said representative
- Your representative’s name, address, and phone number
- Your relationship to your representative AND your representative’s profession, if your relationship is in a professional capacity
- An explanation of why this person is representing you and to what extent
You may also talk to your State Health Insurance Assistance Program for assistance in filing your appeal.
When Can I Enroll In Medicare If I Am Not Receiving Retirement Benefits:
If you are not yet receiving retirement benefits and are close to turning 65, you can sign up for Medicare Part A and/or Part B during your IEP. If you decide to delay your Social Security retirement benefits or Railroad Retirement Benefits beyond age 65, there is an option to enroll in just Medicare and apply for retirement benefits at a later time.
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Level : Redetermination By The Medicare Administrative Contractor
If you disagree with the initial coverage decision listed on the Medicare Summary Notice, you may request a redetermination. You have 120 days from receipt of the MSN to make your request. Appeal instructions include:
- Circle the decisions listed on the MSN that you disagree with and add your name, phone number, and Medicare number
- On a separate sheet of paper, provide a written explanation of why you disagree with the decision and attach it to the MSN
- Attach any documentation you receive from your Medicare provider, adding your Medicare number to all documents
Send your packet to the MAC address listed on the Medicare Summary Notice, under the “File an Appeal in Writing” section. Include the name of your representative, if applicable.
You may also download, complete, and submit CMS-20027: Medicare Redetermination Request Form. If you don’t have access to a printer, you may call 1-800-MEDICARE or TTY 1-877-486-2048 to request any form listed on this page.
The Medicare Administrative Contractor should notify you of their decision within 60 days. If you send supporting documentation after filing your request for redetermination, it may take longer than 60 days.
When Can You File A Medicare Appeal
You may file a Medicare appeal if you disagree with Medicare’s decision regarding one of the following requests:
- A healthcare service, item, prescription, or supply that you believe should be covered
- Payment for a healthcare service, item, prescription, or supply that you already received
- To change your out-of-pocket cost for a healthcare service, item, prescription, or supply
You may also file an appeal if the Medicare program or your Medicare insurance plan refuses or reduces continuing coverage for a healthcare service, item, prescription, or supply you were receiving.
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If Your Claims Aren’t Being Filed In A Timely Way:
When Is My Initial Enrollment Period For Medicare Part D:
You can enroll in a stand-alone Medicare prescription drug plan during your Initial Enrollment Period for Part D. You are eligible for prescription drug coverage if:
- You live in a service area covered by the health plan, and
- You have Medicare Part A AND/OR Medicare Part B.
Generally, your Initial Enrollment Period for Part D will occur at the same time as your Initial Enrollment Period for Medicare Part B .
Once you are eligible for Medicare Part D, you must either enroll in a Medicare prescription drug plan, Medicare Advantage Prescription Drug plan, or have creditable prescription drug coverage. Some people may choose to delay Medicare Part D enrollment if they already have creditable prescription drug coverage through an employer group plan.
However, if you do not sign up for prescription drug coverage when you are first eligible for Part D, you may have to pay a late-enrollment penalty for signing up later if you go without creditable prescription drug coverage for 63 or more consecutive days.
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Applying For Medicare With Employer Coverage
Can you still enroll in Medicare coverage, even if youre not yet seeking retirement? The answer is yes! Medicare coverage can coincide with your group coverage through your employer. If your employer has more than 20 employees, your group coverage will work as your primary insurance, and Medicare will be your secondary insurance.
You can choose to apply for Part B, or you can wait until leaving your employer group coverage. For more information on the benefits of obtaining Medicare while receiving group coverage through work, give our team a call, and we can review the pros and cons.
Sometimes beneficiaries dont want to apply for Part B when they initially become eligible because of employer health coverage. Should you lose your health insurance through your employer, or if you prefer to switch over to Medicare, you can apply any time while receiving coverage through your employer.
What Do The Different Parts Cover
Medicare Part A covers hospital stays and care, while Part B covers physician fees and other costs associated with diagnosing and treating medical conditions. Medicare Part C, called Medicare Advantage, offers options for extra coverage that may include vision, dental, and wellness care. Medicare Advantage plans cover at a minimum what Medicare Part A and Part B cover . Most MA plans also provide prescription drug coverage. You can only apply for a Medicare Advantage plan if you’re already enrolled in both Part A and Part B. Medicare Part D covers prescription medications. If you have a Medicare Advantage plan with prescription drug coverage, you probably don’t need a separate Part D plan.
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What If I Cant Get Copies
You should submit your application even if you dont have copies of some of these documents. Social Security might be able to help you track them down.
In fact, Social Security can often request copies and verification from your states Bureau of Vital Statistics. If not, it can help you get the forms you need in order to get the documents yourself.
The way you enroll in Medicare depends on which parts of Medicare you choose. There are different methods for enrolling in original Medicare as opposed to Medicare Advantage , Medigap, and Part D plans.
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Calculate The Best Time To Start Social Security
If you are confused about when to start, you can use the Social Security Explorer part of the NewRetirement Retirement Planner to compare your monthly income and maximum lifetime payout at different ages.
Or, you might consider the following rules of thumb:
- Take Early: The only people who should consider taking their Social Security early are those who absolutely need the money immediately, or those who do not expect to live for very long, due to illness
- Take at Full Retirement Age: Should you have reason to believe that you will not live past the age of 80, then generally speaking you will maximize your social security benefits if you take them when you reach your Full Retirement Age.
- Wait as Long as Possible: On the other hand, if you are confident that you will live past the age of 80 or 85, then most experts recommend that you defer your social security for as long as you can , so as to maximize the benefits you receive from it.
- Other: If you have dependent children, the additional benefits you receive for them might make filing when you are younger worthwhile.
It can also be a very good idea to have an overall retirement plan before you decide when to start your Social Security benefits. The NewRetirement Retirement Planner can help you assess all of your sources of retirement income and whether or not you will have enough to cover your expenses. This tool was recently named a best retirement calculator by the American Association of Individual Investors .
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Explore Your Other Medicare Coverage Options
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.
Am I Eligible For Medicare
To receive Medicare, you must be eligible for Social Security benefits.
Part A Eligibility
Most people age 65 or older are eligible for Medicare Part A based on their own employment, or their spouse’s employment. Most people have enough Social Security credits to get Part A for free. Others must purchase it.
You are eligible for Medicare Part A if you meet one of the following criteria:
- You are eligible for Social Security or Railroad Retirement benefits, even if you do not receive those benefits.
- You are entitled to Social Security benefits based on a spouse’s, or divorced spouse’s work record, and that spouse is at least 62 years old.
- You have worked long enough in a federal, state, or local government job to be eligible for Medicare.
If you are under 65, you are eligible for Medicare Part A if you meet one of the following criteria:
- You have received Social Security disability benefits for 24 months.
- You have received Social Security benefits as a disabled widow, divorced disabled widow, or a disabled child for 24 months.
- You have worked long enough in a federal, state, or local government job and meet the requirements of the Social Security disability program.
- You have permanent kidney failure that requires maintenance dialysis or a kidney transplant.
- You are diagnosed with ALS or Lou Gehrig’s disease.
Part B Eligibility
If you are eligible for Part A, you can enroll in Medicare Part B which has a monthly premium.
Will I Need To Prove My Age?
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You Should Only Need To File A Claim In Very Rare Cases
Medicare claims must be filed no later than 12 months after the date when the services were provided. If a claim isn’t filed within this time limit, Medicare can’t pay its share. For example, if you see your doctor on March 22, 2019, your doctor must file the Medicare claim for that visit no later than March 22, 2020. Check the “Medicare Summary Notice” you get in the mail every 3 months, or log into your secure Medicare account to make sure claims are being filed in a timely way.
Should You Apply For Ssi Or Ssdi How Are They Different
Social Security Disability Insurance offers benefits to working people who are disabled before retirement age and cannot now work. An applicant must have previously worked, paid FICA taxes, and have a condition defined by the SSA as a disability.
Supplemental Security Income is a different program, funded by the taxpayers, that assists low-income blind or disabled workers. In some circumstances, children may qualify for SSI benefits. SSI applicants must also have a monthly income below the minimum income threshold.
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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 .
Can I Apply For Medicare Prescription Coverage Online
You can apply for Medicare prescription coverage online through the Medicare Plan Finder or the plans website. You can also apply for prescription drug coverage through a paper enrollment form or by calling the plan or Medicare at 1-800-MEDICARE.
When applying for Medicare prescription coverage, youll need to provide your Medicare Number and the date your Part A and/or Part B coverage began, both of which can be found on your Medicare card.
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What Does Medicare Cover
Medicare helps pay for certain health care services and durable medical equipment. To have full Medicare coverage, Medicare beneficiaries must have Part A and Part B .
The following is a partial list of Medicare-covered services. The covered services listed below may require payment of deductibles and Co-Payments.
If you have questions about covered services, call Medicare at 1-800-633-4227.
Where Can I Park With A Disabled Parking Permit In Washington
Washington State disabled parking placard, plate, or decal holders can park in any designated disabled parking space in the state. They can also park in any on-street, time restricted, metered parking space for free for an unlimited period of time. This does not apply to privately owned parking spaces or spaces designated for special vehicles such as loading bays, fire lanes, or bus lanes.
Van-accessible disabled spaces are for wheelchair vans only. However, these spaces can be used by a car with a disabled placard or plate if there are no regular disabled spaces available in the vicinity. Washington State disabled parking permit holders are not allowed to park in areas where all parking, stopping, or standing of vehicles is prohibited.
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How To Sign Up For Medicare
Some people are automatically enrolled in Original Medicare while others need to sign up on their own. In this guide, we explore the step-by-step process of enrolling in Medicare Part A and Part B as well as Part D drug plans, Medigap policies and Medicare Advantage plans.
On This Page
You are automatically enrolled in Medicare Part A and Part B if:
If you already collect Social Security retirement benefits, you are automatically enrolled in Medicare Part A and Part B. No further action is required.
Your coverage will begin the first day of the month you turn 65.
Even if you are automatically enrolled, you may also decide to:
- Sign up for a Medicare Part D drug plan.
- Buy a Medigap supplement insurance policy.
- Switch to a Medicare Advantage plan.
Sign Up For A Mymedicaregov Account
After you sign up for Medicare, you can create a MyMedicare.gov account to manage your coverage.
With your MyMedicare.gov account, you can:
- Get details about the plans youre enrolled in and what they cover.
- Update your personal information.
Creating an account on MyMedicare.gov is quick and easy.
How to Sign Up for MyMedicare.gov
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How To Apply For Medicare
You can apply online or sign up by calling Social Security at 1-800-772-1213. If you’re still working at 65, here’s how it works.
If you are still working, age 65 or older, and covered by group health insurance:
When you turn 65, you should enroll in Medicare Part A even if you have health insurance from an employer. If you aren’t sure, check with your benefits department. Your group health plan usually becomes the secondary payor, with Medicare paying first. Unless your benefits department specifically tells you otherwise, you should apply for Medicare Part A.If you have not applied for Medicare yet, do so as soon as possible.
If you lose your group coverage, you can sign up for Part B during a special enrollment period . This situation may occur if you terminate employment after you reach 65. There is usually no late enrollment penalty if you sign up during the Special Enrollment Period.
For those who do not sign up at 65 and are not eligible for a SEP, Medicare has a general enrollment period each year from January 1 to March 31. If you apply for Medicare during this time, your benefits take effect July 1.
Once you enroll in Part A or Part B, you can enroll in a Part D prescription drug plan. If you’re enrolled in Part A and Part B, you can enroll in a Medicare Advantage plan.
If you have Medicare Part A, and now need to start Part B: