Low Income Subsidy Questions
No. The “extra help” is a subsidy that people with Medicare and Medicaid automatically qualify for without having to complete an application.
If you do not have Medicaid, but Medicaid pays your Medicare Part B premium, you automatically qualify for “extra help” and you don’t need to apply.
You may still be eligible for “extra help” to pay for the Medicare prescription drug plan premiums. To apply for extra help, you should visit or call your local Social Security Administration office or apply on line at
Before You Call The Medicare Phone Number
Before calling 1-800-MEDICARE, have your Medicare card ready in case the representative needs to know your Medicare number. If you are calling with a question about a claim or a bill, have the bill or the Explanation of Benefits handy for reference.
It can also be helpful to keep a pen and paper ready to write down any important information your Medicare representative may share, such as additional phone numbers, dollar amounts, dates and more.
The Parts Of Medicare
Social Security enrolls you in Original Medicare .
- Medicare Part A helps pay for inpatient care in a hospital or limited time at a skilled nursing facility . Part A also pays for some home health care and hospice care.
- Medicare Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.
Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.
- Supplemental policies help pay Medicare out-of-pocket copayments, coinsurance, and deductible expenses.
- Medicare Advantage Plan includes all benefits and services covered under Part A and Part B prescription drugs and additional benefits such as vision, hearing, and dental bundled together in one plan.
- Medicare Part D helps cover the cost of prescription drugs.
Most people age 65 or older are eligible for free Medical hospital insurance if they have worked and paid Medicare taxes long enough. You can enroll in Medicare medical insurance by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. To learn more, read .
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How To Apply Online For Just Medicare
If you are within three months of turning age 65 or older and not ready to start your monthly Social Security benefits yet, you can use our online retirement application to sign up just for Medicare and wait to apply for your retirement or spouses benefits later. It takes less than 10 minutes, and there are no forms to sign and usually no documentation is required.
To find out what documents and information you need to apply, go to the .
What Is Medicare Supplemental Insurance
Its a medical insurance plan offered by private insurance companies that helps fill the gaps in Original Medicare Parts A and B. As mentioned, Original Medicare pays for roughly 80% of Medicare-approved services, but not all.
A supplemental insurance coverage policy can help pay the remaining healthcare expenses. These policies dont add coverage for procedures that Medicare wont cover. Instead, they help pay for what Medicare Parts A and B dont, including coinsurance, co-pays, and deductibles. It doesnt matter which doctors you can visit.
Medical Supplement plans are named with letters from A to N. The most popular being Plan F, Plan G, and Plan N.
The benefits youll get depend on the letter, but the plans are standardized. This means Plan G from one insurance company will offer the exact same benefits as Plan G provided by any other company. However, its important to compare Medigap before choosing one because of the price.
To clearly understand why the Medicare supplemental plan is valuable, you need to know what the original Medicare plan covers and doesnt cover.
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What Are My Options
Before Medicare, picking health insurance coverage while working for your previous employers was fairly straightforward: You picked a single plan for your doctor visits, prescriptions, and medical needs.
Medicare is very different. Medicare is made up of parts. Each part covers different things.
And to make it a little more complicated, each part has lots of different options within them. Let’s take a look.
Already Enrolled In Medicare
If you have Medicare, you can get information and services online. Find out how to .
If you are enrolled in Medicare Part A and you want to enroll in Part B, please complete form CMS-40B, Application for Enrollment in Medicare Part B . If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564, Request for Employment Information.
You can use one of the following options to submit your enrollment request under the Special Enrollment Period:
Note: When completing the forms CMS-40B and CMS-L564
- State I want Part B coverage to begin in the remarks section of the CMS-40B form or online application.
- If possible, your employer should complete Section B.
- If your employer is unable to complete Section B, please complete that portion as best as you can on behalf of your employer without your employers signature and submit one of the following forms of secondary evidence:
- Income tax form that shows health insurance premiums paid.
- W-2s reflecting pre-tax medical contributions.
- Pay stubs that reflect health insurance premium deductions.
- Health insurance cards with a policy effective date.
- Explanations of benefits paid by the GHP or LGHP.
- Statements or receipts that reflect payment of health insurance premiums.
Some people with limited resources and income may also be able to get .
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What Do I Do About Medicare If I Work Past Age 65
If you plan to work past 65, you may be able to delay enrolling in Medicare. Or, you may have to enroll during your Initial Enrollment Period in Parts A, B and D if you want to avoid late penalties. It will depend on your employer and if your employer coverage is creditable. You can find out what you need to do about Medicare when continuing to work here.
Some people who can delay Medicare still choose to enroll in just Part A when they turn 65 in addition to their employer coverage. Part A is premium free if you or your spouse worked and paid Medicare taxes for at least 10 years. Note though, if you do get Part A, you can no longer contribute to your HSA.
Signing Up For Medicare Over The Phone
You can sign up for Medicare over the phone. However, to do so, you do not call 1-800-MEDICARE. Instead, you.
In addition to enrolling in Medicare, you may also call Social Security to:
- Determine whether you’re eligible for Medicare
- Change your contact information, such as phone and address
- Request a Medicare card replacement
- Apply for Extra Help, the Medicare program that helps cover prescription drug costs
- Appeal an Income-Related Monthly Adjustment Amount decision
You may also perform all of the above tasks on the Social Security website. It’s faster, easier, and more convenient, particularly since you can only reach the Social Security Administration Monday through Friday from 8AM to 7PM.
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Getting Started With A Few Medicare Basics
You might not know that Medicare only offers individual coverage. Unlike health insurance plans before age 65, there is no family coverage plan with Medicare. That means your spouse or partner won’t be covered by your Medicare coverage they have to enroll on their own when they become eligible for Medicare.
Medicare gives you a 7-month time frame to sign up/enroll. For those who are eligible when they turn 65, that 7 months begins 3 months before the month you turn 65 and ends 3 months after the month you turn 65. This is the Initial Enrollment Period.
Medicare offers a Special Enrollment window for people age 65 who are still working and/or have health insurance through their employer or spouse’s employer. This window is also available to you if certain events happen in your life, such as moving or losing other insurance coverage.
If you miss the Initial Enrollment Period without qualifying for the Special Enrollment Period, you may have a big gap in your health care coverage. You would have to wait until the following January when the General Enrollment Period begins.
But here’s where missing the Initial Enrollment Period can hurt you: Signing up between January and March means your coverage doesn’t go into effect until the following Julyand you’ll be charged a late enrollment penalty that’s tacked on to your monthly premium .
Choosing The Right Medicare Plan
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I Can’t Afford My Medicare Premiums What Can I Do
If your income is limited, your State may help pay your Medicare costs such as your premiums and deductibles. Check the Important Phone Numbers page of this web site for the phone number of your State Medical Assistance Program. They can help you determine if you are qualified. If you have Medicare Part A, your income is limited, and your financial resources such as bank accounts, stocks, and bonds are not more than $4,000 for an individual, or $6000 for a couple, you may qualify for assistance as a Qualified Medicare Beneficiary or Specified Low Income Medicare Beneficiary. The Qualified Medicare Beneficiary Program pays the Medicare monthly Part B premium, deductibles and coinsurance. The Specified Low Income Medicare Beneficiary Program helps pay the Medicare monthly Part B premium for qualified Medicare beneficiaries.
Medicare Phone Number: Speaking To A Person At Medicare
Sometimes, it may be preferable to speak with someone at Medicare. The Medicare phone number is 800-MEDICARE, or 800-633-4227. A deaf or partially deaf person may call 877-486-2048.
An individual may call Medicare with questions about coverage, medical records, claims, billing, and expenses.
In addition to speaking with Medicare over the phone, individuals may acquire much of the information they need through two websites.
This article provides an overview of Medicare, explains what to expect when calling Medicare, and discusses alternate contact methods and contact methods for people with specific needs. Lastly, it examines non-Medicare sources for Medicare information.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare is the federal insurance program for individuals who are aged 65 and older, along with some younger people who have specific health conditions. It also provides coverage for a person of any age with end stage renal disease.
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Can Someone Call Medicare For You
You can have someone else call Medicare for you, but you will have to take some steps first. Medicare will not give out your private medical information to anyone who calls unless you first give Medicare permission to do so.
You will either have to speak to the customer service representative on the phone and confirm that he or she can speak to someone else on your behalf.
Or you can send an authorization form before the call.
How to Fill Out a Medicare Disclosure Authorization Form
- You can fill out the form online, letting someone call and speak for you immediately.
- You can download and fill out a paper form in English or Spanish that you can mail to Medicare BCC, Written Authorization Dept., P.O. Box 1270, Lawrence, KS 66044.
If you mail in your authorization, it may take a few weeks before permission is granted.
You have the ability to choose how long this authorization will stay in effect. It can be as short as the one call or as long as a lifetime permission. This is helpful when you are caring for an elderly parent or a sick dependent and/or spouse.
Will I Automatically Be Enrolled In Medicare When I Turn 65
If you are receiving Social Security or Railroad Retirement or disability benefits, you will be automatically enrolled in Medicare Part A and Part B. About 3 months prior to your 65th birthday or 24th month of disability, you will be sent an Initial Enrollment Package that will contain information about Medicare, a questionnaire and your red, white and blue Medicare card. If you want both Medicare Part A and Part B , you should sign your Medicare card and keep it in your wallet. If you don’t want Part B coverage, you must put an X in the refusal box on the back of the Medicare card form sign the form and return it with the card to Social Security at the address shown. You will then be sent a new Medicare card showing that you only have Part A.
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Medicare Prescription Drug Coverage
Medicare Prescription Drug Plans are sold by private insurance companies approved by Medicare. All people new to Medicare have a seven-month window to enroll in a PDP three months before, the month of and three months after their Medicare becomes effective. The month you enroll affects the PDPs effective date. All people with Medicare are eligible to enroll in a PDP however, unless you are new to Medicare or are entitled to a Special Enrollment Period, you must enroll or change plans during the Open Enrollment Period for Medicare Advantage and Medicare Part D, Oct. 15 through Dec. 7. There is a monthly premium for these plans. If you have limited income and assets/resources, assistance is available to help pay premiums, deductibles and co-payments. You may be entitled to Extra Help through the Social Security Administration. To apply for this benefit contact SHIIP at 1-855-408-1212 or the Social Security Administration at 800-772-1213 or www.socialsecurity.gov.
Who Can I Contact With Medicare Questions
If youre age 65 or are coming close to it, applying for Medicare and shopping for additional coverage can seem like a complicated process. There are dates to remember for enrollment, limits and rules around coverage and plenty of options to sift through. When you have questions about Medicare, its important to find accurate information.
Your questions regarding Medicare may vary depending on whether youre already enrolled in Medicare or if you just want to check your eligibility. You may also have different concerns related to coverage, whether from Medicare Supplement insurance or a Medicare Advantage plan. If your coverage changes or guidelines change, and your existing plan is phased out, youll want a trusted partner to help navigate your options moving forward. No matter your comfort level with your Medicare coverage, SelectQuote is ready to help connect you to the resources you need.
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Find A $0 Premium Medicare Advantage Plan Today
For California residents, CA-Do Not Sell My Personal Info, .
MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts enrollment in any plan depends upon contract renewal.
The purpose of this communication is the solicitation of insurance. Callers will be directed to a licensed insurance agent with TZ Insurance Solutions LLC, TruBridge, Inc. and/or a third-party partner who can provide more information about Medicare Advantage Plans offered by one or several Medicare-contracted carrier. TZ Insurance Solutions LLC, TruBridge, Inc., and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program.
Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult www.medicare.gov.
Medicare has neither reviewed nor endorsed this information.
Medicare Questions We Have Answers
It is important to sign up for a Medicare Part D Drug plan when you are first eligible. If you do not sign up when first eligible you will most likely have to pay a late penalty. If you have creditable drug coverage you will not have a late penalty.
There are 2 ways to receive a Medicare Prescription Drug Plan or a Part D plan:
You can add drug coverage to Original Medicare
You can get a Medicare Advantage Plan with drug Coverage. Advantage Plans are HMOs or PPOs you get your Part A and B and Drug Coverage through Advantage Plans
For more information or to enroll contact your State Health Insurance Assistance Program for Missouri the number is 1-800-390-3330.
2. What do I do if I am enrolled in a non-benchmark Medicare Plan, but found out that I am eligible to enroll into a Benchmark plan.
There are 4 benchmark plans in 2016 that a beneficiary receiving extra help can enroll. The premium for the benchmark plan will be zero and there is no deductible. If a beneficiary, who receives full extra help, enrolls in a non-benchmark plan then the premium will be reduced and the beneficiary will be required to pay that monthly premium.
3. What do I do if I am already enrolled in Medicare, but also have employer-sponsored or other third-party insurance plan?
4. What do I do if I enroll in a Medicare plan and later have to make an adjustment because of a major life event?
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