Monday, May 16, 2022

Who Must Apply For Medicare

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What If I Am Rejected

Qualify for Medicare benefits…..? Must watch!

If you are rejected for Medicare or Medicaid you can call your local Social Security office to learn more and confirm you provided the correct information.

If you were denied because you did not provide the correct information then you need to reapply and give the correct document.

If you were rejected because you were deemed not eligible you may have to wait until you become eligible. If you believe you are eligible, you need to request

Having Creditable Drug Coverage

Before you officially delay Medicare, make sure you have creditable drug coverage. This means your employer drug coverage is at least as good as the standard Medicare Part D plan coverage. If your employer’s drug coverage isn’t creditable, you will need to enroll in a Part D plan during your Initial Enrollment Period to avoid the Part D late enrollment penalty . Consequently, you’ll also need to get either Part A or Part B in order to get a Part D plan.

After You Apply For Medicare

No matter how you applied, once your application is complete, the Social Security office will send you a copy of the information it has on record regarding your application. Be sure to double-check this document for any mistakes, as this is your chance to correct it.

Some time later, youll get your Medicare card via mail, so be on the lookout for envelopes from the Social Security office.

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How Do I Apply For Medicare Advantage

Medicare Advantage plans provide the same benefits as Original Medicare, and many plans may offer additional benefits that Original Medicare doesnt cover.

If you are eligible for Original Medicare, you may also be eligible for a Medicare Advantage plan. To find out more about your eligibility and to compare plans that are available where you live, call to speak with a licensed insurance agent today.

You can also compare plans online for free, with no obligation to enroll.

Find Medicare Advantage plans in your area

When Do I Have To Sign Up For Medicare

How Medicare and Social Security Work Together

If youre collecting Social Security, youll automatically be enrolled in both Part A and Part B. If youre not receiving Social Security, then youll want to sign up manually during your Initial Enrollment Period.

Three months before your 65th birthday, your Initial Enrollment Period window will start. Your IEP is a once-in-a-lifetime enrollment window that you dont want to miss.

If you do happen to miss it, youll have another opportunity to enroll during another enrollment period. However, you could get a penalty for not signing up when you first become eligible. The only way around the penalty is if you have creditable coverage.

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How To Get More Out Of Your Medicare Coverage

We covered the basics of how to apply for Medicare Part A and Part B, but of course thats not all there is to Medicare.

No matter your need, there is no shortage of options when it comes to Medicare. We’re here to help you navigate those options so you can find the best plan.

Check out our Medicare Guide if you’re looking for a more comprehensive explanation of your Medicare benefits.

What Are The Two Enrollment Methods

Automatic Enrollment

If youre already getting Social Security or Railroad Retirement Board benefits, you dont need to enroll in Medicare. Youll automatically get Original Medicare as of the first day of the month you turn 65.

Those who are automatically enrolled will receive a Welcome to Medicare packet, which will include your Medicare card, three months before turning 65.

If you want a Medicare Supplement Insurance policy.

If you decide you dont want Part B, you must return the Medicare card. If you keep the card, you keep Part B coverage and you will be charged the monthly premium.

Note that if you live in Puerto Rico, you will only receive Medicare Part A automatically. You need to call Social Security at 772-1213 or TTY 325-0778 to apply for Part B if you want it.

Manual Enrollment

You will not get Medicare automatically if you are not already receiving benefits from Social Security or the Railroad Retirement Board, even if youre close to age 65. You need to apply for Part A and Part B if you want them using one of the methods mentioned here, even if youre eligible for premium-free Part A.

The government expects you to know when to enroll. Be sure to apply for Part B during your Initial Enrollment Period unless you have current employment-based insurance coverage elsewhere. If you dont apply and sign up later, you will have to pay a Part B late enrollment penalty for as long as youre enrolled in Part B.

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How Long Does It Take To Sign Up

That depends on the method you choose. It can take as little as 10 minutes to sign up online, a month or more by phone or, if you prefer to sign up in person, it will depend on how long it takes to get an appointment.

  • Medicaid number, if applicable, with start and end dates.
  • Start and end dates for group health insurance through your employer.
  • Start and end dates of employment with the employer providing your group health plan.

Once your account is set up, you can start the Medicare application process here. Its unlikely that youll need to sign anything physically.

When youre finished applying online, youll get a confirmation number. Keep it handy and use it to check the status of your application through your My Social Security account. Social Security will let you know if more information is needed.4

Medicare Eligibility If You Are Under 65

How Do I Apply for Medicare?

People younger than 65 may qualify for Medicare if they have certain costly medical conditions or disabilities.

If you are under 65, you qualify for full Medicare benefits if:

  • You have been receiving Social Security disability benefits for at least 24 months. These do not need to be consecutive months.
  • You have end-stage renal disease requiring dialysis or a kidney transplant. You qualify if you or your spouse has paid Social Security taxes for a specified period of time based on your age.
  • You have amyotrophic lateral sclerosis, also known as Lou Gehrigs disease. You qualify for Medicare immediately upon diagnosis.
  • You receive a disability pension from the Railroad Retirement Board and meet certain other criteria.

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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 .

Who Is Eligible For Premium

Theres a monthly premium for Medicare Part A. You generally dont have to pay a Part A premium if either of these applies to you:

  • You or your spouse worked long enough while paying Medicare taxes
  • You or your spouse had Medicare-covered government employment or retiree who has paid Medicare payroll taxes while working but has not paid into Social Security.

Normally, you pay a monthly premium for Medicare Part B, no matter how many years youve worked. Read more about the Part A and Part B premiums.

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Documents Needed If You Sign Up In Person

  • An original or certified copy of your birth certificate or other proof of birth
  • Proof of United States citizenship or legal residency if not born in the U.S.
  • Your Social Security card if you are already receiving benefits
  • A copy of your most recent W-2 form and/or self-employment tax return
  • U.S. military discharge papers if you served before 1968
  • Health insurance information

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What Do The Different Parts Cover

Where do I apply for Medicare benefits? : Medicare Insurance

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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When Should You Apply For Medicare

In most cases, you should apply for Medicare as soon as you’re eligible. The initial enrollment period starts three months before the month you turn 65, includes your birth month, and extends three months past the month you turn 65, giving you a seven-month window to apply. Your Part B coverage will likely be delayed if you enroll the month you turn 65 , so apply early to avoid a gap in coverage.

Medicare imposes a hefty late enrollment penalty if you enroll in Part B or D after the initial enrollment period and don’t qualify for a special enrollment period .You might qualify for a SEP if you have coverage, including creditable drug coverage from an employer or a union . Medicare does not charge a late enrollment penalty for enrolling in a Medicare Advantage plan or Medicare Supplement plan after IEP. But it’s best to apply for Medigap as soon as you’re eligibleif you apply within the first six months of having Part B coverage, you can’t be denied a Medigap policy or be required to pay more because of health conditions. Here’s how enrollment works depending on whether or not you already receive Social Security benefits.

If you already receive Social Security benefits:

You should also check out the Medicare Enrollment Booklet which contains clear, concise information about both Medicare Part A and Part B.

If you are not yet receiving Social Security benefits:

When to get prescription drug coverage:

When Does My Coverage Start

The way you apply and when you apply will affect when your coverage begins. Your coverage may start immediately or 3 months after you apply.

Once your coverage starts, you will not need to reapply each year.

You can make a change or adjust your plan during the open enrollment period. This is from October 15th to December 7th of each year.

David Duford

David Duford is the owner of SSAOffices.com. He owns numerous businesses including life and Medicare agencies, dedicated to helping seniors with their insurance needs. David resides in Chattanooga, Tennessee with his wife and four chlidren.

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Medicare Advantage Open Enrollment Period

Medicare Advantage Open Enrollment happens every year from Jan. 1 to March 31. If youre enrolled in a Medicare Advantage plan and want to make changes, you can do one of these:

  • Switch to a different Medicare Advantage plan with or without drug coverage
  • Go back to Original Medicare and, if needed, also join a Medicare prescription drug plan

Your new coverage begins on the first day of the month following the month you make a change and will be in effect for the rest of the year.

Did You Answer Yes To Question 1

Medicare Advantage (MA) Application Training

If so, then you will most likely need to sign up for Medicare at age 65. Retirees that dont sign up for Medicare when they first become eligible can suffer from late penalties.

If you are a retiree who has a retiree health plan provided by a former employer, then you need to sign up for Medicare Parts A and B. Medicare is usually mandatory in this circumstance because it is primary to retiree health plans. If you dont enroll, you may be penalized for not signing up for Medicare on time.

People with retiree health plans should sign up for Medicare when they are first eligible. Usually, retiree health plans and Medicare work well together and provide substantial coverage.

On the other hand, maybe youre a retiree whose former employer doesnt offer retiree coverage, so you have an individual Health Insurance policy through the ACA marketplace exchange.

In this circumstance, it is mandatory to sign up for Medicare unless you are one of the few people who pay premiums for Part A. Youll still want to sign up for Medicare at age 65 to avoid late penalties, delayed coverage, and loss of Social Security benefits.

Visit this post for more information on why you should leave your ACA plan and transition to Medicare.

If you answered No to question 1 because you are still working, move on to question 2.

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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 .

  • 40B form: This form allows you to apply for enrollment into Part B only. The 40B form must be included in your online application or mailed directly to the Social Security office.
  • L564 form: Your employer must complete this form if you delayed Part B due to creditable group coverage through a said employer. The completed L564 form also must be included in your online application or mailed directly to the Social Security office.
  • When Do I Need To Sign Up For Medicare Part A

    As stated above, if youre collecting Social Security benefits, youll automatically get Part A and Part B. If youre not automatically enrolled, the best time to enroll in Part A is during your Initial Enrollment Period.

    As long as you worked a minimum of ten years, Part A will be premium-free. Even if youre still working, it makes sense to join Part A to help keep your out-of-pocket medical costs to a minimum.

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    How To Apply For Medicare In Person

    Some people prefer to apply for Medicare in person at a local Social Security office. This can be a convenient option if you are very close to turning 65 and need to get your application processed quickly.

    Visit the social security website to search for the office nearest you. When you meet with a representative, ask for a printout which shows that you have applied for Medicare Part A & B. This form will give you all the information you need to move forward with your Medicare supplement application and/or Part D drug plan.

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

    Apply for Medicare
    • 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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    How To Apply For Medicare: The Basics

    Original Medicare is made up of two parts: Part A and Part B.

    Part A is known as hospital insurance and covers services like a room, meals, nursing services, and treatment in a hospital or skilled nursing facility. Most people do not have to pay premiums for Part A because of the payroll taxes paid during their working career.

    Part B is known as medical insurance and covers services like tests, services performed by doctors , preventive services like flu shots, and much more. Part B is covered by a monthly premium, set by law each year.

    Although Medicare is its own entity, all applications for Original Medicare go through the United States Social Security Administration. You can apply for Medicare in one of three ways:

    • Online: This method is the easiest and quickest way to apply, taking ten to thirty minutes.
    • : If you want to talk to a human but from the convenience of your home.
    • In person: If your situation is complicated, you dont wish to mail important documents, or you prefer speaking to someone face-to-face.

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