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Are You Asking The Right Questions When It Comes To Your Medicare Enrollment?

Are you reaching Medicare Eligibility age, and you just aren’t sure where to begin with it, or what questions you should be asking? Our agents compiled a list of seven of the most asked questions they get asked daily, and we decided we needed to share them:

1. When can I enroll in Medicare?  

A. You can enroll in Medicare during your ICEP, Initial Coverage Election Period.  This time frame is the 3 months before your 65th birthday, your birth month, and the 3 months directly following your birth month. The sooner you get enrolled the better. You should never delay your enrollment as it could result in an indefinite penalty.  

2. If I continue to work past age 65, and have coverage through my employer do I still need to sign up for Medicare?

A. Many Medicare eligibles that we speak with have decided to continue working past the age of 65, and many will remain covered by their group health plan.  In this case you have two options. You could delay both Medicare Part A and Part B as long as they have creditable coverage, which means as good as Medicare. OR you can elect to your Part A, which is premium free and delay Part B until retirement. Depending on the size of the group one plan would become primary while the other would be secondary.  

The first step would be to call your HR Department and verify if your coverage is creditable. The next step would be to apply for Medicare Part A Or Part A and Part B

3. Do I have to apply for Medicare?  Or will I be enrolled automatically? 

A.  If you are already collecting Social Security when you turn 65, either retirement benefits or disability benefits, you will be automatically enrolled in Part A and Part B. (You become Medicare eligible when you either turn 65, or have collected Social Security Disability for 24 months.)  If you are not automatically enrolled when you become eligible, you must enroll through Social Security.  You can do this over the phone, online or at your local Social Security Office. 
(People with Lou Gehrig’s Disease (ALS) or End Stage Renal Disease (ESRD) do not have to collect Social Security Disability for 24 months to qualify for Medicare)   

4. Do I have to pay for Medicare?

Medicare Part A is generally free for most people. As long as you, or your spouse, has worked and paid into Medicare taxes for 40 quarters, which is 10 taxable years, your will not have to pay Part A premiums.  If you do not have enough quarters, there will be a premium amount you will be required to pay in order to receive Part A benefits. There is a premium amount associated with Part B, and Social Security will be able to tell you the exact amount you will be paying monthly. If you enroll in an MA, Medigap or Part D Prescription Drug Plan, you may have a monthly premium associated with those as well.  

5. I am low income and cannot afford much.  Are there programs available that can help me afford my Medicare?

A. The answer is yes.  There are programs in every state that have Medicare Savings Programs (MSP’s) that, if you qualify, could help pay for your Part B premiums.  MSP’s also help pay for copays and deductibles. We can also see if you would qualify for Extra Help.  Extra Help is a federal program that can help pay for Part D (prescription drug) costs. 

6. I am 65, but my spouse is younger than I am by several years.  Can my spouse enroll in Medicare too? 

A. The answer to that question is no.  Your spouse cannot be enrolled in Medicare based on your eligibility.  In order to qualify for Medicare an individual must be:

  • Age 65
  • Or have received Social Security Disability Benefits for 4 months
  • Or have End Stage Renal Disease (ESRD)
  • Or have Lou Gehrig’s Disease (ALS)

7. Can someone refuse Medicare?

A. Yes, someone can refuse Medicare. Most people who have Group, VA. COBRA, or a Retirement options will typically refuse Part B. They don’t see the need to pay for the Part B premium if they have another source for coverage. Part A is free for those who worked 40 quarters so most people won’t refuse it. 

There is a lot to consider before taking this approach. If they have Group Coverage, is the prescription portion Creditable? Does having Part B actually save them money on deductibles and coinsurance? Do they meet the VA’s priority list each year? What if the illness is not service related or they have an emergency? Be aware of COBRA’s deadlines, also, this coverage is NOT Creditable. Retirement plans are not considered Creditable and can be canceled or sold at any time, leaving the beneficiary exposed to Medicare’s Late Enrollment Penalty. It is strongly advised to speak with an expert before making the decision to refuse Medicare.  

Do you have a question that we didn’t tackle here? Then give us a call!

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