Medicare Part B Enrollment

Medicare Part B Enrollment

Question: Do I need to enroll in Medicare Part B when I turn 65? 

Answer:  Maybe.

If you have elected early Social Security retirement or have been on Social Security disability for less than 2 years you SHOULD be automatically enrolled in Medicare Part B at age 65. In this case the premium will be deducted monthly from your Social Security check. You still need to verify with Social Security that you are in fact enrolled in Medicare Part B because mistakes can happen. 

If you were born after 1943, your full retirement age is later than age 65. Here is a link for more information about retirement age: http://www.socialsecurity.gov/retire2/agereduction.htm . You very likely may not be receiving Social Security.

If you are not receiving Social Security you will need to contact them and enroll in Medicare Part B – IF YOU NEED IT.

If you are employed by a company with 20 or more employees or are covered under an employed spouse and have health insurance through the employer’s group health plan, you may not need to enroll in Medicare Part B. This group insurance typically is PRIMARY to Medicare. Check with your HR department or the insurance company. When you leave this employer health plan you will have 8 months to enroll in Medicare Part B without a penalty.

If you are employed by a company with less than 20 employees or are covered under an employed spouse and have health insurance through the employer’s group health plan, you will need to enroll in Medicare Part B or receive a penalty should you enroll at a later time.

This group insurance typically is SECONDARY to Medicare. In many cases you will have better benefits at a lower cost if you drop the employer group health plan and use original Medicare with a Medicare Supplement. Social Security will bill you quarterly for the Medicare Part B premiums.

Should you fail to enroll in Medicare Part B during your initial enrollment period (3 months prior to and 3 months after your 65^th birthday) or during your special enrollment period after leaving qualified group health coverage (within 8 months after coverage ends) you may only enroll in Medicare Part B during annual enrollment (January through March each year) and your part B coverage will begin the following July. You will also be assessed a premium penalty based on the length of time you have been eligible but without Medicare Part B.

It is VERY important to make sure your Medicare coverage is correct. At age 65 you will receive an approval letter and a Medicare card whether you enroll in Medicare Part B or not (in most cases). Most people get Medicare Part A automatically at age 65 without premium. Check your approval letter for accuracy of coverage and check your Medicare card for accuracy. Make corrections immediately.

For answers to your Medicare Questions or to request a quote on a Texas Medicare Supplement or Part D Drug Plan visit www.MedicareAnswersfromConnie.com .



Medicare and Social Security Disability at Age 65

Medicare and Social Security Disability at Age 65

Question:  I am on Social Security disability. I turn 65 in September. Do I need to do anything and is anything going to change in my disability status?

Answer:  If you have been on disability longer than 25 months, you may be aware that while you can get Medicare in the 25^th month, you can only get a Plan A Medicare Supplement in Texas. If it’s been less than 24 months, congratulations, you can now get Medicare! Once you reach age 65, all Medicare Supplement plans are available to you. If you are interested in getting a Medicare Supplement, you need to apply within six months before or after your 65^th birthday to be in the guarantee issue period. This is your initial enrollment period and after this time you would be required to meet certain underwriting health criteria to qualify. Given your disability, you may not be able to get a Supplement outside this period. 

Your Social Security Disability will stay the same. Because your birth year is 1946, you do not reach full retirement age until you are 66. At that time your status will change with Social Security from disability benefits to retirement benefits but you do not have to do anything and benefits will not change. It’s just bookkeeping with Social Security! Also at age 66(full retirement age) there is not a limit on the amount of income you can earn in addition to your retirement benefits.

Here is a link to Social Security that provides details on allowable earnings prior to and after retirement age:  http://www.ssa.gov/pubs/10003.html . Scroll through the page a little, the information you need is down a little!

Medicare, Social Security and the Congressional Deficit Reduction Plan

Medicare, Social Security and the Congressional Deficit Reduction Plan

Question:  What are the proposals Congress is making to cut Medicare and Social Security?

Answer:  Congress is looking at cuts in Medicare and Social Security as part of the deficit reduction plan. Details are veiled but basically involve greater cost sharing on the part of you, the beneficiary. Cost sharing is a popular concept in insurance that simply means you pay more out of your pocket for your care. You can get more information and find out what you can do to take action to prevent Medicare and Social Security cuts by calling 1-866-869-1923, M-F 8-4  CDT. You will talk to an operator, who will guide you through the latest developments and then connect you directly to one of your representatives' offices.

Medicare, Tricare for Life and Dental, Vision and Hearing Aid Benefits

Medicare, Tricare for Life and Coverage for Dental, Vision and Hearing Aids

Question:  Does Medicare cover dental care? vision? hearing aids? The person in question is on Medicare A&B with Tricare for Life as the supplement, and is also on Social Security disability.

Answer:  Medicare does not cover routine dental, vision or hearing aids. Here is a link to details:  http://blog.medicareanswersfromconnie.com/2011/03/medicare-coverage-for-dental-and-vision.html

Tricare for Life does provide some dental coverage; there are also some provisions for obtaining hearing aids. Here is a link to the Tricare For Life Handbook: 

http://www.tricare.mil/mybenefit/ProfileFilter.do;jsessionid=TvcL2V0SMv6TQpXGvzCyCf0yZWvB2dF2RchgpxqJTfWr1f0Zk8cJ!-1473747591?puri=%2Fhome%2Foverview%2FPlans%2FLearnAboutPlansAndCosts%2FTRICAREForLife

I think you’ll find the entire handbook helpful but be sure to check out Page 17 (hearing aids) and Page 21(provisions for dental care).

If the disability is service related, there is a very good possibility there are additional benefits available through the VA. Contact the VA to learn what benefits are available. Here’s a link to numbers for the VA:  https://iris.custhelp.com/app/answers/detail/a_id/1703 

For answers to your Medicare Questions or to request quotes on a Medicare Supplement or Part D Drug plan visit www.MedicareAnswersfromConnie.com.

Be Sure to Read my Book, Available at Amazon.com
 

 

 

Medicare Coverage of Ostomy Supplies

Medicare Coverage for Ostomy Supplies

Question:   I have Medicare Part B coverage mainly to partially cover ostomy appliance costs. I've heard Medicare Part B no longer covers this. Is this so?

Answer:  Providers must be APPROVED suppliers but ostomy supplies are covered by Medicare Part B. Here is a link that should give you complete information: http://www.medicare.gov/Coverage/Search/Results.asp?State=TX%7CTexas&Coverage=44%7COstomy+Supplies&submitState=View+Results+%3E

This information is specific to Texas.

A Medicare Supplement could pay the deductible and coinsurance for ostomy supplies not covered by Medicare Part B.

For answers to your Medicare Questions or to request a quote on a Texas Medicare Supplement or Part D Drug Plan visit www.MedicareAnswersfromConnie.com .

Medicare Coverage for Bariatric Surgery

Medicare Coverage for Bariatric Surgery

Question:  If a person is diabetic, high blood pressure and all that goes with those two, like obese yet can’t get their weight down and it becomes a life or death situation, would they qualify for any of the surgeries for weight loss through Medicare?

Answer: Bariatric Surgery (weight loss surgery) is covered by Medicare under the conditions you are describing so long as your BMI (Body Mass Index) is greater than 35. The procedure must be performed at a CMS approved facility and there are several in Texas. Here is a link to search for approved facilities:  https://www.cms.gov/MedicareApprovedFacilitie/BSF/list.asp . You can sort the list by state. 

I recommend you find a facility nearest you and contact them.

Medicare Eligibility

Medicare Eligibility

Question:  My job is one that does not require that I pay Social Security taxes. Will I be eligible for Medicare when I turn 65?

Answer:  It’s possible that you will be eligible for Medicare. Many city, state or federal employees, as well as some self-employed, do not pay Social Security taxes. However, there are 2 different taxes, a Social Security tax and a Medicare tax. Even if you aren't paying Social Security tax, you or your employer MAY still be paying Medicare tax. The only way to know is to look on your pay stub or W-2, it shows it in either of these places. It will say Medicare Tax.

Also, if you are married or were married for at least 10 years and your spouse paid Medicare taxes for at least 10 years, you may qualify under your spouse’s or ex-spouse’s Medicare tax payment.

Medicare and the Shingles Vaccine (Zostovax)

Medicare Coverage of the Shingles Vaccine

Question:  Does Medicare pay for the Shingles vaccine?

Answer:  The Shingles vaccine is covered under Part D, the prescription drug plan and you would have to be enrolled in a Part D plan to receive this coverage.  Medicare Part B does cover some injectables administered in a physician's office but the Shingles vaccine is NOT included under that Medicare Part B coverage.  

As with any medication, check with your Part D plan to confirm that the Shingles vaccine (Zostovax) is part of their formulary. Many Part D plans have a deductible and most have copays. The Shingles vaccine is expensive. It is a higher tier drug on most plans, around $170 retail on average, so also check your cost. Most Part D plans have agreements with their network participating pharmacies to administer the Shingles vaccine at the pharmacy for a reduced charge (similar to the flu vaccine). Check with your Part D plan~Check with your pharmacy BEFORE getting the injection.