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COVID-19 and Medicare – How Do I Enroll in Medicare Online?

August 13, 2020 By Garrett Ball Leave a Comment

Due to the COVID-19 pandemic, Social Security offices are not accommodating walk-in visitors until further notice. This has an impact on those who need to enroll in Medicare. Formerly, one of the options for enrolling in Medicare was to go in to a local office. But now, if you need to see someone in person, you must make an appointment, and it must be for a limited, dire situation only. The Social Security Administration is dedicated to protecting the population they serve— older Americans and people with underlying medical conditions—as well as their staff during the COVID-19 pandemic. Please visit the Office Closings and Emergencies link for the most up-to-date information about office closings.

Although the Social Security offices are currently closed to walk-in visitors, there are, fortunately, still options for enrolling in Medicare online. These options have been expanded in recent months with a revamped and improved enrollment tool for signing up for Medicare Part B. Enroll in Medicare online

If you are already getting Social Security benefits, or Railroad Retirement Benefits, you will automatically be enrolled in Original Medicare Part A and Part B. The effective date will be the first of the month you turn 65. If your birthday falls on the 1^st of the month, then your Medicare benefits will start on the first day of the previous month. If you are under 65 and disabled, you will automatically get Part A and Part B if you have gotten disability benefits from Social Security (or from the RRB) for at least 24 months. If you have ALS, you’ll get Part A and Part B automatically the month your Social Security disability benefits begin. Note: If you are a resident of Puerto Rico or reside abroad, you will not get Part B automatically and must apply for it.

You should sign up for Medicare online:

If you are in your IEP (Initial Enrollment Period), you can sign up three months before your 65^th birthday
During the “General Enrollment Period” – If you haven’t enrolled in Medicare Part B during your initial enrollment period, you can still sign up each year from January 1 through March 31. Your coverage will start July 1 of the year in which you enroll.
If you are in a Special Enrollment Period (SEP) – you may enroll for Part B:
- in any month you remain covered under the group health plan and your, or your spouse’s, employment continues (in other words, while you or your spouse are still working); or
- in the 8-month period commencing with the month after your group health plan coverage or your or your spouse’s employment ends, whichever comes first.

What are the benefits of signing up for Medicare online?

You do not have to make an appointment at your local Social Security office (during the COVID pandemic, Social Security offices are not seeing walk-in visitors). During busy times of the year, your wait to get in to see someone may be up to 3 or 4 weeks;
The application online process can be started immediately;
You can save your application and go back to it later, without losing any of your information;
You can sign up in the comfort of your own home, using your own computer;
You will save time and money by not having to travel to your local Social Security office.
You can rest assured that the technology used to input your personal information is secure.

Here are some tips that will help you complete your online application:

Prior to enrolling online, go to the “Checklist for Online Applications” at www.ssa.gov/hlp/isba/10/isba-checklist.pdf. This information will help you to prepare for the process
Visit www.socialsecurity.gov/medicare/apply.html and choose “Apply for Medicare Only.”
If you need further information, click on “Related Information”.
The normal application process online usually takes from 10 to 30 minutes to complete.
Click on “Submit Now” and your application will electronically go to Social Security.

Once you have submitted your application, a receipt will be generated which you can print for your records. You will then be assigned an application number that will be necessary in case you want to check the status of your application. During the review process, if clarification is needed, including additional documentation, Social Security will contact you. A letter will be sent to you by mail with the decision (usually 7-10 days). Then, within 3-4 weeks, your Medicare card will arrive.

Although Social Security offices are not providing service to walk-in visitors, they are still available by phone. You can call your local office by using the Field Office Locator, under “Social Security Office Information”. Alternatively, you can call the toll-free national number at 1-800-772-1213. If you are hard of hearing or deaf, the TTY number is 800-325-0778. A staff member is available from 7:00 am to 7:00 pm, Monday through Friday.

At this time, Social Security is requesting that you should access their online services before reaching out by phone. That said, it’s understandable that if you don’t have a computer or are not computer savvy, you can always call them! Otherwise accessing their online services is the most practical way to contact them. Some advantages of using the online system are:

Applying for benefits
Getting useful information
Find publications
Get the answers to FAQs

You can create a My Social Security account, which will give you additional options, i.e. review your Social Security statement, verify earnings, print a Benefit Verification Letter, or modify your direct deposit information. If you need a replacement Medicare card or Social Security card (if there are no changes and your state participates), or a duplicate SSA-1099/1042S, you can request those as well.

Important note: If you are enrolling in Medicare Part B for the first time, that generates your initial open enrollment window for Medicare Supplement (Medigap) and Medicare Advantage plans as well. It is crucial to be aware of this and not miss any deadlines for enrolling.

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. If you have any questions about this information, you can contact us online or call us at 877.506.3378.

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2019 Medicare Costs

April 4, 2019 By Garrett Ball Leave a Comment

It seems like each year, health costs of seniors increase higher and higher. Monitoring your Medicare costs from time-to-time, will keep you on the right track for all your financial planning and retirement needs. If you are already in this phase of your life, or will be approaching it soon, this is an integral part of your overall financial health.

It is a common misconception that seniors have access to free healthcare. That may generally be true for Part A. However, that is not the case for Medicare Part B, Medicare Advantage, Medicare Part D, or Medicare Supplement (Medigap) plans. Below you will see pertinent information on 2019 Medicare costs, including those that are premium-free.

MEDICARE PART A – Premium

Medicare Part A covers inpatient hospital stays, skilled nursing, and rehabilitation up to certain limits, once a deductible is met. If you are hospitalized for longer than 60 days, you will need to pay a share of the expenses; after 90 days, if you’ve already used up your 60 lifetime reserve days, you will be responsible for 100% of your bill.

You Can Get Part A Premium-Free If:

You already receive Social Security benefits or Railroad Retirement Board benefits.
You’re eligible to collect Social Security or Railroad benefits but have not yet filed for them.
You or your spouse had Medicare-covered government employment.

If you’re under 65, you can get premium-free Part A if:

You have already collected Social Security or Railroad Retirement Board disability benefits for 24 months.
You have End-Stage Renal Disease (ESRD)and meet certain requirements.

The Part A premium, for most people, is free. Hence, it is usually called “Premium-free” Part A – it is not one of the normal Medicare costs; however, it is not free for those who do not qualify. To qualify, you are required to have completed at least 40 quarters of employment (10 years) of paying Medicare and FICA taxes while working. If you paid Medicare taxes for 30 quarters or less, Part A premium is $437. If you paid Medicare taxes for 30-39 quarters, the Part A premium is $240.

Usually, if you decide to buy Part A, you are required to also have Medicare Part B (Medical Insurance) and pay monthly premiums for both Part A and Part B. For more information about Part A, contact the Social Security Administration.

MEDICARE PART A – Inpatient Hospital Deductible & Coinsurance:

Deductible: $1,364 (for each benefit period)

Coinsurance:

Days 1-60 $0 (for each benefit period)
Days 61-90 $341 (per day for each benefit period)
Days 91+ $682 (per each “lifetime reserve day” after day 90 for each benefit period, up to 60 days over your lifetime)
Beyond lifetime reserve days: You pay all costs

MEDICARE PART B – Premium

The 2019 monthly Part B premium is $135.50, or higher depending on your income (see IRMAA below). However, if you are already collecting Social Security benefits, the premium may be less, on average $134.

The standard premium amount of $135.50 pertains to you if:

You are signing up for Part B for the first time
You are not collecting Social Security benefits
You are on direct bill for the premiums
You are on Medicare and Medicaid, and your premium is paid by Medicaid (your state pays the standard $135.50 premium amount)

What is IRMAA?

IRMAA stands for “Income Related Monthly Adjusted Amount”. If your modified adjusted gross income on your IRS tax return 2 years prior is over a certain amount, you will have to pay the standard premium amount plus an IRMAA. In short, it is an additional charge on your premium. See table below.

If your yearly income in 2017 was:

Individual Joint Married/Separate Tax Return Monthly Premium

$85,000 or less $170,000 or less $85,000 or less $135.50

$85,000-170,000 $170,000-214,000 Not Applicable $187.50

$107,000-133,500 $214,000-$267,000 Not Applicable $267.90

$133,500-160,000 $267,000-$320,000 Not Applicable $348.30

$160,000 + $320,000 + Above $85.000 $428.60

Important Note: If you’ve had a life changing event, i.e. you just retired, you might be qualified for a reduction on any of the above amounts. Call Social Security at 800-772-1213, to find out more.

MEDICARE PART B – Annual Deductible

The annual deductible in 2019 for Part B is $185/year. Once you meet that deductible, then you pay 20% coinsurance (the Medicare-approved amount) for covered services, which includes:

Most doctor services (including while you are in the hospital)
Any outpatient therapy
Durable medical equipment

Clinical laboratory services: Cost is $0 for Medicare-approved services

Home health services:

$0 for home health care services
20% of the Medicare-approved amount for durable medical equipment

Outpatient mental health services:

You are entitled to a free yearly depression screening, provided that your physician or health care provider accepts assignment.
You pay 20% of the Medicare-approved amount for doctor or other health care provider visits, to diagnose or treat your condition. Part B deductible will apply.

Please note: you might be obligated to pay an additional copayment or coinsurance amount to the hospital, if you receive your services in a hospital outpatient clinic or outpatient department, i.e. if you have x-rays taken by a physician whose office is in a Medical Center or hospital,

Mental health services requiring partial hospitalization:

You pay a percentage of the Medicare-approved amount for doctors’ services or other qualified mental health professionals, provided they accept assignment.
You will also pay coinsurance for services in a hospital outpatient setting or community mental health center, while you are an inpatient, and the Part B deductible will apply.

Please be aware that in 2019, there may be limits on physical therapy, occupational therapy, and speech language pathology services. If there are, there may be exceptions to these limits.

Outpatient hospital services:

Your share is 20% of the Medicare-approved amount for physician or other health care provider’s services. Part B deductible will apply.
You will usually pay a copayment for all other services in a hospital outpatient setting. That copayment might be higher if in a hospital outpatient setting as opposed to a doctor’s office.
Some screenings/preventive services might be at no cost, since your coinsurance, copayments and Part B deductible will not apply.

MEDICARE PART C – Medicare Advantage

Deductibles, copayments, & coinsurance:

The cost for Part C (Medicare Advantage) deductibles, copayments, and/or coinsurance also varies according to which plan you have. To see a list of Medicare Advantage plans in your service area, you can go online at https://www.medicare.gov/find-a-plan. Once you find a plan, you can call that provider for further information and to enroll. Also, note that, on this type of plan, the deductibles, co-pays and overall out of pcoket costs change annually.

MEDICARE PART D – Prescription Drug Coverage

Part D monthly premiums vary considerably by plan and where you live. Also, if you earn a higher income, you may pay more (IRMAA).

Medigap / Medicare Supplement Plans

Medigap plans are plans that fill in the gaps in Medicare Part A and B. The premiums for this type of plan are based on several variables including: age, zip code, gender, tobacco use, health, and others in some cases.
Costs vary tremendously in different parts of the country – in some states, Medigap premiums are as much as 3x other states
Go here to get a list of current Medigap rates delivered via email

If you have any questions about what your Medicare costs will be in 2019, please visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) for more information. TTY users call 1-877-486-2048.

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Medicare Part B Covered Charges

September 7, 2018 By Garrett Ball Leave a Comment

Medicare Part B is the medical insurance part of Medicare. Medicare Part B medicare part b covered charges covered charges fall into two categories:

1) Medically necessary services or supplies necessary for the diagnosis or treatment of a health condition. However, these services/supplies must meet certain guidelines or standards prior to acceptance. They are not free of charge – a 20% coinsurance applies (if you have only Medicare and no Medigap plan). A deductible also applies unless otherwise indicated. These covered services and supplies include the following:

· ambulance services

· ambulatory surgical centers

· blood

· diabetes supplies

· diagnostic tests (X-rays, MRIs, EKGs, etc.)

· durable medical equipment

· emergency room services (additional copayments may apply for separate services)

· home health services (if individual is not covered by Part A)

· kidney dialysis services and supplies

· prosthetic or orthotic items

· occupational therapy

· outpatient hospital services (co-payments may apply separately per service)

· outpatient medical and surgical services and supplies (copayments may apply separately per service)

· physical therapy

· physician, physician assistant, and nurse practitioner services

· speech-language pathology services

· corneal transplants

· physician’s services and other fees

pertaining to organ transplants

The following medically necessary services are covered by Medicare Part B, but with other than a 20 percent coinsurance requirement:

mental health services—For diagnosis or physician-monitoring visits, the Medicare beneficiary pays 20 percent coinsurance and the Part B deductible applies. For outpatient psychiatric services, the Medicare beneficiary pays 20 percent. If services are provided in a hospital clinic or hospital outpatient setting, a higher copayment might be applicable. A copayment is not applied to yearly depression screening wellness visits, provided the physician accepts assignment.
clinical laboratory services—Urinalysis and certain blood and screening tests are provided to the Medicare beneficiary at no cost

2) Preventive Services – below are some of the most common preventive services that are covered under Part B, at no charge. In addition, no deductible applies and there is no coinsurance payment, provided the healthcare prevent illness with Medicare-covered screenings provider accepts assignment. Assignment means that your physician, other healthcare provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as payment in full for all covered services.

· abdominal aortic aneurysm screening

· alcohol misuse screening and counseling

· bone mass measurement

· cardiovascular disease screenings and behavioral therapy

· colorectal cancer screenings

· diabetes screenings and self-management training

· flu shots

· glaucoma tests

· hepatitis B shots

· HIV screening

· mammograms

· medical nutrition therapy services

· obesity screening and counseling

· Pap tests and pelvic exams

· pneumococcal shot

· prostate cancer screenings (a deductible and coinsurance apply to digital rectal exams, but not to a PSA test)

· sexually transmitted disease screening and counseling

· smoking cessation counseling (a deductible and coinsurance apply only if a patient has been diagnosed with an illness related to tobacco use)

· a one-time “Welcome to Medicare” physical exam

· a yearly wellness exam, starting 12 months after the “Welcome to Medicare” exam

MEDICARE PART B COSTS

The costs for Medicare Part B comprises a monthly premium and a yearly deductible ($183/year for 2018). The monthly premium amount can vary depending upon your situation:

For 2018, if any of the following circumstances applies to you, you’ll generally pay $134 for your Part B premium:
- You enroll in Part B for the first time in 2018.
- You aren’t receiving Social Security or Railroad Retirement Board benefits.
- You’re billed directly for your Part B premium.
- You have both Medicare and Medicaid coverage, and Medicaid pays for your monthly premiums.
If you are already receiving Social Security benefits, your Part B premium may be an average of $130.

Please be aware that if your annual income exceeds a certain level, you may have to pay a higher premium, based on your previous tax return from two years ago. Further, if you have not signed up for Medicare Part B when you were first eligible, you will have to pay a late-enrollment penalty. This will no doubt increase your premium. That said, there are circumstances under which you may be eligible for a Special Enrollment Period. For more information you may call Medicare at 1-800-633-4227 or go to www.medicare.gov and put in the search box “Special Enrollment Period.”

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. We have worked with 10,000+ Medicare-eligible individuals over the last 10+ years, assisting with understanding and comparing the plans. You can get a list of Medigap quotes in your area. Or, if you have any questions about this information, you can contact us online or call us at 877.506.3378.

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Steps to Take When Turning 65

May 11, 2018 By Garrett Ball Leave a Comment

You might be turning 65, getting ready to retire, and/or this is your first opportunity to enroll in Medicare (Turning 65 Roadmap). Whatever the situation, when turning 65 or starting Medicare after age 65, you will be bombarded with information to make a better-informed decision about your healthcare coverage. You will want to be proactive about what you need to do in preparation for this important, yet overwhelming, time in your life. The Centers for Medicare & Medicaid Services (CMS) manages Medicare. Social Security works in conjunction with CMS by enrolling people in Medicare. parts of medicare when turning 65

To be better prepared and organized in your research and ultimately your decision, there are several steps listed below for you to follow as guidelines.

1) Familiarize yourself with the different parts of Medicare:

Original Medicare:

Part A (hospital insurance):

Provides for inpatient hospital stays, skilled nursing, and rehabilitation after meeting a deductible and up to specific limits.

Part B (medical insurance):

Provides for doctors’ services, outpatient care, medical equipment and supplies and preventive services

Other Parts of Medicare:

Part C (Medicare Advantage – privatized version of Medicare):

Medicare Advantage is a completely separate part of Medicare that takes the place of Parts A and B if you elect to enroll in it. These are private plans, sold through private insurance companies, with their own set of co-pays, deductibles and out of pocket costs. (What Is the Difference Between Medigap and Medicare Advantage?)

Part D (Prescription drug coverage):
Prescription drug coverage for people on Medicare falls under Medicare Part D. This is a completely optional part of Medicare, but it is the only way to have prescription drug coverage once you are on Medicare. Some Part C (Medicare Advantage plans) also include Part D. (Do I Have to Sign Up for a Medicare Part D Plan?)

2) Know when you can enroll in Medicare:

When you enroll in Medicare depends upon your situation – you may be able to be enrolled automatically, or you may have to sign up yourself. However, there are certain times during the year when you are also able to enroll.

Get Medicare Automatically:

You can get Medicare automatically if you are already getting Social Security benefits, or the Railroad Retirement Board. Social Security will send you your Red, White & Blue card three months before you turn 65, and your benefits will begin on the first of the month that you turn 65. If your birthday is on the first of the month, then your benefits begin on the first day of the previous month.

If you are not currently receiving Social Security benefits, you will need to sign up for Part A and Part B by either going online at www.SSA.gov, or calling them at 1-800-772-1213. TTY users call 1-800-325-0778. You may also sign up in person at your local Social Security office. If you are a retired railroad worker, you can enroll in Medicare by calling the Railroad Retirement Board at 1-877-772-5772. TTY users call 1-312-751-4701.

The Initial Enrollment Period:

This is for Medicare beneficiaries who are enrolling for the first time in Parts A and B. It covers a 7-month period, starting 3 months prior to the month in which you turn 65, including the month in which you turn 65; ending in 3 months following the month in which you turn 65. (Medicare Supplement Open Enrollment)

Eligibility and Premium Calculator:

If you want to find out when you are eligible for Medicare and how much the premium will be, go to www.Medicare.gov/eligibilitypremiumcalc/. There you will be able to learn when your eligibility will begin and your exact premium will be calculated for you.

3) Do I Want Both Part A and Part B?

It is up to you whether you want Part A and Part B. If you have been employed and paid Medicare taxes, then for you, the Part A premium would be $0. Typically, if you have paid Medicare taxes, you are enrolled into Medicare Part A automatically upon reaching the month of your 65^th birthday.

If you do have your health insurance with your employer, then you may decide to delay Part B when turning 65 (see below). It all boils down to how good your present coverage is as far as deductible, copays, etc. But you should take care when considering whether you should enroll in Part B if you are intending to keep group coverage. Doing so initiates certain enrollment time periods that you would not have in the future when you do retire or lose the group coverage.

If you are enrolling in Part B for the first time your premium in 2018 is $134/month. However, you may pay more if your modified adjusted gross income on your 2016 IRS tax return is higher. This increase is called “IRMAA” (Income Related Monthly Adjustment Amount).

Part B late enrollment penalty: If you don’t have credible coverage, you may have to pay a penalty if you don’t enroll during your initial enrollment period when turning 65, in addition to a gap in coverage when you do decide to enroll. (Medicare Late Enrollment Penalties)

4) Consider Enhancing Your Medicare Part A and Part B:

Once you choose to enroll in Part A and Part B, you can either choose Original Medicare with additional coverage of a Medigap plan; or enroll in a Medicare Advantage plan (Part C – either an HMO or PPO depending upon the plans available in your county). You can also get prescription drug coverage (Part D). Important to note is that you may have to pay a penalty if you do not enroll in Part D during your initial enrollment period, if you choose Original Medicare. This does not pertain to Part C, as that already includes prescription drugs.

You can find and compare Medicare Advantage plans as well as prescription drug plans by going to www.medicare.gov/find-a-plan. By entering your medications, you will be able to see what the most cost-effective drug plan will be when you do the comparison.

5) Choosing a Medicare Supplement (Medigap Plan):

If you decide to enroll in a Medigap plan, you should compare Medigap quotes on each of the plans you are considering. Also, you should compare the yearly deductibles, copays, and coverage for foreign travel on the different standardized plans. The most popular plans are F, G, and N, although Plan F will be closed to new enrollees starting in 2020.

Plan F = $0 deductible/$0 copay

Plan G = $183 Medicare Part B deductible/$0 copay

Plan N = $183 Medicare Part B deductible; up to $20 copay for outpatient/doctor visits; up to $50 copay for an ER visit if you are not admitted; and up to 15% excess charges (Medicare assignment below).

To get a list of the Medigap plans available for your age and zip code when turning 65, as well as company ratings, request Medigap quotes by email. This list of plans, premiums and ratings will allow you to compare all options in a centralized place.

Some companies allow you to apply online in just a few minutes (apply for Mutual of Omaha Medigap).

6) Make Sure Your Doctor Accepts Medicare Assignment:

To lower your costs, make sure that your doctor/provider/supplier accepts Medicare Assignment. This means that they agree to accept the amount that is approved by Medicare as full payment for covered services. If they do not accept assignment, then you might pay more for your covered services. If you have a Medigap Plan N, you may have to pay up to 15% in excess charges.

To summarize, don’t wait until the last minute before you turn age 65. Do your due diligence in finding out about your Medicare options, supplemental coverage and late penalties if you do not enroll in a timely fashion. Be informed, knowledgeable, and prepared and you’ll be able to get through this Medicare maze with ease!

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. We have worked with 10,000+ Medicare-eligible individuals over the last 10+ years, assisting with understanding and comparing the plans. You can get a list of Medigap quotes in your area. Or, if you have any questions about this information, you can contact us online or call us at 877.506.3378.

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