Tuesday, December 24, 2019

When can I sign up for MediCare? I'll soon be 65

I'll soon be 65 – when can I sign up for MediCare?
This is a common question. When a person looks for information on when it's often confusing or incomplete. So to eliminate the confusion I am pleased to share the rules for those who decided to sign up when 65. 

  Are no longer automatically signed up at 65!
  Can apply in the 3rd, 2nd, or month before 65. MediCare says when 65 is the eligible month. Part A (Hospital) and Part B (Outpatient) coverage will be effective the first of the eligible month.
  Can apply during the eligible month. Part B is effective the first of the next month but A stays the first of the eligible month.
  Can apply the month after eligible, two months after, and three months after. Part B will be effective either two or three months after applying. A stays the first of the eligible month and can be as much as six months back from B!
Those are the rules SS follows for when a person can signup at 65. 

Let’s now look at how to sign up. An Individual can:
  Sign up through Social Security's online system which is responsible to enroll people in MediCare.
  Go to the Local Social Security office. I encourage people to do this. Why? A face to face meeting with a retirement person is easy, less confusing for most, and they will: 
    + complete the Part A & B application for them, 
    + review the options to pay the 25% share of Part B's monthly base cost so the one best for their situation can be selected. B’s base cost is $144.60 in 2020.
       Note: An additional amount is added to B's base cost if the IRS 1040 AGI from two years ago is above 87 k for Single & 174 k for Joint. The rules for higher-income individuals have five other higher income levels’ and each adds an additional amount to B's base cost.
    + review SS's informative charts which are helpful in deciding the best age to start receiving benefits.

When a person has completed the signup MediCare considers them "entitled". [not enrolled]  They are then covered by:
       Part A for inpatient care in a hospital.
       Part B for medically necessary outpatient services.
       + The MediCare ID card shows entitled above Part A & B.

Monday, October 14, 2019

October 15th is an important date for Individuals covered by MediCare!

Why? The Annual Election Period (AEP) begins the 15th and continues through December 7th.

What does the AEP mean? Everyone covered by MediCare has an annual opportunity to change their current Medicare Advantage plan (Medicare Plan C) or Prescription Drug Plan (Medicare Plan D). It is a – time to take action only if you want – not a time everyone has to do something.

Why would someone want to change? Situations such as a person:
     + Had a change in health and now wants a prescription plan to provide better coverage for their new medications.

    + Who is enrolled in a Medicare Supplement and wants to lower their monthly cost by selecting a Medicare Advantage plan. Some have no monthly cost.

Can a person buy any Medicare Advantage Plan or Prescription Drug Plan? The answer is NO.
    + Medicare Advantage Plan companies submit the proposed plans they want to offer in the next year to the Center for Medicare & Medicaid Studies (CMS) each year in early summer. As part of the proposal, the company indicates what states and within the state what Counties they want to offer the plan. Thus, a Medicare Advantage Plan is selected based on what is available in the County they live in.

    + Medicare Prescription Plan companies also submit their proposed plans to CMS and just indicate the states where they want to make it available.

    + Here in New London County we now have more Medicare Advantage plans and quite a few Prescription Plans.

Have questions about these plans or the somewhat confusing rules to apply for MediCare? Call or send a text to my cell (860) 662-3000.

John C Parker, Niantic CT

Saturday, June 15, 2019

What’s with my Medicare Part A effective date being backdated six months?

Many people now work after age 65 and are surprised when they decide to sign up for Medicare learn Part A's (hospitalization) effective date was adjusted back six months from the date received for Part B (outpatient treatments0.

The first part to answer this is to understand three things about the MediCare enrollment process. The MediCare system tells us:

First - When a person turns 65 they are considered – Eligible the month of becoming 65.

Second - When an application for Part A & Part B is submitted and complete the person is considered – Entitled. [not enrolled] 
Note: Their ID card will show Entitled above the coverage date.

Third - A person who is becoming eligible has a seven-month Initial Enrollment Period (IEP). They can apply in any of the three months before eligible, the month they are eligible, and during any of the three months after becoming eligible.

Now why does Part A’s effective date go back for six months?
The source of the rule stating Part A will be retroactive is found on Page 9 of a Medicare Enrollment Pub (1) It’s in a section of the Pub called -  When can I sign up?- and reproduced here. I added bold to keywords
-  -  -   You can sign up for free Medicare Part A (Hospital Insurance) (if you’re eligible) any time after your Initial Enrollment Period starts. Your Part A coverage will start six months back from the date you apply for Medicare (or Social Security/RRB benefits), but no earlier then the first month you were eligible for Medicare.
(1)   The above information, shown between [snip], is from – Enrolling in Medicare Part A & Part B.  This Pub is - CMS Product No. 11036 - Revised January 2018.

Now I want to share some points on how Part B’s effective date is set and how the Part A dated is adjusted:

First - When a person submits an application after they are eligible, the system will set their Part B date connected to when they apply and Part A is connected to their Eligible month. Let’s say a person is in their IEP and they apply:
    + A month after Eligible - Part B is delayed two months from the month of application and Part A will be back to their Eligible month.
    + In the second and third month after being Eligible [last available in IEP] - Part B is delayed three months and Part A will be back to their Eligible month. 
   Note: Applying in the last available IEP month results in B being six months after A.

Second - The rule which sets Part B’s effective date when a person applies in the last month of their IEP, is thus applied to anyone who signs ups after being Eligible. Backdating Part A, however, will be no more than six months.

Thus,  the famous – Part A is always back for six months. 

 Couple other points:
   + Having Part A backdated has an impact on a person who has a HSA medical benefit plan. 
   + More information about signing up for MediCare can be found on this page of my MediCare site.

John C Parker, RHU, LTCP
Niantic CT

Saturday, May 11, 2019

Phone call says - you can apply for medical plans! Beware! !

Consumers should beware of phone calls and TV ads saying – Medical plan and Medicare Plan choices are now available!

Why? Individuals can not enroll at any time because federal regulations limit the periods when people can enroll in medical related coverage:
   • Individual medical plans can normally only be selected each year in the fall. Currently Nov 1st to Dec 15th.
   • An exception is made if someone just moved to CT or something changed and they lost the coverage they had.  These are considered change of life situations and allow a person to take advantage of a Special Enrollment Period.

At a high level an individual can only apply for a Medicare Advantage plan:
   • When turning 65
   • If they just moved to CT. In some case's a change can be made when a person moves from one County to another.
   • During the Annual Election Period in the fall of each year. Currently if is Oct 15th to Dec 7th.

More information on the Medicare Health Plan enrollment periods can be found on this page of my Medicare web site.

Want more information on Medicare Health Plan enrollment?
   • Call my Google Voice line (860) 451-9793

   • Send a note to Learn@JohnCParker.agency

John C Parker, RHU, LTCP