Tuesday, August 18, 2020

Two particular words — MediCare uses when signing up!

People report being confused when online looking for when can I sign up for MediCare and when does it start! That’s understandable since online info. is often “not quite accurate”! Thus, my post is to answer the “when can” and “when does” questions and review two special words used in signing up.

The first word in MediCare’s eligibility & signing up regulations to review is  — “eligible.” Social Security (SS) manages eligibility regulations and CMS manages coverage details.  These regulations, which I call “rules”, define eligible as a month not a specific date and it’s the month a person becomes 65. If a person does decide to apply at 65 they have what’s called an Initial Eligibility Period (IEP) to complete an application.


The IEP is seven months, with their eligible month in the middle, and they can —  complete an application:

● Any month before eligible. If they do, both Part A & Part B start the first day of their eligible month. 
    Note: Eligible month is moved to the previous one when a birthdate is the 1st

● During their eligible month or any month after. If they do:

   + Part A continues at the first of their eligible month.


  + Part B will be different! Why? “Rules” say it starts the:

        - Next month if a person signs up the month when 65

        - Second month after if sign up the month after 65. 

        - Third month after if sign up either the second or third month after 65. 


Signing up in the IEP’s last month — means Part B is six months after A.  Having effective dates, other than the first of the next month, is confusing. To further complicate this SS decidedPart A will also be backdated six months from the date of a person’s Part B for everyone who signs up six months or more after eligible! Do not know the logic of why this is done.

   Note: Going back six months means a person with a HSA has to stop making contributions six months before leaving employment and starting Part B.


The second word in the eligibility “rules” to review is  "entitled".  MediCare applies this term to everyone who has completed signing up. Entitled therefore is the date a person’s coverage begins for:

    + Part A’s inpatient hospital services and

    + Part B’s medically necessary outpatient services.


BTW — we know entitled is important because MediCare puts it on a person’s ID card! It’s printed above Part A and Part B to show when each coverage started.

Bottom line – when talking to individuals I use the official words.  MediCare refers to individuals as beneficiaries and I believe it’s important for new and current beneficiaries to hear correct names even though people often read or hear other words, such as:     

    + entitlement date instead of eligible

    + enrolled instead of entitled


John C Parker, RHU, LTCP

Niantic CT

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