Medicare is a national federal insurance program that pays for various health care expenses. This program is managed by the Medicaid Services (CMS) and the Centers for Medicare. Social Security helps the CMS in enrolling people in the program.
Medicare beneficiaries are mainly senior citizens aged 65 or older.
The Medicare Program and all the Parts
The program has four different parts; Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). Medicare Part D offers prescription drug coverage and all Part D plans are provided by private insurance companies, like Humana, Aetna and several other companies..
How to Enroll in Medicare
Who Gets Enrolled in Medicare Automatically
If you are receiving benefits from Social Security you will be automatically enrolled in Part A and B starting the first day of the month you turn 65. If your birthday is on the first day of the month, Medicare will start the first day of the prior month.
Enrolling in Part A and B Online when you turn 65
The initial enrollment window for Medicare is seven months. This period starts three months before attaining 65 years and ends three months after the birthday month. Signing up for the program can be done online, or by making an appointment with Social Security. The easiest way is using the online enrollment process. Simply login to SSA.gov and click on the Medicare link in the menu, for detailed instructions click here.
Next, you’ll need to give some necessary information such as; your name, address, telephone number, and Social Security number to complete your application. Social Security will ask if you have an online Social Security account and if not ask you to set up the account. If you are unwilling or unable to establish the online Social Security account you will be able to proceed to the Medicare enrollment section and complete the Medicare enrollment process, Social Security will contact you to verify your identity. If you are not a citizen, you’ll need your permanent resident card number.
If you are still working and covered under your employer group health plan you may choose not to enroll in Part B. There is a charge for Part B typically $148.00 per month. However, we recommend you sign up for Part A only (as long as you are not contributing to a Health Saving Account), there is no cost for Part A and you will receive a Medicare card and be assigned a Medicare number making it easier to enroll in Part B at a later date.
Enrolling through Social Security
It is easy to reach the Social Security agents through the telephone at 1-800-772-1213. They operate from Monday to Friday, and one can contact them from 7 AM to 8 PM.
Enrolling in Part A after 65
If you are eligible for premium-free Part A, you can enroll in Part A anytime after you are first eligible for Medicare. Your Part A coverage will go back retroactively 6 months from when you sign up, but no earlier than the 1st day of the month you were eligible. Enrolling online or calling Social Security would be the best options to enroll in Part A only.
Enrolling in Part B after 65
If you decide to delay Part B because you are covered under a group health plan, you can complete an Application for Enrollment in Part B (CMS-40B). You will also need to provide verification that you have had coverage under employer health insurance since turning 65. Complete form L 564 and have it signed by your employer is the best option.
You have three options to submit your enrollment request under the Special Enrollment Period, our advisers can assist you with any of these options. You can do one of the following:
- Go to “Apply for Part B only and complete the online version of CMS-40B and CMS-L564. Then upload your evidence of Group Health Plan or Large Group Health Plan.
- Fax your CMS-40B and employer-signed CMS-L564 to 1-833-914-2016.
- Mail your CMS-40B and employer-signed CMS-L564 to your local Social Security office.
Note: When completing the CMS-L564
- State on the form “I want Part B coverage to begin (MM/YY)” in the remarks section of the CMS-40B form or online application.
- If possible, your employer should complete Section B.
- If your employer is unable to complete Section B, please complete that portion as best as you can on behalf of your employer without your employer’s signature and submit one of the following forms of secondary evidence:
- Income tax form that shows health insurance premiums paid;
- W-2s reflecting pre-tax medical contributions;
- pay stubs that reflect health insurance premium deductions;
- health insurance cards with a policy effective date;
- explanations of benefits paid by the GHP or LGHP; or
- statements or receipts that reflect payment of health insurance premiums.
After You Enroll
The Centers for Medicare & Medicaid Services CMS) manages Medicare. After you are enrolled they will send you a Welcome to Medicare packet in the mail with your Medicare card. You will also receive the Medicare & You handbook, with important information about your Medicare coverage choices.
After enrolling in Medicare and you receive your Medicare number then you can decide to add a drug plan (Part D) or buy a Medigap policy to help pay for costs that Original Medicare doesn’t cover. You can also choose to join a Medicare replacement program called Medicare Advantage Plans (Part C) these plans are offered by insurance companies and include all your Medicare coverage (including drugs and extra benefits like vision, hearing, dental, and more) bundled together in one plan. Make sure you speak to one of our advisors before signing up for an Advantage plan, you need to know all the facts to make a smart choice.
Some people with limited resources and income may also be able to get Extra Help to pay for Part D drug costs.
Please contact one of our Medicare advisors for enrollment assistance, you can call 940-382-4700 or email bob@icusa-tx.com