Lee Ann Torrans Social Security Disability Appeal Social Security DisabilityMedicare the Ins and Outs!

At 65 your health care system includes Medicare.  Medicare does not cover all expenses, supplemental insurance helps with those gaps in coverage.  Social Security eligibility for full benefits currently begins at age 66 which enrolls you automatically in both Medicare A and B.  Medicare Part A applies hospitalization expense and for most will not incure a cost or premium.  Medicare Part B addresses those expenses associated doctors’ visits, tests and scans.  The cost is roughly  $134 a month though it can be more for recipients with a strong income.

You can incur a lifetime late-enrollment penalty.  Social Security websites at www.socialsecurity.gov allows you to sign in three months before you turn 65 and three months after you turn 65.  This is known as your initial enrollment period and should be done even if you are not receiving Social Security benefits.

 The McKinney Texas Social Security Office will be able to provide one on one help with your enrollment.

If you have primary health insurance coverage from your employment or your spouse’s employment Medicare coverage will be secondary to that primary coverage.  No penalties will be assessed although you must sign up with Medicare within eight months of leaving the job that provided health care insurance.

Penalty for Not Signing Up

The late-enrollment penalty is ten percent of the Part B premium that you should have paid and applies for as long as you have receive Medicare benefits.  You can sign up from January through March in any year for coverage to begin July 1 and that’s it.  You must sign up in that period.

Deductibles and co-payments must still be paid. Medicare supplement policies known as Medigap pay the deductibles and copays and Part D prescription-drug coverage.  Medicare does not cover prescriptions.  A Medicare Advantage plan will cover both medical and drug coverage.

Lee Ann Torrans:  Medigap Policies Compare and Evaluate

Medigap policies are sold by private insurers and come in 10 standardized versions (A through D; F; G; and K through N). Every medigap plan with the same letter designation must provide the same coverage, even though prices can vary by insurer. You can use any doctor or facility that is covered by Medicare.

Many state insurance departments have Medigap price lists by insurer. The NAIC webite is helpful with a map link: www.naic.org .

Part D prescription-drug plans are sold by private insurers and have average premiums of $34 per month. You can compare premiums and out-of-pocket costs for your drugs under each Part D plan in your area at www.medicare.gov/find-a-plan.

Medicare Advantage Helpful Websites

Medicare Advantage in addition to providing for deductibles, co-pays and drugs may also cover dental and vision care.  You may experience a limited network of physicians and hospitals.  A website will help you with this:  Medicare Advantage plan at www.medicare.gov/find-a-plan.

Another website will help you analyze and evaluate this information:  www.medicarenewswatch.com.

Preexisting conditions should not impact your costs if you sign up within six months of signing up for Medicare Part B.   After that point costs and coverage options may be adjusted upward for preexisting conditions.

Waiver of Penalty for Part B Coverage

Many beneficiaries did not understand other health coverage programs they had in place were NOT a substitute for Medicare Part B.  The penalty associated with delaying or not timely participating in Part B has been waived for participants with a marketplace plan, retiree coverage from a former employer, or health coverage through the Department of Veterans Affairs, or through a current employer with fewer than 20 workers.

For those who were confused by this issue, a new retroactive Medicare waiver for the penalty has been enacted.  The Medicare Rights Center is a consumer advocacy nonprofit.  Part B must be activated by the participant within three months before or after turning 65.  Those under 65 receiving Social Security disability benefits qualify for Part B after 24 months of benefits.  The waiver is officially named the “time-limited equitable relief.”  Your waiver must submitted by September 30, 2017.  The Medicare Rights Center’s Medicare Interactive website has more information or call the center’s helpline at 800-333-4114.