Medicare Part B Enrollment – Advancing Access To Medicare And Healthcare

Medicare is a health-insurance program for persons over the age of 65 in the United States. People under the age of 65, such as those with disabilities or those who have irreversible renal failure, may be eligible for Medicare.

What is Medicare?

Medicare is a popular program, but it requires vigilance to guarantee that all beneficiaries are provided with complete coverage and equitable treatment. The Medicare program, which many Americans rely on, has been allowed to suffocate. Traditional Medicare, which most beneficiaries prefer, hasn’t been enhanced in years, but private Medicare Advantage programs have been bolstered on numerous occasions. It’s past time to improve Medicare for people who rely on it today and in the future.

The program assists with health-care costs, although it does not cover all medical bills or most long-term care costs. You can receive Medicare coverage in a variety of ways. You can purchase a Medicare Supplement Insurance (Medigap) policy from a private insurance provider if you opt to have Original Medicare (Part A and Part B) coverage.

The program assists with health-care costs, although it does not cover all medical bills or most long-term care costs. You can receive Medicare coverage in a variety of ways. You can purchase a Medicare Supplement Insurance (Medigap) policy from a private insurance provider if you opt to have Original Medicare (Part A and Part B) coverage.

Original Medicare (Part A and Part B)

• Part A (hospital insurance) of Medicare helps pay for inpatient care in a hospital or a short period in a skilled nursing facility (following a hospital stay). Part A also covers some home health and hospice services.
• Medicare Part B (medical insurance) helps pay for outpatient care, home health care, durable medical equipment, and some preventive services provided by doctors and other health care professionals.

Other parts of Medicare are run by private insurance companies that follow rules set by Medicare

• Supplemental (Medigap) insurance helps pay for Medicare copayments, coinsurance, and deductibles.
• All of the benefits and services covered under Parts A and B, as well as supplementary benefits like vision, hearing, and dentistry, are bundled together in a Medicare Advantage Plan (formerly known as Part C).
• Prescription medications are covered under Medicare Part D (Medicare prescription drug coverage).

If they have worked and paid Medicare taxes long enough, most people aged 65 and up are eligible for free medical hospital insurance (Part A). By paying a monthly premium, you can enroll in Medicare medical insurance (Part B). Larger-income participants will pay a higher monthly Part B cost.

Special Enrollment Period (SEP)

You may not need to apply for Medicare Part B at age 65 if you have medical insurance via your or your spouse’s current employer’s group health plan. You may be eligible for a “Special Enrollment Period” (SEP) that allows you to sign up for Part B during any month that you or your spouse are still covered under the corporate health plan.

The 8-month period begins the month following the conclusion of your group health plan coverage or the job on which it is based, whichever occurs first.

How to apply online for just Medicare

If you are within three months of turning 65 and have not yet begun receiving monthly Social Security payments, you can use our online retirement application to enroll in Medicare only and wait to apply for your retirement or spouse’s benefits later. It takes less than ten minutes, and there are no forms to sign or paperwork to complete.

Go to the checklist for “The Online Medicare, Retirement, and Spouses Application” to see what documents and information you’ll need to apply.

Medicare cards

Your Medicare card carries a Medicare number that is unique to you to help secure your identity. If you haven’t received your red, white, and blue Medicare card, something may have gone wrong, such as your mailing address. By logging into or creating a personal social security account, you can change your mailing address.

Other Medicare enrollment options

If you live in Puerto Rico, you will not automatically be enrolled in Medicare Part B (medical insurance). If you don’t sign up for it during your initial enrollment time, you’ll be charged a fee. Please call our toll-free hotline at 1-800-772-1213 to join up (TTY 1-800-325-0778). You can also contact the social security administration in your area. Using the office locator, you can find your nearest social security office.

You can also contact the Federal Benefits Unit in your country of residency if you do not live in the United States or one of its territories.

Medicare Part B

Original Medicare is divided into two parts: Part A provides hospital insurance, and Part B provides medical coverage. Original Medicare, the government-run healthcare program for seniors and some disabled people, is made up of these two elements.

Medically essential treatments and supplies, such as doctor visits, preventative care, and durable medical equipment, are covered by Medicare Part B. We’ll also go over how to enroll in Medicare Part B.

Should I sign up for medical insurance (Part B)?

You can enroll in Medicare Part A (hospital insurance) and Part B (medical insurance) using our online application (medical insurance). You have the option to decline Part B coverage because it requires a premium.

If you’re 65 years old and eligible, your initial enrollment period starts three months before your birthday, includes the month you turn 65, and concludes three months following your birthday.

If you delay enrolling in Medicare Part B and later decide to do so, your coverage may be delayed, and you may have to pay a higher monthly premium for the duration of your Part B coverage. Unless you qualify for a “Special Enrollment Period,” your monthly premium will increase by 10% for each 12-month period during which you were eligible for Part B but did not enroll (SEP).

If you don’t sign up for Medicare Part B during your initial enrollment period, you’ll have another chance each year from January 1 to March 31 during a “general enrollment period.” The year you enroll, your coverage begins on July 1 of that year. For additional information, see our Medicare publication.

If you have a Health Savings Account (HSA) or health insurance via your current job, you should check with your HR department or insurance company to see how Medicare may affect you.

What does Medicare Part B cover?

The following are some examples of what Medicare Part B covers:

• Ambulance services: transport and travel to and from certain locations
• Chemotherapy
• Chiropractic care for spine manipulation to correct a subluxation (in medically necessary circumstances, when performed by a chiropractor or other qualified healthcare provider)
• Diagnostic tests and lab work
• Doctors services, such as office visits
• Durable medical equipment (DME)
• Home health services
• Outpatient physical, speech, and occupational therapy services provided by a Medicare-certified physical, speech, or occupational therapist
• Outpatient mental health services, including partial hospitalization
• Preventive-care services, including screenings and vaccines
• “Welcome to Medicare” and yearly “Wellness” physical exams
• X-rays

If you’re enrolled in a Medicare Advantage plan, you’ll continue to be covered for Medicare Parts A and B as you would have been under Original Medicare. Medicare Advantage plans must give at least the same level of coverage as Original Medicare, so you’ll get the same basic benefits as you would with the government program. Your Medicare Advantage plan may also include other health-related benefits, such as routine vision or dental care, wellness programs, or prescription medicines.

Medicare Part B enrollment: how do I get Medicare Part B?

You must be a United States citizen or a legal permanent resident of the United States for at least five years and be 65 years old or older to be eligible for Medicare. If you’ve been receiving disability benefits from Social Security or the Railroad Retirement Board for at least two years, or if you have end-stage renal disease or amyotrophic lateral sclerosis (commonly known as Lou Gehrig’s illness), you may be eligible for Medicare before you turn 65.

There are regulations about when you’re eligible for Medicare and when you can sign up for coverage, just like there are rules about other aspects of the program. You may be automatically enrolled in Medicare Part A and/or Part B the month you turn 65 if you are currently receiving retirement benefits. If you’ve been collecting Social Security or Railroad Retirement Board disability benefits for at least two years, you’ll be automatically enrolled in Medicare; you’ll be automatically enrolled in the 25th month of disability benefits

You can also sign up for Medicare Part B during the following periods:

• The Initial Enrollment Period (IEP)

The Initial Enrollment Period (IEP) is when you are first eligible to enroll in Medicare, either because you are 65 years old or because you are disabled. If you are eligible due to age, your Initial Enrollment Period begins three months before you turn 65 and ends seven months later. If you qualify for Medicare as a result of a disability, your Initial Enrollment Period begins three months before the end of your 25th month of Social Security or Railroad Retirement Board disability benefits and lasts seven months.

If you missed your Initial Enrollment Period, you can enroll in Medicare Part B during the General Enrollment Period, which runs from January 1 to March 31 each year. If you sign up for Medicare Part B during the General Enrollment Period, your coverage will begin on July 1st of the following year. If you didn’t sign up for Medicare Part B when you initially became eligible, you’ll have to pay a penalty. If you didn’t sign up for Medicare Part B when you initially became eligible, you could face a late-enrollment penalty, and your Medicare Part B premium could be 10% higher for any 12 months during which you could have gotten it but didn’t.

• Special Enrollment Period (SEP)

If you or your spouse are working and have group health coverage via your current employer, you may choose to delay your Medicare Part B enrollment during the Special Enrollment Period (SEP). You will be allowed a Special Enrollment Period to enroll in Medicare Part B when you or your spouse retires and lose your corporate health coverage. The Special Enrollment Period is the eight months after your employer’s coverage finishes or you cease working (whichever happens first). You can enroll at any moment during the Special Enrollment Period or while you and your spouse are still covered by the employer health plan.

You can enroll in Medicare Part B through Social Security in the following ways:

• Online at SSA.gov. If you’re not yet ready to apply for retirement benefits, you can apply for Medicare only.
• In-person at a local Social Security office.
• By calling Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778. Social Security representatives are available Monday through Friday, from 7 AM to 7 PM.

If you worked for a train, instead of Social Security, you can apply for Medicare through the Railroad Retirement Board. To enroll, call the Railroad Retirement Board at 1-877-772-5772 (TTY users, dial 1-312-751-4701) from 9 a.m. to 3:30 p.m., Monday through Friday.

Medicare Part B costs

While some people may be eligible for premium-free Medicare Part A if they’ve worked for at least 10 years (40 quarters) and paid Medicare taxes during that time, the majority of Medicare Part B enrollees must pay a monthly premium unless they qualify for low-income assistance. The amount of the premium may vary from year to year.

If your income exceeds a specific level, you may be required to pay a higher premium for Medicare Part B coverage. This is referred to as an Income Related Monthly Adjustment Amount (IRMAA), which is a one-time payment in addition to your monthly Part B premium. If this applies to you, Social Security will contact you.

In addition, you may be responsible for certain out-of-pocket charges for Medicare Part B-covered services, such as copayments, coinsurance, and the yearly Part B deductible. After you’ve satisfied your yearly deductible, most medical expenses will cost you 20% of the Medicare-approved amount.

Do you have any questions regarding what Part B of Medicare covers? Perhaps you’d like to supplement Original Medicare with additional benefits, such as through a Medicare Advantage plan. If you’d like to speak with a professional insurance agent about your Medicare coverage options, call eHealth now to learn about Medicare plan options that might be right for you.

This website and its contents are provided solely for educational reasons. Nothing on this website should be used to replace professional medical advice. Always consult your medical provider before beginning any exercise or nutritional plan, as well as before receiving a diagnosis or treatment for a health problem, including decisions about the proper medicine for your condition.

How do I apply for Medicare Part B online

As of 2010, you may also enroll online at www.socialsecurity.gov. Click “Online Services” and then “Apply for Benefits.” The application process can take less than 10 minutes.

Working elderly

When the Medicare program was formed in 1965, most people retired at 65, and their participation in the program began automatically at that age. However, as more people working past the age of 65 and Medicare tried to cut costs, the coverage and enrollment policies for Medicare altered.

Several pieces of legislation introduced in the early 1980s made Medicare benefits secondary to benefits paid under an employer group health plan (EGHP) for employees and their spouses aged 65 and higher. Employers are also no longer allowed to give Medicare-eligible employees and their spouses a different health plan than the rest of the workforce. Employers with fewer than 20 employees are free from the new requirements, but they may voluntarily participate.

As a result of these modifications, a new “special enrollment time” for the working elderly was established. Individuals over 65 who are covered by an EGHP due to their own or a spouse’s job have the option to enroll in Medicare once they turn 65 without paying a premium surcharge. Many workers may not want to pay for Medicare coverage that is redundant because their EGHP is the primary payer. If you don’t enroll within this “special enrollment time,” you may be charged a premium surcharge and won’t be able to join until the next standard enrollment period.

The special enrollment period (SEP) used to start on the first day of the month after the employee’s EGHP coverage terminated and concluded seven months later. Individuals covered by an EGHP, however, have been able to enroll in Medicare while still being covered since March 1, 1995.

In addition, the time frame for enrolling once EGHP coverage expires has been extended from seven to eight months.

Under the new rules, an individual can enroll in Medicare while still covered by an EGHP and choose whether coverage begins that month or in one of the three months after that.

To avoid coverage gaps, enroll three months before your employment ends or in the month before your employment ends. It’s vital to keep in mind that the legal changes haven’t changed the fact that the Special Enrollment Period is only open to persons who are covered by an EGHP through their own or a spouse’s employment.

Failure to enroll in Medicare Part B

Individuals who fail to enroll in Medicare during the right enrollment time may face harsh consequences. For each year that an individual fails to enroll in Part B, a 10% fee is applied to the Part B premium. Failure to enroll during the initial or special enrollment period will prevent the individual from enrolling in Medicare Part B until the regular enrollment period, which is held during the first three months of each year. Part B benefits coverage would not start until July of that year. As a result, there may be several months when an individual, having no Part B Medicare coverage, may be vulnerable to costly out-of-pocket medical expenses.

It’s worth noting that people who are eligible for Social Security or Railroad Retirement payments can join in Part A at any time and receive up to 6 months of free coverage. Only Part B coverage is subject to limitations on enrollment periods and a premium. Individuals who are not eligible for Part A coverage but choose to pay the premium and participate voluntarily are an exception. They will be subject to the fee and enrollment limits.

Appeals

A decision by the Social Security Administration or the Railroad Retirement Board to reject Medicare eligibility or coverage for any reason can be appealed. When a person’s enrollment rights have been harmed due to the federal government’s action, inaction, misrepresentation, or error, she cannot be fined or subjected to hardship. If a person can prove this, the decision to deny Medicare eligibility or coverage, or the imposition of a penalty surcharge, may be overturned. The local Social Security office handles appeals. If you believe you are being denied Medicare coverage unfairly, you must exercise your right to appeal.

How to enroll in Medicare if not eligible for social security

Due to the steady increase in the age of full Social Security benefit eligibility from 65 to 67, an increasing proportion of people will need to enroll in Medicare at the age of 65 without also enrolling for Social Security benefits. These are the three ways you can do it:

1. Apply securely online at http://www.socialsecurity.gov/forms/apply-for-benefits.html.

• Fill out the simple questions on applying for self or other and visual impairment on the right under “to start the application process”
• Click the “apply for benefits” button
• Fill out the electronic forms on the following pages.
• The sections are divided to keep them short and clear. Just be sure to be accurate and complete.

2. Call the Social Security 800 telephone number

• Call 1-800-772-1213, choose prompt 1 for English, 3 for other additional services or to speak with a representative, and finally 0 to speak with a claims representative;
• Once you are talking to a claims representative, explain that you want to enroll in Medicare but NOT Social Security. They will fill out an application for you and instruct you how to submit your birth certificate;
• Your application will then be submitted by the claims representative;
• Four to six weeks after the receipt of your documentation, you will receive your Medicare card and handbook in the mail.

3. Visit your local Social Security office

• Visit your local Social Security office. (You can find it online, or by calling 1-800-772-1213);
• Once you are talking to a claims representative, explain that you want to enroll in Medicare but NOT Social Security. They will fill out an application for you and make a copy of your birth certificate;
• Your application will then be submitted by the claims representative;
• Four to six weeks later, you will receive your Medicare card and handbook in the mail.

Medicare covers skilled care to maintain or slow decline as well as to improve.

Improvement Isn’t Required. It’s the law!

Improve Medicare for all beneficiaries

Medicare is a popular program, but it requires vigilance to guarantee that all beneficiaries are provided with complete coverage and equitable treatment. The Medicare program, which many Americans rely on, has been allowed to suffocate. Traditional Medicare, which most beneficiaries prefer, hasn’t been enhanced in years, but private Medicare Advantage programs have been bolstered on numerous occasions. It’s past time to improve Medicare for people who rely on it today and in the future.

Final words

We can avert severe national implications by prioritizing Medicare seniors and the health systems that serve them. The Center for Medicare Advocacy has proposed a five-part plan to make Medicare a bulwark against the nation’s deteriorating health and economic problems.