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How To File For Medicare Benefits

What Medicaid Helps Pay For

How To Apply For Medicare Online – Step By Step

If you have Medicare and qualify for full Medicaid coverage:

  • You’ll automatically get Extra Help with your drug costs. Learn more about Extra Help.
  • Medicaid may pay for other drugs and services that Medicare doesn’t cover.
  • What Do I Submit With The Claim

    Follow the instructions for the type of claim you’re filing . Generally, youll need to submit these items:

    • The completed claim form )
    • The itemized bill from your doctor, supplier, or other health care provider
    • A letter explaining in detail your reason for submitting the claim, like your provider or supplier isnt able to file the claim, your provider or supplier refuses to file the claim, and/or your provider or supplier isnt enrolled in Medicare
    • Any supporting documents related to your claim

    How Do I Sign Up For Medicare Parts A And B

    If you’re already receiving Social Security retirement benefits before you turn age 65, Social Security will automatically enroll you in Medicare. Also, if you’re already receiving Social Security Disability benefits, Social Security will automatically enroll you in Medicare after 24 months. If you’re not sure if you need to enroll yourself, contact Social Security to find out.

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    How To Enroll In Medicare Advantage

    Medicare Advantage, or Medicare Part C, is a private bundled health insurance plan. It offers the same coverage as parts A and B. If often provides prescription coverage as well. Some Medicare Advantage plans also cover vision, dental, and other healthcare benefits.

    This plan may place a yearly cap on your out-of-pocket costs. That can be helpful if you expect to have any large healthcare expenses.

    But a Medicare Advantage plan will be an additional cost on top of any premiums you pay for other parts of Medicare. Many Medicare Advantage plans will cover some or all of your Medicare Part B premium costs. Weigh your healthcare needs with the costs of coverage when .

    If you want to enroll in Medicare Advantage, you can sign up during your initial enrollment period. You can also change your selections during Medicares open enrollment period from October 15 through December 7. If you sign up outside these times, you may pay a late-enrollment fee, and your coverage wont begin until July 1.

    You have two ways to sign up for Medicare Part C:

    • Online. Shop for Part C plans with Medicare.govs plan finder tool.
    • With a private company. Insurance companies offer Part C plans, and you can enroll directly with them via their website or by phone.

    Applying For Medicare Online

    How To Apply For Medicare Part B Online

    Applying for Medicare online is a quick and easy process on the Social Security website, taking approximately ten minutes. After you have applied for Medicare online, you can check the status of your application and/or appeal, request a replacement card, and print a benefit verification letter.

    You can easily apply online for Medicare and Social Security retirement benefits or just Medicare.

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    How Much Does Medicare Cost

    Original Medicare

    Original Medicare is divided into Part A and Part B .

    • Part A helps pay for inpatient hospital care, some skilled nursing care, home health care and hospice care.
    • Part B helps pay for doctor services, outpatient hospital care, durable medical equipment, home health care not covered by Part A, and other services. Medicare was never intended to pay 100% of medical bills. Its purpose is to help pay a portion of medical expenses. Medicare beneficiaries also pay a portion of their medical expenses, which includes deductibles, copayments, and services not covered by Medicare. The amounts of deductibles and copayments change at the beginning of each year.

    Part A – Monthly Premium

    If you are eligible, Part A is free because you or your spouse paid Medicare taxes while you were working. You earn Social Security “credits” as you work and pay taxes. For each year that you work, you earn 4 credits.

    $471 $499

    You are 65 or older, and you receive or are eligible to receive full benefits fr om Social Security or the Railroad Retirement Board

    You are under 65, and you have received Social Security disability benefits for 24 months You are under 65, and you have received Railroad Retirement disability benefits and you meet Social Security disability requirements You or your spouse had Medicare-covered government employment You are under 65 and have End-Stage Renal Disease

    You Have Health Insurance You Want To Keep

    If you currently have a health insurance plan that you love either through a job, your spouse, a union, or other source you may wish to continue your current coverage.

    Deferring Medicare may save you money on monthly premiums, especially if youre a high-wage earner. If your current insurance is provided through a large group insurer and covers everything that Medicare parts B and D cover, you wont be hit with a penalty if you defer for this reason.

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    Do I Need Other Documents If Im Enrolling In A Specific Part Of Medicare

    Youll need to provide the documents listed above when you enroll in Medicare Part A and Medicare Part B . Together, parts A and B are known as original Medicare.

    Youll need to enroll in original Medicare before you can enroll in any other Medicare parts. Other parts of Medicare include:

    You shouldnt need to submit any additional documentation when you enroll in these other parts.

    Youll just be asked to provide your Medicare number and your Medicare Part A start date. You can find your Medicare number and Part A start date on your Medicare card.

    You can get new copies of any documents you no longer have. Its a good idea to start gathering documents before you apply for Medicare.

    If you need new copies of any documents, you can follow the steps below.

    How To Enroll In Medicare

    Medicare Basics: Parts A & B Claims Overview

    Enrolling in Medicare is easy once you understand how to do so. It’s important to know that how you enroll in Medicare Part A and Part B is different from how you enroll in Medicare Advantage , Part D or Medicare supplement insurance.

    See the table below for a quick overview of how to enroll in a Medicare or Medigap plan and read on for how-to steps for both Original Medicare and the three kinds of Medicare and Medigap plans.

    Original Medicare Medicare Advantage plan Medicare Prescription Drug plan Medicare Supplement Insurance plan How to Enroll

    Enroll in Original Medicare online at the Social Security website or by calling or visiting your local Social Security office.

    Enroll directly in the plan e.g., on the plans website or Medicare.gov .

    Enroll directly in the plan e.g., on the plans website or Medicare.gov .

    Enroll directly in the plan e.g., on the plans website

    Original Medicare

    How to Enroll

    Enroll in Original Medicare online at the Social Security website or by calling or visiting your local Social Security office.

    Medicare Advantage plan

    How to Enroll

    Enroll directly in the plan e.g., on the plans website or Medicare.gov .

    Medicare Prescription Drug plan

    How to Enroll

    Enroll directly in the plan e.g., on the plans website or Medicare.gov .

    Medicare Supplement Insurance plan

    Enroll directly in the plan e.g., on the plans website

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    Documents You Need To Apply For Medicare

    To begin the application process, youll need to ensure you have the following documentation to verify your identity:

    • A copy of your birth certificate
    • Your drivers license or state I.D. card
    • Proof of U.S. citizenship or proof of legal residency

    You may need additional documents as well. Make sure to have on hand:

    • Your Social Security card
    • W-2 forms if still active in employment
    • Military discharge documents if you previously served in the U.S. military before 1968
    • Information about current health insurance types and coverage dates

    If you are already enrolled in Medicare Part A and have chosen to delay enrollment in Medicare Part B, you must complete the additional forms .

    • 40B form:This allows you to apply for enrollment into Medicare Part B only. The 40B form must be included in your online application or mailed directly to the Social Security office.
    • L564 form:Your employer must complete this form if you delayed Medicare Part B due to creditable group coverage through said employer. You must also include the completed L564 form in your online application, or mail it directly to the Social Security office.

    When You Decide To Retire

    For a smooth transition from a CalPERS Basic to a CalPERS Medicare health benefits plan, you are encouraged to enroll into Medicare Parts A & B prior to or within 30 days of retirement. Timely enrollment allows us to receive notification of your enrollment electronically and automatically transition you into a CalPERS Medicare health benefits plan. You will not need to send any additional documentation to us if:

    • Your enrollment is more than 30 days from retirement, you may be required to provide supporting Medicare documentation to CalPERS.
    • Your CalPERS Basic health plan has a corresponding Medicare health plan, you will be automatically transitioned to the CalPERS Medicare plan with your carrier. If your Basic plan does not have a corresponding Medicare plan, you will be transferred into UnitedHealthcare . If UnitedHealthcare is not available where you live, you will be transferred into PERS Choice .

    You have 60 days from the date of enrollment in a CalPERS Medicare plan to elect a different plan by contacting CalPERS at 888 CalPERS .

    You’re able to enroll in Medicare Parts A & B online with SSA by contacting SSA at 772-1213 or by visiting your local Social Security office. Call first to make an appointment.

    You may enroll in Medicare Part B by completing the following forms and applying directly with SSA.

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    Employer Or Military Retiree Coverage

    If you or your spouse has an Employer Group Health Plan as retiree health coverage from an employer or the military , you may not need additional insurance. Review the EGHPs costs and benefits and contact your employer benefits representative or SHIIP to learn how your coverage works with Medicare.

    If You Are Younger Than Age 65 With A Disability

    How to Apply for Medicare 2020

    If you are younger than age 65 and receive disability benefits under Social Security Disability Insurance or Railroad Retirement, you will automatically be enrolled in Medicare Parts A and B in the 25th month of your disability payments, or sooner if you have either end-stage renal disease or amyotrophic lateral sclerosis . You will need to to cover your prescription drug benefits.

    During the 24th month of your SSDI payments, Medicare will send you an initial enrollment package containing general information, a questionnaire and your Medicare card.

    If you want both Medicare Part A and Part B , simply sign your Medicare card and keep it in your wallet.

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    If You Delay Enrolling In Part B

    If you do not want Part B coverage because you are actively employed and covered by the employer plan and you automatically received Medicares initial enrollment package, sign the included form and check the box next to I do not want medical insurance. Return the form to the Social Security Administration in the provided envelope before the date listed so you wont owe a monthly premium.

    If you turn down Part B and dont have other coverage due to active employment, but later decide you want Part B coverage, you can only enroll during the annual General Enrollment Period , which is January 1 through March 31. Your Part B benefits will not be effective until July 1 of that year. You may also be required to pay a late enrollment penalty of 10% of the current Part B premium for each 12-month period you could have had Part B coverage, but did not take it.

    For beneficiaries age 65 and older, this penalty is for life, and you will always pay more for your Part B coverage than other people.

    If you are younger than age 65, have Medicare because of a disability and are charged the Part B penalty, it will be waived when you turn 65 and qualify for Medicare based on age.

    • Part B within 8 months
    • Part D within 2 months

    When Does Deferring Medicare Make Sense

    If youre thinking about deferring Medicare, discuss the pros and cons with your current insurer, union representative, or employer. Its important to know how or if your current plan will work with Medicare, so you can choose the most comprehensive overage possible.

    No matter your reasons for deferring, you must enroll in Medicare within 8 months of losing your current coverage. If you delay, you will incur penalties that may last for the entire duration of your Medicare coverage.

    Next, well discuss some of the common reasons you may be thinking about deferring Medicare.

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    If You Are Under Age 65 And Disabled:

    If you are under age 65 and disabled, and have been entitled to disability benefits under Social Security or the Railroad Retirement Board for 24 months, you will be automatically entitled to Medicare Part A and Part B beginning the 25th month of disability benefit entitlement. You will not need to do anything to enroll in Medicare. Your Medicare card will be mailed to you about 3 months before your Medicare entitlement date. , you get your Medicare benefits the first month you get disability benefits from Social Security or the Railroad Retirement Board.) For more information about enrollment, call the Social Security Administration at 1-800-772-1213 or visit the Social Security web site. See also Social Security’s Medicare FAQs.

    For more information, see Medicare.gov

    Medicare Faqs And Information To Consider

    Medicare & You: Medicare Advantage Plan appeals

    Automatic Enrollment:

    If you are already receiving Social Security benefits, Railroad Retirement benefits, or Federal Retiree benefits, your enrollment in Medicare is automatic. Your Medicare card should arrive in the mail shortly before your 65th birthday. Check the card when you receive it to verify that you are entitled to both Medicare Parts A and B.

    Initial Enrollment Period:

    If you are not eligible for Automatic Enrollment, contact the Social Security Administration at 800-772-1213 or enroll online at www.socialsecurity.gov, or visit the nearest Social Security office to enroll in Medicare Part A and Medicare Part B. You have a seven month window in which to enroll in Medicare without incurring a penalty. If youre not automatically enrolled in premium-free Part A, you can sign up for it once your Initial Enrollment Period starts. Your Part A coverage will start six months back from the date you apply for Medicare, but no earlier than the first month you were eligible for Medicare. However, you can only sign up for Part B during the times listed below.

    General Enrollment Period:

    • General Enrollment Period for Medicare Parts A & B

    If you have coverage through a current employer, you are not required to enroll in Medicare Part A and B. Below are some things to keep in mind about each part of Medicare.

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    If Your Income Has Gone Down

    If your income has gone down and the change makes a difference in the income level we consider, contact us to explain that you have new information. We may make a new decision about your income-related monthly adjustment amount for the following reasons:

    • You married, divorced, or became widowed.
    • You or your spouse stopped working or reduced your work hours.
    • You or your spouse lost income-producing property because of a disaster or other event beyond your control.
    • You or your spouse experienced a scheduled cessation, termination, or reorganization of an employers pension plan.
    • You or your spouse received a settlement from an employer or former employer because of the employers closure, bankruptcy, or reorganization.

    If any of the above applies to you, we need to see documentation verifying the event and the reduction in your income. The documentation you provide should relate to the event and may include a death certificate, a letter from your employer about your retirement, or something similar. If you filed a federal income tax return for the year in question, you need to show us your signed copy of the return. Use Form Medicare Income-Related Monthly Adjustment Amount Life-Changing Event to report a major life-changing event. If your income has gone down, you may also use Form SSA-44 to request a reduction in your income-related monthly adjustment amount.

    How To Apply For Medicare Disability Benefits

    You can apply for Social Security disability benefits if you’re unable to work because of a medical condition that’s expected to last at least 12 months or will result in death.

    If you have worked long enough and paid Social Security taxes on your earnings, you’re eligible to qualify for Social Security Disability Insurance or Supplemental Security Income . While these two programs are different, they both provide or pay benefits to those who have a qualifying disability.

    Once you are approved for disability benefits, you may also be eligible for Medicare. If you’re already 65 or older when you begin receiving disability benefits, there’s no difference in the way you would apply for Medicare. You also don’t have to wait 24 months to qualify, because you’ve already aged into the program If you aren’t yet 65 and collect disability benefits, you will qualify for Medicare after 24 months. Those who aren’t yet 65 but qualify for Medicare due to ALS or ESRD do not have the same 24-month waiting period.

    The following information explains how and where to apply for Medicare disability benefits, what information and documentation you’ll need for your application, and additional details about qualifying.

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