Query: I acquired a letter from Medicare saying I might need to join Half B. What ought to I do?
Reply: Pleased Normal Enrollment Interval (GEP)!
The letter you acquired from Medicare is a part of an effort to verify these eligible for Half B are appropriately enrolled. Keep in mind that Medicare Half A, B and D all have totally different guidelines. This text defines the principles relating to Medicare Half B solely.
People who’ve solely Medicare Half A, obtain a letter from Facilities for Medicare and Medicaid Companies (CMS) stating that you could be want to join Medicare Half B. You could have Medicare Half A solely and it’s at the moment the Normal Enrollment Interval (GEP) permitting you to join Medicare Half B, January 1 to March 31 annually. For those who failed to join Medicare Half B when you must have, you possibly can join Half B throughout the annual GEP. The letter informs you in regards to the GEP and the final guidelines of the GEP.
If you find yourself working and carry insurance coverage out of your present employer, it’s possible you’ll not want Medicare Half B. The Medicare Half B exemption requires your worker group should be bigger than 20 staff if you’re over 65 (bigger than 100 staff when you have Medicare as a consequence of a incapacity). When your worker group meets these measurement necessities, and also you carry insurance coverage by means of your present worker group, you don’t want Medicare Half B. This rule additionally applies in case your protection is thru your partner and their present employer protection.
When you or your partner cease working, or determine to drop the worker protection, you’ve a Particular Enrollment Interval (SEP) to join Medicare Half B. There may be paperwork you have to file to get your Medicare Half B began. As soon as your protection begins you’ll start to pay the Medicare Half B premium ($164.90 per 30 days for many enrollees).
Once you turned 65, you have been working with insurance coverage, or coated by your partner’s employer insurance coverage, you signed up for Medicare A and refused Half B since you had insurance coverage from one other supply. You made the proper choice on this state of affairs. Your Half B choice should change whenever you or your partner cease working. This choice may additionally change as a result of your present insurance coverage protection is dearer than Medicare Half B. Once you drop your worker protection and request Half B to begin instantly you’re high-quality, as there is no such thing as a hole in protection.
You could have 8 months to join Medicare Half B after your employer protection ends. Now I might not advocate going for 8 months with out Half B insurance coverage protection, however typically that occurs.
For those who go greater than 8 months with out Half B protection AND no insurance coverage from a present employment supply, you should have solely the GEP to join Half B, January 1 to March 31 annually. Once you join Medicare Half B throughout this GEP your Half B begins the primary of the month following your request (February 1, March 1 or April 1). It is a model new rule defining when your Half B will start. This late enrollment may additionally embrace a premium penalty for time with out insurance coverage protection. The Half B premium penalty is 10% for every 12 months with out applicable protection. The ten% penalty is predicated on the present Half B premium (10% of $164.90) and lasts for the remainder of your life.
You’ll be able to see I don’t advocate delaying enrollment in Medicare Half B.
Different situations the place people miss enrollment into Medicare Half A & Half B are once they have insurance coverage by means of a previous employer which continued to cowl them after retirement, a COBRA plan or a Market Plan. These causes are NOT good causes to delay Half B. In case you are not going to work, you’re carrying COBRA insurance coverage or a Market Plan and are eligible for Medicare, you MUST enroll in Medicare Half A & Half B.
In some situations, people are provided insurance coverage at a decrease price or no price once they first go away work, so that they maintain this insurance coverage and don’t join Medicare Half B. In case you are not going to work for the corporate that gives the medical insurance to you, you’ll want to have Medicare A & B.
The letter you acquired from CMS ought to immediate you to consider your scenario and ensure that it’s okay to not have Half B. I attempt to impress the significance of this GEP as a result of there aren’t many SEP’s obtainable to get you into Medicare Half B.
Considering and making choices about Medicare is usually “If this than that, but when that then this” sort pondering. It makes it laborious to know and comply with the correct path for you.
Senior Life Issues is a neighborhood based mostly program sponsored by Lutheran Jamestown. For questions and considerations or to achieve Janell Sluga, GCMC, name 716-720-9797 or e mail at SLM@lutheran-jamestown.org.