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Medicare Frequently Asked Questions
If you already get Social Security benefits, you do not need to sign up for Medicare. We will automatically enroll you in Original Medicare (Part A and Part B) when you become eligible. We will mail you the information a few months before you become eligible.
Because you must pay a premium for Part B coverage, you can turn it down. However, if you decide to sign up for Part B later, your coverage can be delayed and you may have to pay a late enrollment penalty for as long as you have Part B coverage. Residents of Puerto Rico or foreign countries will NOT automatically receive Part B. They must elect this benefit.
If you don’t get Social Security benefits and are not ready to apply for them yet, you should sign up for Medicare three months before your 65th birthday. The easiest way to apply for Medicare is by using our online application (https://www.ssa.gov/medicare/sign-up)or you can make an appointment by calling us at 1-800-772-1213 (TTY 1-800-325-0778), 8:00 a.m. – 7:00 p.m., Monday through Friday.
For more information read our Medicare (https://www.ssa.gov/pubs/EN-05-10043.pdf)publication.
Source: https://faq.ssa.gov/en-us/Topic/article/KA-02125
Medicare Part B premiums vary based on beneficiary’s income and can change each year. For current rates visit the Medicare Cost (https://www.medicare.gov/basics/costs/medicare-costs)site.
Each year, Social Security sends a letter to people collecting Social Security benefits (and those who pay higher premiums because of their income) stating each person’s exact Part B premium.
You can get details at Medicare.gov (http://www.medicare.gov/)or by calling 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048).
For more information about higher premiums go to the Medicare Premiums: Rules for Higher-Income Beneficiaries (https://www.ssa.gov/benefits/medicare/medicare-premiums.html)page.
Source: https://faq.ssa.gov/en-us/Topic/article/KA-02166
You may have health insurance coverage under a group health plan based on your or your spouse's current employment. In this case, you may not need to apply for Medicare Part B at age 65. You may qualify for a Special Enrollment Period and be able to delay signing up for Medicare Part B without a late enrollment penalty.
Coverage based on current employment does not include COBRA (Consolidated Omnibus Budget Reconciliation Act), Retiree health coverage VA (Veterans Affairs) health coverage, or Individual health coverage (such as through the Health Insurance Marketplace).
For more information read our How to Apply for Medicare Part B During Your Special Enrollment Period (https://www.ssa.gov/pubs/EN-05-10012.pdf)and Medicare (https://www.ssa.gov/pubs/EN-05-10043.pdf)publications.
Find out how your coverage works with Medicare at Medicare.gov (https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b/should-i-get-parts-a-b)or contact your employer or union benefits administrator.
Source: https://faq.ssa.gov/en-us/Topic/article/KA-02983
Some people with higher income may pay a larger percentage of their monthly Medicare Part B and prescription drug costs based on their income. We call the additional amount the income-related monthly adjustment amount. Visit Medicare Premiums: Rules For Higher-Income Beneficiaries (https://www.ssa.gov/benefits/medicare/medicare-premiums.html#anchor5)to see if the adjustment amount applies to you.
More Information
Medicare Premiums: Rules For Higher-Income Beneficiaries(https://www.ssa.gov/benefits/medicare/medicare-premiums.html)
Medicare Income-Related Monthly Adjustment Amount-Life-Changing Event(https://www.ssa.gov/forms/ssa-44.pdf)
Source: https://faq.ssa.gov/en-us/Topic/article/KA-02154
Signing up for Medicare Part B may provide you with additional service and location options.
If you don’t sign up for Part B when you are first eligible:
• You may have to wait to sign up, which will delay your coverage, and;
• you may also have to pay a late enrollment penalty for as long as you have Medicare Part B.
Visit Medicare.gov (https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b/should-i-get-parts-a-b)for more information.
Source: https://faq.ssa.gov/en-us/Topic/article/KA-02989
If you have Medicare Part A, but you did not enroll in Medicare Part B during your Initial Enrollment Period (IEP), you may sign up during the General Enrollment Period (GEP), or you may qualify for a Special Enrollment Period (SEP).
The annual GEP runs from January 1 to March 31, with coverage starting the month after you enroll. You may have to pay a late enrollment penalty for not signing up when you were first eligible.
Those with group health plan coverage through an employer or spouse may qualify for an SEP. If you qualify for an SEP, you can apply online at Apply for Medicare Part B Online during a Special Enrollment Period.(https://secure.ssa.gov/mpboa/medicare-part-b-online-application/)
You can also fax or mail your completed Application for Enrollment in Medicare – Part B (CMS-40B) (https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS017339)and the Request for Employment Information (CMS-L564) (https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS009718)enrollment forms and evidence of employment to your local Social Security office.(https://secure.ssa.gov/ICON/main.jsp) If you have questions, please contact Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
Note: When completing the forms CMS-40B and CMS-L564:
• State “I want Part B coverage to begin (MM/YY)” in the remarks section of the CMS-40B form or online application.
• 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.
• Also submit one of the following forms of secondary evidence:
• Income tax returns that show 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.
• Statements or receipts that reflect payment of health insurance premiums.
For more information go to our Medicare Benefits (https://www.ssa.gov/benefits/medicare/#anchor2)page.
Source: https://faq.ssa.gov/en-us/Topic/article/KA-02131
If your Medicare card was lost, stolen, or destroyed, you can request a replacement online at Medicare.gov.(https://www.medicare.gov/)
You can print an official copy of your card from your online Medicare account (https://www.mymedicare.gov/)or call 1-800-MEDICARE (1-800-633-4227 TTY 1-877-486-2048) to order a replacement card to be sent in the mail.
Source: https://faq.ssa.gov/en-us/Topic/article/KA-01735
Medicare (https://www.ssa.gov/pubs/EN-05-10043.pdf)is a health insurance program for people age 65 or older. Some younger people are eligible for Medicare including people with disabilities, permanent kidney failure and amyotrophic lateral sclerosis (Lou Gehrig’s disease or ALS). Medicare helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.
Original Medicare included:
• Part A—Hospital insurance helps pay for inpatient care in a hospital or limited time at a skilled nursing facility (following a hospital stay), and some home health care and hospice care.
• Part B—Medical insurance helps pay for doctors’ services and many other medical services and supplies that the hospital insurance does not cover.
Other parts of Medicare are:
• Part C—Medicare Advantage plans are offered by private companies and approved by Medicare. These plans generally help you pay the medical costs not covered by Original Medicare.
• Part D—Prescription drug coverage helps pay for prescribed medications.
Source: https://faq.ssa.gov/en-us/Topic/article/KA-02113
States must help pay some of the Medicare costs for beneficiaries who have limited income and resources. Under these programs, states help pay for Medicare Part A and Part B premiums, deductibles and copayments. Some of these programs also pay additional Medicare expenses for elderly and disabled people.
To find out if you are eligible for state help, contact your local medical assistance office. A representative can tell you the specific requirements and help you apply.
For more information see (Medicare.gov)(https://www.medicare.gov/).
Source: https://faq.ssa.gov/en-us/Topic/article/KA-02137
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