Which Medicare plans do I need to enroll my employees in?
Note that most retiree and small employer plans (employers with fewer than 20 employees) require enrollment in Part A and Part B. If the retiree plan you offer requires Medicare enrollment, please advise your employees planning to retire well in advance.
Why is it important to know how people qualify for Medicare?
It’s important to know the different ways that people qualify for Medicare so you can help current and former employees and their dependents anticipate their eligibility for Medicare so they can make timely and appropriate decisions about their enrollment. 2.
Who is eligible for Medicare?
1. People are eligible for Medicare for different reasons. Some are eligible when they turn 65. People under 65 are eligible if they have received Social Security Disability Insurance (SSDI) or certain Railroad Retirement Board (RRB) disability benefits for at least 24 months.
Will I be automatically enrolled in Medicare if I don’t collect Social Security?
People who aren’t yet collecting Social Security, or aren’t eligible for Social Security Retirement, aren’t automatically enrolled into Medicare. They must sign up by contacting Social Security.
Who is the best person to talk to about Medicare?
Do you have questions about your Medicare coverage? 1-800-MEDICARE (1-800-633-4227) can help. TTY users should call 1-877-486-2048.
Who enrolls most in Medicare?
UnitedHealthcare and Humana have consistently accounted for a large share of Medicare Advantage enrollment. UnitedHealthcare has had the largest share of Medicare Advantage enrollment since 2010. Its share of Medicare Advantage enrollment has grown from 19 percent in 2010 to 27 percent in 2021.
What federal government agency is responsible for eligibility and enrollment in the Medicare program?
The federal agency that oversees CMS, which administers programs for protecting the health of all Americans, including Medicare, the Marketplace, Medicaid, and the Children's Health Insurance Program (CHIP).
How does Medicare Helpline work?
The Medicare Coverage Hotline is a private for-profit lead generation campaign and does not offer insurance and is not an insurance agency or broker. Your call is sold to a licensed insurance agent to give you information about your Medicare Advantage Plans.
What percent of seniors choose Medicare Advantage?
[+] More than 28.5 million patients are now enrolled in Medicare Advantage plans, according to new federal data. That's up nearly 9% compared with the same time last year. More than 40% of the more than 63 million people enrolled in Medicare are now in an MA plan.
What are the top 3 Medicare Advantage plans?
The Best Medicare Advantage Provider by State Local plans can be high-quality and reasonably priced. Blue Cross Blue Shield, Humana and United Healthcare earn the highest rankings among the national carriers in many states.
Who administers the Medicare program?
CMSThe federal agency that oversees CMS, which administers programs for protecting the health of all Americans, including Medicare, the Marketplace, Medicaid, and the Children's Health Insurance Program (CHIP).
Is CMS a real company?
The Centers for Medicare & Medicaid Services, CMS, is part of the Department of Health and Human Services (HHS).
Is CMS legitimate?
CMS.gov is the official website of the Centers for Medicare & Medicaid Services and includes information about Medicare, Medicaid, and Medicare-Medicaid coordination as well as other information.
Why do doctors not like Medicare Advantage plans?
If they don't say under budget, they end up losing money. Meaning, you may not receive the full extent of care. Thus, many doctors will likely tell you they do not like Medicare Advantage plans because private insurance companies make it difficult for them to get paid for their services.
How do I ask Medicare a question?
Call 1-800-MEDICARE For questions about your claims or other personal Medicare information, log into (or create) your secure Medicare account, or call us at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
Is the Medicare coverage helpline for real?
You can call the Medicare helpline at 1-800-MEDICARE (1-800-633-4227) for questions about Medicare coverage. Or you can call our licensed insurance agents to learn about Medicare Advantage plan options in your area. 1-800-MEDICARE (1-800-633-4227) is the official phone number for Medicare.
What information does an agent or broker need to help me enroll in Medicare?
An agent or broker can help you with the process of selecting a plan and completing the enrollment. In order to best assist you, they will need to...
Can a friend or family member help me sign up for Medicare?
You always have the right to have a trusted friend or family member present while you’re discussing your health coverage needs with Medicare, your...
How can I authorize Medicare to discuss my coverage with someone else?
If you want Medicare to be able to directly share your personal health information with someone else, there’s an authorization form that you’ll nee...
Can someone help me sign up for Medicare if I'm incapacitated?
If you’re incapacitated and unable to participate in your own plan selection process, someone else can act on your behalf as long as you’ve created...
Can a friend or family talk about my coverage with a private Medicare insurance company?
If you’re enrolled in a private Medicare plan (a Part D plan, a Medicare Advantage plan, or a Medigap plan), the insurance company will have their...
State Health Insurance Assistance Programs
These centers, known by the acronym SHIP, are available in every state plus the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands.
Centers for Medicare & Medicaid Services
This federal agency, which is part of the Department of Health and Human Services, runs the Medicare program. Its website offers information about how Medicare works, what it covers, when to enroll and how to buy private insurance policies that can fill in coverage gaps.
Social Security Administration
This independent federal agency handles Medicare enrollment. It can be a helpful source of information about signing up, applying for the Part D prescription drug Extra Help program and understanding Medicare’s high-income premium surcharges.
Medicare Rights Center
This nonprofit has been helping people navigate Medicare for more than 30 years.
State insurance departments
Individual states’ insurance departments can give you information about supplemental Medigap policies in your area. Visit the National Association of Insurance Commissioners and look for your state in the Insurance Departments drop-down menu.
What to do when you are 65 and new to Medicare?
People who are new to Medicare and/or are turning 65 have many decisions to make about health benefits. We recommend bringing together everyone who will be involved in the decision-making process, when helping someone enroll in a Medicare Advantage plan. Explain the purpose of getting together; share what you have learned; and, most importantly, ...
When does Medicare coverage start?
For people who enroll in a Medicare Advantage plan during the Medicare Advantage and Prescription Drug Plan Annual Enrollment Period (October 15 - December 7 every calendar year), coverage becomes effective on January 1.
What is Medicare Advantage Plan?
Medicare Advantage plans typically include drug coverage and fixed copayments, which can help you estimate monthly costs. CarePlus offers Medicare Advantage plans.
How long do you have to enroll in Medicare?
However, the law only allows for enrollment in Medicare Part B (Medical Insurance), and premium-Part A (Hospital Insurance), at limited times: 1 Initial Enrollment Period – a 7-month period when someone is first eligible for Medicare. For those eligible due to age, this period begins 3 months before they turn 65, includes the month they turn 65, and ends 3 months after they turn 65. For those eligible due to disability, this period begins three months before their 25th month of disability payments, includes the 25th month, and ends 3 months after. By law, coverage start dates vary depending on which month the person enrolls and can be delayed up to 3 months. 2 General Enrollment Period – January 1 through March 31 each year with coverage starting July 1 3 Special Enrollment Period (SEP) – an opportunity to enroll in Medicare outside the Initial Enrollment Period or General Enrollment Period for people who didn’t enroll in Medicare when first eligible because they or their spouse are still working and have employer-sponsored Group Health Plan coverage based on that employment. Coverage usually starts the month after the person enrolls, but can be delayed up to 3 months in limited circumstances.#N#People who are eligible for Medicare based on disability may be eligible for a Special Enrollment Period based on their or their spouse’s current employment. They may be eligible based on a spouse or family member’s current employment if the employer has 100 or more employees.
How long is the initial enrollment period for Medicare?
Initial Enrollment Period – a 7-month period when someone is first eligible for Medicare. For those eligible due to age, this period begins 3 months before they turn 65, includes the month they turn 65, and ends 3 months after they turn 65. For those eligible due to disability, this period begins three months before their 25th month ...
What is a SEP in Medicare?
Special Enrollment Period (SEP) – an opportunity to enroll in Medicare outside the Initial Enrollment Period or General Enrollment Period for people who didn’t enroll in Medicare when first eligible because they or their spouse are still working and have employer-sponsored Group Health Plan coverage based on that employment.
How long do you have to wait to get Medicare if you have ALS?
People under 65 are eligible if they have received Social Security Disability Insurance (SSDI) or certain Railroad Retirement Board (RRB) disability benefits for at least 24 months. If they have amyotrophic lateral sclerosis (ALS), there’s no waiting period for Medicare.
Who can help with Medicare prescriptions?
SHIP counselors can also help people figure out if they're eligible for extra help with Medicare prescription drug costs or other programs to help with their premiums and expenses. Some organizations do screening for low-income extra help programs automatically as part of other services, but you can also contact the SHIP to find out if you are eligible for any programs. "Anyone who is struggling or concerned about their Medicare costs can contact us," says Hohl. "Even if they don't qualify for a program, maybe they could do a plan review and save some money."
When is open enrollment for Medicare?
Open Enrollment Help. The busiest time for SHIP counselors is during open enrollment from Oct. 15 to Dec. 7, when people can choose a Part D prescription drug plan or Medicare Advantage plan for the upcoming year.
Can a ship counselor answer Medicare questions?
SHIP counselors can answer personal Medicare questions over the phone. (Getty Images) Medicare can be complicated. It's easy to make mistakes when signing up that could result in lifelong penalties or coverage gaps, and people who lose their jobs after age 65 have an extra layer of complexity. Everyone on Medicare has the opportunity ...
Can a ship counselor help with Medicare?
How SHIPs Can Help With Your Medicare Questions and Problems. Medicare is complicated, but SHIP counselors can provide free help with open enrollment decisions, sign-up questions and appeals in every state. SHIP counselors can answer personal Medicare questions over the phone. (Getty Images)
Do you need to sign up for Medicare if you are 65?
SHIPs also provide help with Medicare sign-up issues. Unless you're already receiving early Social Security benefits at 65, you need to proactively sign up for Medicare. Your sign-up decisions can be complicated if you're still working past age 65 and have health insurance through your employer, especially if you lose your job ...
Can low income people get help with Medicare?
Low-income people often don't realize that they're eligible for extra help to pay Medicare drug costs. And if your care or drug is denied, you can appeal and fight back. You can get help with all of these complicated Medicare issues from your State Health Insurance Assistance Program, or SHIP.
Can counselors share screen on Zoom?
Because of COVID-19 restrictions, the counselors had to change the way they meet, but they've been providing personal counseling through Zoom, GoToMeeting or Webex, where they can share computer screens and walk through the Plan Finder's results together. They also work with adult children who are helping their parents.
Who Is Eligible for Medicare Coverage?
Medicare eligibility falls into three categories. You're usually eligible if you meet the requirements of one of these categories:
How Do You Sign Up for Medicare?
For those who are turning 65 soon and who meet the eligibility requirements, there are a few ways to enroll in Medicare.
What Types of Medicare Coverage Are There?
Part A Medicare is designed to pay major medical benefits, such as inpatient hospital expenses. It may also cover surgery, lab tests, hospice care, treatment in a skilled nursing facility and some home health care.
If you have only Medicare Part B
If you have Medicare Part A (Hospital Insurance), you’re considered covered under the health care law and don’t need a Marketplace plan.
Expanded Medicare benefits for preventive care, drug coverage
Medicare benefits have expanded under the health care law – things like free preventive benefits, cancer screenings, and an annual wellness visit.
More Medicare details
Medicare’s annual Open Enrollment Period (October 15-December 7) hasn’t changed.