Medicare Blog

how do i apply for medicare in massachusetts

by Simeon Kris II Published 3 years ago Updated 2 years ago
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How do I enroll in Medicare for the first time?

Apply online (at Social Security) – This is the easiest and fastest way to sign up and get any financial help you may need. You'll need to create your secure my Social Security account to sign up for Medicare or apply for Social Security benefits online. Call 1-800-772-1213. TTY users can call 1-800-325-0778.

Do I automatically get Medicare when I turn 65?

You automatically get Medicare when you turn 65 Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

How many months before I turn 65 should I apply for Medicare?

3 monthsGenerally, we advise people to file for Medicare benefits 3 months before age 65. Remember, Medicare benefits can begin no earlier than age 65. If you are already receiving Social Security, you will automatically be enrolled in Medicare Parts A and B without an additional application.

When should I start my Medicare application?

Generally, you're first eligible starting 3 months before you turn 65 and ending 3 months after the month you turn 65. If you don't sign up for Part B when you're first eligible, you might have to wait to sign up and go months without coverage.

Are you automatically enrolled in Medicare if you are on Social Security?

Yes. If you are receiving benefits, the Social Security Administration will automatically sign you up at age 65 for parts A and B of Medicare. (Medicare is operated by the federal Centers for Medicare & Medicaid Services, but Social Security handles enrollment.)

Do I need to notify Social Security when I turn 65?

Is it automatic when I turn 65? To enroll in Medicare, most people need to contact Social Security directly. Do this before your 65th birthday to avoid a lapse in health coverage.Sep 15, 2013

Does Medicare start on birthdays?

Your Medicare coverage generally starts on the first day of your birthday month. If your birthday falls on the first day of the month, your Medicare coverage starts the first day of the previous month. If you qualify for Medicare because of a disability or illness, in most cases your IEP is also seven months.

Is Medicare Part A free?

Medicare Part A (Hospital Insurance) Most people get Part A for free, but some have to pay a premium for this coverage. To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child.Dec 1, 2021

How do I pay for Medicare Part B without Social Security?

If you don't get benefits from Social Security (or the Railroad Retirement Board), you'll get a premium bill from Medicare. Get a sample of the Medicare bill. An extra amount you pay in addition to your Part D plan premium, if your income is above a certain amount.

What do I need to do before I turn 65?

This quick checklist covers some of the most important things you should review.Prepare for Medicare. ... Consider Additional Health Insurance. ... Review Your Social Security Benefits Plan. ... Plan Ahead for Long-Term Care Costs. ... Review Your Retirement Accounts and Investments. ... Update Your Estate Planning Documents.Nov 22, 2021

What is Medicare Part C called?

Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by Medicare-approved private companies that must follow rules set by Medicare.

How long does it take for Medicare Part B to go into effect?

Yes. You automatically get Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months. If you're automatically enrolled, you'll get your Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability.

Living Well at Home

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When and how to apply for Medicare in Massachusetts

You can apply for Medicare when you turn 65 during your Initial Enrollment Period (IEP). This is the 7-month period that begins 3 months before you turn 65 and ends 3 months after the month you turn 65. For example, if your birthday is July 10, your IEP is from April 1 to October 31.

Best bet

Medicare.gov Everything you need to know to manage your Medicare benefits, including information on prescription drug options, comparing hospitals, comparing nursing homes, comparing health plans, and learning more about eligibility and coverage

Laws

MGL c.112 § 2 Prohibition against “balance billing” if the doctor accepts Medicare patients. “The board shall require as a condition of granting or renewing a physician's certificate of registration, that the physician, who if he agrees to treat a beneficiary of health insurance under Title XVIII of the Social Security Act, shall also agree not to charge to or collect from such beneficiary any amount in excess of the reasonable charge for that service as determined by the United States Secretary of Health and Human Services.”.

Web sources

Health insurance counseling . The Massachusetts SHINE Program (Serving the Health Insurance Needs of Everyone) provides free health insurance information, counseling, and assistance to all Massachusetts residents with Medicare.

Medicare Part D Prescription Drug Plan Enrollment

When youre eligible to enroll in Original Medicare, you also become eligible to enroll in a Medicare Part D prescription drug plan.

When To Apply For A Medicare Supplement Plan

Medigap open enrollment begins when you sign up for Medicare Part B and lasts for six months. If you defer Part B coverage past age 65 because of health coverage from your employer, this six-month window would start whenever you sign up for Part B. If you want to purchase a Medigap policy, it is crucial that you get your policy within this window.

Applying For Medicare With Our Free Assistance

Still concerned about how to sign up for Medicare? Dont want to go in it alone or feel unsure about your Medicare enrollment dates?

How Can I Make Changes To My Medicare Advantage Coverage

The fall open enrollment period, which runs from October 15 to December 7 each year, is an opportunity to switch to a different Medicare Advantage plan or to switch to Original Medicare if you think it would serve you better.

Medicare General Enrollment Period

If you did not enroll during the IEP when you were first eligible, you can enroll during the General Enrollment Period. The general enrollment period for Original Medicare is from January 1 through March 31 of each year.

Sign Up: Within 8 Months After Your Family Member Stops Working

If you have Medicare due to a disability or ALS , youll already have Part A .

What Should I Do Next

If youre eligible to enroll in Medicare Massachusetts in 2022, carefully compare Medicare plans to weigh your options.

How to apply for medicare in Massachusetts?

Applying for Original Medicare in Massachusetts works the same as in any other state. To qualify for Medicare, you must be either a United States citizen or a legal permanent resident of at least five continuous years. If you need to enroll in the program manually, you can apply through the Social Security office or the Railroad Retirement Board, if you worked for a railroad. To apply: 1 Visit the Social Security website. 2 Call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday through Friday, 7AM to 7PM. 3 Apply in person at a Social Security office. 4 If you worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772 (TTY users call 312-751-4701), Monday through Friday, 9AM to 3:30PM.

How long do you have to be a resident of Massachusetts to qualify for Medicare?

To qualify for Medicare, you must be either a United States citizen or a legal permanent resident of at least five continuous years.

What is Medicare Part D in Massachusetts?

Here are the types of Medicare plans available in Massachusetts. Medicare Part D is Medicare prescription drug coverage. If you have Original Medicare, you can add on stand-alone drug coverage by enrolling in a Medicare Prescription Drug Plan. If you have Medicare Advantage, your plan might already include prescription drug coverage, ...

What is the coinsurance for Medicare Part B?

Medicare Part B coinsurance (generally 20% of the Medicare-approved amount) The Supplement 1 plan also covers additional benefits, including: State-mandated benefits, such as annual Pap tests, mammograms, and more. *The Core Plan covers 60 days per year of inpatient days in a mental health hospital.

What is Medicare Supplement?

Medicare Supplement plans, also known as Medigap, are policies that cover “gaps” in Original Medicare coverage. A Medicare Supplement policy may cover out-of-pocket costs like deductibles, copayments, and coinsurance. The specific benefits will depend on the plan, and these plans only work with Original Medicare costs.

How many Medigap plans are there in Massachusetts?

Most states offer up to 10 standardized Medigap plans, with benefits that don’t change across each plan type, regardless of insurer. In Massachusetts, however, beneficiaries have two options when it comes to Medigap coverage: the Core Plan and the Supplement 1 Plan. Both the Core Plan and Supplement 1 Plan cover state-mandated benefits ...

What is the shade program in Massachusetts?

The Massachusetts SHINE program (Serving the Health Insurance Needs of Everyone) is a free health insurance counseling program for people with questions about Medicare and health coverage. You can reach the SHINE program at 1-800-243-4636 Monday through Friday, 8:45AM-5PM.

What is Medicare Savings Program?

A Medicare Savings Program can help pay some out-of-pocket costs, including: Your monthly Medicare Part B premium. Prescription drug costs through the Part D Extra Help program, which you automatically qualify for with a Medicare Savings Program.

When will Medicare limits change?

These new limits make more people eligible for these programs. *These amounts may change as of March 1, 2020. **These amounts may change as of January 1, 2021. To see if you qualify for a Medicare Savings Plan, see the Medicare Savings Program application.

How to become a Medicare provider?

Become a Medicare Provider or Supplier 1 You’re a DMEPOS supplier. DMEPOS suppliers should follow the instructions on the Enroll as a DMEPOS Supplier page. 2 You’re an institutional provider. If you’re enrolling a hospital, critical care facility, skilled nursing facility, home health agency, hospice, or other similar institution, you should use the Medicare Enrollment Guide for Institutional Providers.

How to get an NPI?

If you already have an NPI, skip this step and proceed to Step 2. NPIs are issued through the National Plan & Provider Enumeration System (NPPES). You can apply for an NPI on the NPPES website.

How long does it take to change your Medicare billing?

To avoid having your Medicare billing privileges revoked, be sure to report the following changes within 30 days: a change in ownership. an adverse legal action. a change in practice location. You must report all other changes within 90 days. If you applied online, you can keep your information up to date in PECOS.

Can you bill Medicare for your services?

You’re a health care provider who wants to bill Medicare for your services and also have the ability to order and certify. You don’t want to bill Medicare for your services, but you do want enroll in Medicare solely to order and certify.

Do you need to be accredited to participate in CMS surveys?

ii If your institution has obtained accreditation from a CMS-approved accreditation organization, you will not need to participate in State Survey Agency surveys. You must inform the State Survey Agency that your institution is accredited. Accreditation is voluntary; CMS doesn’t require it for Medicare enrollment.

How does Medicare work with my job-based health insurance when I stop working?

Once you stop working, Medicare will pay first and any retiree coverage or supplemental coverage that works with Medicare will pay second.

When & how do I sign up for Medicare?

You can sign up anytime while you (or your spouse) are still working and you have health insurance through that employer. You also have 8 months after you (or your spouse) stop working to sign up.

Do I need to get Medicare drug coverage (Part D)?

Prescription drug coverage that provides the same value to Medicare Part D. It could include drug coverage from a current or former employer or union, TRICARE, Indian Health Service, VA, or individual health insurance coverage.

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When Can I Enroll in Medicare in Massachusetts?

How Do I Enroll?

  • To enroll, the first step is to call your local Social Security Administration office or visit MyMedicare.gov.1 Click here1for a listing of Social Security office locations in Massachusetts. When applying, you must provide the following documents: 1. An original or certified copy of your birth certificate 2. W-2 forms you have received over the las...
See more on commonwealthcarealliance.org

Some People Get Part A and Part B Automatically

  • The Social Security Administration will sign you up for Medicare Parts A and B automatically under the following circumstances: 1. You turn 65 and already get Social Security retirement benefits, Railroad Retirement Board Benefits, or Social Security Disability Insurance (SSDI). 2. You’re under 65 and have a disability. You’ll automatically get Part A and Part B coverage 24 mo…
See more on commonwealthcarealliance.org

Need More Information?

  • The official federal Medicare website is an excellent source of information and answers to your questions. Visit Medicare.gov.1 Sources: When you click these links, you will leave the Commonwealth Care Alliance website 1. https://www.medicare.gov/Pubs/pdf/10050-medicare-and-you.pdf 2. Medicare.gov 3. https://www.mass.gov/info-details/turning-age-65-and-medicare …
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