Medicare Blog

how to establish protective filing for medicare part b

by Ceasar Block Published 3 years ago Updated 2 years ago

A beneficiary may establish a protective filing:
  1. at an SSA office,
  2. with an SSA employee on official duty at a place other than an SSA office, or.
  3. by partially completing an i1020 online via SSA's online website (socialsecurity.gov).
Aug 27, 2020

What is a protective filing?

What Is a Protective Filing Date (PFD)? The Protective Filing Date is the date the applicant first contacts SSA indicating an intent to file SSI and SSDI applications. (Case managers will help people apply for both.) This date is used to determine when an individual can start receiving SSI benefits.

What is a protective filing date SSA?

A protective filing date establishes the earliest possible application date based on the claimant's oral inquiry about SSI eligibility or a verbal or written statement of the claimant's intent to file for SSI. The protective filing date is the earliest possible date the claimant can receive title XVI benefits.May 21, 2021

What is SSA L2?

The SSA-L2 states that the claimant must review, sign, and submit the application to SSA before any processing can begin.Jan 29, 2014

Are Social Security child benefits retroactive?

Exception #2: If you are filing for a) disability benefits or b) spousal/widow(er)/child benefits based on the work record of somebody who is currently entitled to Social Security disability benefits, you can backdate your application by up to 12 months rather than the normal 6 months.May 5, 2020

How does SSI determine onset date?

Onset and the five month waiting period

The EOD is the first day of the claimant's five-month waiting period. If we establish onset after the first day of the month, the claimant's five-month waiting period begins the first day of the following month.
4 days ago

What does onset date mean?

Your onset date is defined as the first day you are unable to work because of your disability.

What is form SSA 16 used for?

An Adult Disability Report that collects more details about your illnesses, injuries or conditions, and your work history; Medical evidence already in your possession.

What is SSA 552 form?

Instructions. This online service allows you to electronically complete, sign, and submit the Dedicated Account Use of Funds Statement (Form SSA-552). You may use this online service as an alternative to completing a paper version of this form. To complete the form online, you will need a valid email address.

What is form SSA 795 used for?

Individuals use Form SSA-795 to make signed statements relating to claims for Social Security benefits or Supplemental Security Income (SSI) payments under 20 CFR 404.702 and 416.570 of the Code of Federal Regulations.

Can I take my Social Security in a lump sum?

If you wait until after your full retirement age to claim your Social Security retirement benefits, there is a little-known rule that could entitle you to a large chunk of cash all at once. This provision enables retirees who meet this requirement to receive up to six months of retroactive benefits in one lump sum.Aug 12, 2021

Who is entitled to death benefits in Social Security?

A widow or widower age 60 or older (age 50 or older if they have a disability). A surviving divorced spouse, under certain circumstances. A widow or widower at any age who is caring for the deceased's child who is under age 16 or has a disability and receiving child's benefits.

Can a widow get benefits from a spouse that was on disability?

Surviving Spouses of SSDI Recipients. If your spouse who was receiving SSDI benefits dies, you may be eligible to receive widow's or widower's benefits, if your spouse was "currently insured" before becoming disabled.

When do you get Medicare Part B?

Most people get Medicare Part B (Medical Insurance) when they turn 65. If you didn't sign up for Part B then, now's the time to decide if you want to enroll. During Medicare's General Enrollment Period (January 1–March 31), you can enroll in Part B and your coverage will start July 1.

How to sign up for Part B?

There are 3 ways you can sign up: Fill out a short form, and send it to your local Social Security office. Call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778. Contact your local Social Security office.

What to do if you don't sign up for Part B?

If you don’t sign up for Part B during your IEP, you cansign up without a late enrollment penalty during a SpecialEnrollment Period (SEP). If you think that you may be eligible for a SEP, please contact Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778 You can use a SEP when your IEP has ended.

How much is the late enrollment penalty for Part B?

If you sign up after your IEP, you may have to pay a late enrollment penalty (LEP) of 10% for each full 12-month period you don’t have Part B but were eligible to sign up.

What is the OMB number?

The valid OMB control number for this information collection is 0938-1230.

When is Medicare enrollment period?

During your Initial Enrollment Period (IEP) when you’re first eligible for Medicare. During the General Enrollment Period (GEP) from January 1 through March 31 of each year. If you’re eligible for a Special Enrollment Period (SEP), like if you’re covered under a group health plan (GHP) based on current employment.

How long does an IEP last?

Initial Enrollment Period. Your IEP is the first chance you have to sign up for Part B.It lasts for 7 months. It begins 3 months before the month you reach 65, and it ends 3 months after you reach 65.

When does IEP end?

It begins 3 months before the month you reach 65, and it ends 3 months after you reach 65. If you have Medicare due to disability, your IEP begins 3 months before the 25th month of getting Social Security Disability benefits, and it ends 3 months after the 25th month of getting Social Security Disability benefits.

What is the witness signature in question 11?

In the case that question 9 is signed by an “X” instead of a written signature, a witness signature is needed in question 11 showing that the person who signs the application is the person represented on the application. If a witness signs this application, the witness must provide the date of the signature.

What is Medicare Part B billing?

An important thing to understand about Medicare Part B billing is that each person must pay a premium each month, and pay a yearly deductible and copay. As such, Part B is a lot like regular commercial insurance plans. But unlike regular commercial insurance plans, Part B Medicare coverage only includes two types of services:

What is the difference between Medicare Part B and Part A?

Medicare part B is the plan that you use to go see your doctor, whereas Medicare part A is the plan that you'd use if you were an inpatient in a hospital. The two are not interchangeable!

What is CMS in Medicare?

CMS, the Centers for Medicare and Medicaid Services, governs all parts of Medicare, including Part B. CMS holds a great amount of influence over the way insurance companies pay doctors, as well as the services that doctors provide. This is, in large part, because of Medicare Part B restrictions. Every type of healthcare service eligible ...

Why is Medicare important?

Because Medicare is a service provided for the elderly, disabled, and retired, the patients who are covered by Medicare will usually have limited financial resources . Because of this, it's very important to make sure that your office bills and codes within all Part B guidelines and provides only approved Part B services.

What is Part C?

Part C combines Parts A and B (and sometimes D), and is managed by private insurance companies as approved by Medicare. Part D is a prescription drug coverage program which is also managed by private insurance companies as approved by Medicare. Each of these parts provides a different type of coverage, with different limitations ...

What is medically necessary?

Medically Necessary Services: These include services and supplies needed to treat your medical condition. To be covered, the service also has to be within the standards of medical practice. This means that holistic or naturopathic treatments wouldn't be covered.

What is Part B reimbursement?

Every type of healthcare service eligible for reimbursement by Part B is subject to a great deal of rules, regulations, and guidelines. These range from the rule that all medical procedures must meet the standards of currently accepted medical practice, to the way certain claims must be billed for special services.

What happens if you don't sign up for Part B?

If you don’t sign up for Part B during your IEP, you can sign up during the GEP. The GEP runs from January 1 through March 31 of each year. If you sign up during a GEP, your Part B coverage begins July 1 of that year. You may have to pay a late enrollment penalty if you sign up during the GEP. The cost of your Part B premium will go up 10% for each 12-month period that you could have had Part B but didn’tsign up. You may have to pay this late enrollment penalty aslong as you have Part B coverage.

How long do you have to be a SEP?

You have a SEP if you were volunteering outside of the United States for at least 12 months for a tax-exempt organization and had health insurance (through the organization) that provided coverage for the duration of the volunteer service.

How to file for SSDI?

SSDI. For SSDI, to establish a protective filing date you must: 1 send a signed written notification that clearly states your intent to file for disability within the next six months 2 if you filed for disability online, include the date you completed the Internet Claim Applicant Identification screen and received an Application Number 3 include a clear statement of intent (for example, "I plan to file for disability benefits") 4 make sure the statement is signed by you, a qualified third party (like a guardian), or by an SSA employee, and 5 file your application within six months of the date you send or submit the letter.

Can I file for SSDI after my DLI has passed?

A protective filing date can make an applicant's "insurance" last longer. If an applicant establishes a protective filing date before the applicant's date last insured (DLI) has passed, the applicant will still be eligible for SSDI even if he or she completes the application after his or her DLI has passed. Example 1.

What is SSI insurance?

SSI is a federal income supplement for disabled people who don't have a qualifying work history. Unlike SSDI, SSI isn't insurance. This means that as long as you can prove you are disabled and that you meet the income and asset requirements, you can receive SSI.

How long can you get retroactive benefits?

SSDI and Retroactive Benefits. If you are approved for SSDI, you can receive up to a full year of retroactive benefits based on your protective filing date. (Your filing date is the date of your application if you didn't notify the SSA at an earlier point that you would be applying for disability benefits.)

How long can you get retroactive benefits if you are approved for SSDI?

If you are approved for SSDI, you can receive up to a full year of retroactive benefits based on your protective filing date. (Your filing date is the date of your application if you didn't notify the SSA at an earlier point that you would be applying for disability benefits.)

How does SSDI work?

SSDI works similarly to homeowners or renters insurance in the sense that premiums are paid (in the form of taxes) to insure against future disability. Just like homeowner's insurance, if the premium is not paid, coverage ends. Oftentimes people with a disability quit working before they have been approved for disability benefits.

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