Medicare Blog

how to meet elderly going onto medicare

by Graham Ankunding Published 3 years ago Updated 2 years ago
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Are You being forced into Medicare at the age 65?

Nearly every American 65 or older are eligible for Medicare, and almost all of them are eligible for Medicare Part A (hospital insurance) with no premiums. However, not everyone in this age group wants to receive Medicare. Some individuals feel like that are being forced into Medicare at the age of 65 against their personal wishes.

How do I sign up for Medicare if I already have Medicare?

If you already have Medicare, you can get information and services online. Find out how to manage your benefits. If you already have Medicare Part A and wish to sign up for Medicare Part B, please complete form CMS 40-B, Application for Enrollment in Medicare - Part B (Medical Insurance), and take or mail it to your local Social Security office.

How does Medicare help the elderly?

Medicare has a program called Extra Help for those with limited income and resources. The program helps pay for costs associated with prescription drugs, such as premiums, deductibles, and coinsurance. Programs of All-Inclusive Care for the Elderly (PACE) programs are available through both Medicare and Medicaid.

Do I need to apply for Medicare Part B at 65?

If you have medical insurance coverage under a group health plan based on your or your spouse's current employment, you may not need to apply for Medicare Part B at age 65. You may qualify for a "Special Enrollment Period" (SEP) that will let you sign up for Part B during:

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How do I apply for Medicare as one approaches 65 years old?

Ways to sign up:Call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.Contact your local Social Security office.If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.

What is the 60 day rule for Medicare?

The 60-day rule requires anyone who has received an overpayment from Medicare or Medicaid to report and return the overpayment within the latter of (1) 60 days after the date on which the overpayment was identified and (2) the due date of a corresponding cost report (if any).

Can a senior be denied Medicare?

In all but four states, insurance companies can deny private Medigap insurance policies to seniors after their initial enrollment in Medicare because of a pre-existing medical condition, such as diabetes or heart disease, except under limited, qualifying circumstances, a Kaiser Family Foundation analysis finds.

Does Medicare automatically kick in at 65?

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.)

What is the Medicare lifetime maximum?

In general, there's no upper dollar limit on Medicare benefits. As long as you're using medical services that Medicare covers—and provided that they're medically necessary—you can continue to use as many as you need, regardless of how much they cost, in any given year or over the rest of your lifetime.

How Long Will Medicare pay for home health care?

Medicare pays your Medicare-certified home health agency one payment for the covered services you get during a 30-day period of care. You can have more than one 30-day period of care. Payment for each 30-day period is based on your condition and care needs.

What documents do I need to apply for Medicare?

What documents do I need to enroll in Medicare?your Social Security number.your date and place of birth.your citizenship status.the name and Social Security number of your current spouse and any former spouses.the date and place of any marriages or divorces you've had.More items...

Do you automatically get Medicare with Social Security?

If you are already getting benefits from Social Security or the RRB, you will automatically get Part A and Part B starting on the first day of the month when you turn 65. If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.

Is Medicare enrollment automatic?

Medicare will enroll you in Part B automatically. Your Medicare card will be mailed to you about 3 months before your 65th birthday. If you're not getting disability benefits and Medicare when you turn 65, you'll need to call or visit your local Social Security office, or call Social Security at 1-800-772-1213.

What do I need to do before I turn 65?

Turning 65 Soon? Here's a Quick Retirement ChecklistPrepare 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.

Does Medicare start on your birthday or the month of your birthday?

When does Medicare start?If you sign up for Medicare Part A and/or Medicare Part B in this month:Your coverage starts:3, 2, or 1 month before you turn 65The first day of your birthday monthThe month you turn 651 month after you sign up1, 2 or 3 months after you turn 65The first day of the month after you sign up1 more row

When should you apply for Medicare?

Generally, we advise people to file for Medicare benefits 3 months before age 65. Remember, Medicare benefits can begin no earlier than age 65.

Medicare basics

Start here. Learn the parts of Medicare, how it works, and what it costs.

Sign up

First, you’ll sign up for Parts A and B. Find out when and how to sign up, and when coverage starts.

What age group do you sell Medicare?

As an insurance agent who sells Medicare, most of your clients probably fall into the 65 and older population. When you talk to people in this age group, there are several communication do’s and don’ts to keep in mind.

How to avoid a slipup when meeting with an older adult?

Getting into the habit of using the right words when you’re talking about older adults will help prevent a slipup when you’re meeting with a client. It’s essential to practice using the appropriate identifiers when talking to other agents, your field marketing organization, and especially your clients.

What is the tendency to use patronizing language or simplified words when talking to seniors?

Avoiding Elderspeak. One major offense an agent can make when talking to older Medicare clients is falling into elderspeak. This is the tendency to use patronizing language or simplified words when talking to seniors or addressing them with names like, “sweetie” or “dear.”.

What does "still" mean in seniors?

Note that it’s not just demographic labels that can insult seniors. A word like “still” can also convey negativity, as in still driving or still exercising. Phrases like these imply that seniors are doing something out of the ordinary, when in fact, many of them drive and work out on a daily basis.

Why is it important to exercise choice as an insurance agent?

For seniors, being able to exercise choice can lead to a greater sense of confidence and self-esteem. It also helps them feel empowered to be more proactive in life.

Is it okay to call someone a baby boomer?

A large percentage of older adults also seem OK with being called “baby boomers” since it simply indicates the generation in which they were born. “Seniors” is another option that’s inoffensive. However, “senior citizen” has a negative and patronizing connotation, so you should avoid using it.

Do seniors have to learn simplified words?

Many seniors maintain the same vocabulary they had years ago, several improving their vocabulary as they age. There’s no reason to assume someone over the age of 65 needs simplified words or phrases any more so than younger individuals.

When do retirees stop receiving Medicare?

Some Retiree Health Plans Terminate at Age 65. If you're not yet 65 but are retired and receiving retiree health benefits from your former employer, make sure you're aware of the employer's rules regarding Medicare. Some employers don't continue to offer retiree health coverage for former employees once they turn 65, ...

What are the other parts of Medicare?

That includes Medicare Part B (outpatient coverage) and Part D (prescription coverage), as well as supplemental Medigap plans.

How much will Medicare pay in 2020?

In 2020, most Medicare Part B enrollees pay $144.60/month. 7  So a person who is now enrolled but had delayed their enrollment in Medicare Part B by 40 months would be paying an extra 30% in addition to those premiums (40 months is three full 12-month periods; the extra four months aren't counted).

What is the Medicare Part D penalty for 2020?

In 2020, the national base beneficiary amount is $32.74/month. 9  Medicare Part D premiums vary significantly from one plan to another, but the penalty amount isn't based on a percentage of your specific plan—it's based instead on a percentage of the national base beneficiary amount.

How much would Medicare pay if you delayed enrollment?

So a person who delayed Medicare Part D enrollment by 27 months would be paying an extra $8.84/month (27% of $32.74) , on top of their Part D plan's monthly premium in 2020. A person who had delayed their Part D enrollment by 52 months would be paying an extra $17.02/month.

What are the benefits of supplemental retirement?

The supplemental retiree health benefits may include prescription drug coverage (which isn't covered by regular Medicare but can be purchased via Medicare Part D if you don't have access to supplemental employer-sponsored coverage), doctor visits, and other outpatient health care.

How long do you have to pay Medicare premiums?

6  So if you were eligible for Medicare for three years before enrolling, you'd have to pay the extra Part A premiums for six years.

How old do you have to be to get Medicare?

Medicare eligibility at age 65. You must typically meet two requirements to receive Medicare benefits: You are at least 65 years old. You are a U.S. citizen or a legal resident for at least five years. In order to receive premium-free Part A of Medicare, you must meet both of the above requirements and qualify for full Social Security ...

Who can help you compare Medicare Advantage plans?

If you have further questions about Medicare eligibility, contact a licensed insurance agent today. A licensed agent can help answer your questions and help you compare Medicare Advantage plans (Medicare Part C) that are available where you live.

How much is Medicare Part A 2020?

In 2020, the Medicare Part A premium can be as high as $458 per month. Let’s say Gerald’s wife, Jessica, reaches age 62 and has worked for the required number of years to qualify for premium-free Part A once she turns 65. Because Jessica is now 62 years old and has met the working requirement, Gerald may now receive premium-free Part A.

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

Medicare eligibility chart - by age. - Typically eligible for Medicare if you're a U.S. citizen or legal resident for at least 5 years. - If you won't be automatically enrolled when you turn 65, your Initial Enrollment Period begins 3 months before your 65th birthday.

What is the Social Security retirement rate at 65?

Your Social Security retirement benefits will be reduced to 93.3% if you take them at age 65. - Not typically eligible for Medicare, unless you receive SSA or RRB disability benefits or have ALS or ESRD.

Can a 65 year old spouse get Medicare?

When one spouse in a couple turns 62 years old, the other spouse who is at least 65 years old may now qualify for premium-free Medicare Part A if they haven’t yet qualified based on their own work history. For example, Gerald is 65 years old, but he doesn’t qualify for premium-free Part A because he did not work the minimum number ...

Is Medicaid based on income?

Yes. Medicaid qualification is based on income, not age. While Medicaid eligibility differs from one state to another, it is typically available to people of lower incomes and resources including pregnant women, the disabled, the elderly and children. Learn more about the difference between Medicare and Medicaid.

What is Medicare and Medicaid?

Medicare and Medicaid are government-run programs that help pay healthcare costs for older adults and younger people who qualify. This article discusses the different Medicare and Medicaid options, when a person is eligible, how to enroll, and what is covered.

What is Medicare Advantage?

Medicare Advantage is also known as Medicare Part C. These plans are administered by private medical insurance companies who are in contract with Medicare to provide benefits. Parts A and B are combined under one policy.

What is the program for all inclusive care for the elderly?

Programs of All-Inclusive Care for the Elderly (PACE) programs are available through both Medicare and Medicaid. They help people pay for health care within the community. For people who qualify for PACE, healthcare professionals work as a team to coordinate care.

What are the criteria for Medicaid?

Other criteria include a person’s citizenship, state of residency, and immigration status.

Can a disabled person enroll in Medicare?

Some younger people with disabilities are also qualified to enroll. There are several parts to Medicare, and a person must enroll in each part separately. Medicare parts A and B are called original Medicare.

Can older adults get SSI?

Older adults may qualify for SSI, Extra Help, or PACE to help pay for medical costs. The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products.

Can seniors with Medicare get SSI?

Seniors with Medicare and Medicaid may be eligible for additional assistance through SSI, Extra Help, and PACE. Medicare is a federal health insurance plan. The plan is for people who are aged 65 or older. Some younger people with disabilities are also qualified to enroll. There are several parts to Medicare, and a person must enroll in each part ...

What to do if you need long term care?

You may have other long-term care options (besides nursing home care) available to you. Talk to your family, your doctor or other health care provider, a person-centered counselor, or a social worker for help deciding what kind of long-term care you need. Before you make any decisions about long term care, talk to someone you trust ...

What is the program of all inclusive care for the elderly?

PACE (Program of All-inclusive Care for the Elderly) is a Medicare/Medicaid program that helps people meet health care needs in community. Learn more about PACE. Note. Visit LongTermCare.gov for information and resources to help you and your family plan for future long-term care needs.

What is hospice care?

Hospice is a program of care and support for people who are terminally ill. Hospice helps people who are terminally ill live comfortably. The focus is on comfort, not on curing an illness. Respite care is a very short inpatient stay given to a hospice patient so that their usual caregiver can rest.

What are some examples of services and programs that may be available in your community?

Examples of the services and programs that may be available in your community are: Adult day services. Adult day health care (which offers nursing and therapy) Care coordination and case management (including transition services to leave a nursing home)

What is a person centered counselor?

A person-centered counselor. A social worker. If you’re in a hospital, nursing home, or working with a home health agency (HHA), you can get support to help you understand your options or help you arrange care. Talk to: A discharge planner. A social worker.

What is subsidized senior housing?

Subsidized senior housing. There are state and federal programs that help pay for housing for some seniors with low to moderate incomes. Some of these housing programs also offer help with meals and other activities, like housekeeping, shopping, and doing the laundry.

Can you move from one level to another in a nursing home?

A nursing home (for people who require higher levels of care. Residents can move from one level to another based on their needs, but usually stay within the CCRC. If you're considering a CCRC, be sure to check the quality of its nursing home and the inspection report (posted in the facility).

What is Medicaid for seniors?

Medicaid is a state-operated government assistance program that pays for long term care for seniors who don’t have any money. In order to qualify for Medicaid, you must “spend down” your personal assets to a state-specified threshold and meet the state’s income requirements.

What does a senior provider need to do?

The senior’s primary provider (family doctor) will need to write an order confirming that the patient requires skilled nursing care. The physician will be handing over care to the nursing home’s doctor, so he or she will also need to issue appropriate orders for medication, treatment, physical therapy, etc.

How to discharge a patient?

Assuming that moving the patient is not detrimental to their health, there are five situations where a discharge or transfer may be permitted: 1 The patient requires medical care that’s not available in a nursing home (e.g. hospitalization or transfer to a specialized mental institution) 2 The patient’s condition has improved and they no longer require skilled nursing care 3 The patient jeopardizes the health and safety of others in the nursing home 4 The patient has not paid for care in at least 15 days 5 The nursing home plans to cease operations

How long does it take to get into a skilled nursing home?

Admittance into a skilled nursing home requires a doctor’s order, much like writing a prescription. In most cases, the patient must see their doctor less than 30 days before entering the nursing home.

What is skilled nursing?

Skilled nursing homes are for seniors who are unable to care for themselves for a sustained period of time, and present a danger to themselves or others without the necessary assistance. To determine this, doctors will evaluate four key areas:

What information do nursing homes need?

The nursing home and physician will need to see the patient’s medical and physical history, including past/current conditions, surgeries, immunizations, allergies, and diagnostic tests. Now is also a good time to start gathering the senior’s financial information, which you’ll need when working with the elder law attorney, ...

What does a senior need to know about healthcare?

The senior will need an advance healthcare directive (also known as a living will) to indicate their healthcare preferences in case they become incapacitated and cannot communicate with their doctor. They will also need a power of attorney to appoint an attorney-in-fact who can manage their financial, legal, and medical affairs should they become incapacitated.

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The Proper Terms For Older Adults

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Senior citizens? Older adults? The elderly? If you’ve ever been unsure of how to talk to Medicare clients who are over the age of 65, you’re not the only one. The last thing any agent wants to do is offend a client by calling them an “old person.” (Yikes!) Several studies have been done over the years to see which terminology i…
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Practicing Patience with Medicare Clients

  • When talking to seniors, and really any client, it’s very important to never talk down to them or be condescending in any way. A lot of the information you share with your clients will probably be brand new to them, and for many, this could be their first time buying a Medicare plan. You may have to go over the same information more than once, but you shouldn’t let this frustrate you. Tr…
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Avoiding Elderspeak

  • One major offense an agent can make when talking to older Medicare clients is falling into elderspeak. This is the tendency to use patronizing language or simplified words when talking to seniors or addressing them with names like, “sweetie” or “dear.” If you find yourself using a high-pitched voice, you might be using elderspeak. Many seniors main...
See more on ritterim.com

Decisions Equal Empowerment

  • As an insurance agent, it’s your job to guide your clients through the decision-making process. It’s important that you don’t make a decision for them or assume you know what’s best for them. For seniors, being able to exercise choicecan lead to a greater sense of confidence and self-esteem. It also helps them feel empowered to be more proactive in life. Allowing your clients to make deci…
See more on ritterim.com

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