Medicare Blog

why is medicare retroactie 6 months?

by Corbin Goldner Published 2 years ago Updated 1 year ago
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Why is there an HSA and Medicare 6 Month Retroactive Period? Fundamentally, the government is trying to protect people from being uninsured when they come off of employer plans. If you apply for Medicare after 65, you are automatically considered enrolled six months before your enrollment request.

Robertson: Beginning in 1983, the Department of Health and Human Services started backdating Medicare coverage retroactively for six months to ensure that people coming off of employer health coverage would not inadvertently find themselves uninsured while transitioning to Medicare.Dec 20, 2021

Full Answer

How to handle retroactive Medicare entitlement?

Per IRS Publication 969, HSA eligibility requires:

  • You are covered by a high deductible health plan
  • You have no other health coverage (few exceptions)
  • You aren’t enrolled in Medicare
  • You can’t be claimed as a dependent

Can Medicaid be retroactive?

While most states’ Medicaid can retroactively provide coverage for the same services normally paid for, there are exceptions to every rule. Always check with a Medicaid worker or healthcare benefits coordinator before assuming a service can be paid for after the fact. Most states make it relatively easy to apply for retroactive Medicaid.

How often does Medicare back date part a start date?

Your Part A coverage starts 6 months back from when you sign up or when you apply for benefits from Social Security (or the Railroad Retirement Board). Coverage can’t start earlier than the month you turned 65. I have a Health Savings Account (HSA) After your Initial Enrollment Period ends, you can only sign up for Part B and Premium-Part A during one of the other enrollment periods.

What is retroactive Medicare coverage?

Table of Contents

  • Definition. Retroactive Medicaid allows Medicaid applicants to receive nursing home coverage for up to 3 months prior to the date of one’s application.
  • Benefits of Retroactive Medicaid. ...
  • Qualifying for Retroactive Medicaid / Eligibility Criteria. ...
  • State-by-State Restrictions on Retroactive Eligibility. ...
  • Expenses that can be Paid via Retroactive Medicaid. ...

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Why does Medicare backdate coverage?

Beginning in 1983, the Department of Health and Human Services (HHS) started backdating Medicare coverage retroactively for six months to ensure that people coming off employer-sponsored health coverage would not inadvertently find themselves uninsured while transitioning to Medicare.

Is Medicare retroactive for 6 months?

Part A, and you can enroll in Part A at any time after you're first eligible for Medicare. Your Part A coverage will go back (retroactively) 6 months from when you sign up (but no earlier than the first month you are eligible for Medicare).

Are Medicare benefits retroactive?

A Medicare program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance. with an effective date in the past (retroactive). You'll be automatically enrolled in a Medicare drug plan unless you decline coverage or join a plan yourself.

Why do you have to stop HSA contributions 6 months before Medicare?

This is because when you enroll in Medicare Part A, you receive up to six months of retroactive coverage, not going back farther than your initial month of eligibility. If you do not stop HSA contributions at least six months before Medicare enrollment, you may incur a tax penalty.

What is retroactive reimbursement of Medicare premium?

If you are enrolled in the QI program, you may receive up to three months of retroactive reimbursement for Part B premiums deducted from your Social Security check. Note that you can only be reimbursed for premiums paid up to three months before your MSP effective date, and within the same year of that effective date.

Can I opt out of Medicare Part A retroactive?

Can you opt out of Retroactive Medicare coverage? You may be able to opt out of retroactive Medicare coverage by contacting the Social Security Administration.

Does Medicare Part B pay retroactively?

Social Security also offers you Part B coverage retroactively if you want it—while making it clear that, if you accept, you must pay backdated Part B premiums for the time period in question, which can amount to hundreds or even thousands of dollars.

What is medical retro?

Retroactive Medi-Cal covers unpaid medical expenses from the three months prior to the month you apply for Medi-Cal. If you have unpaid bills from the three previous months, enter that information during the application process. If you qualify for Medi-Cal, you will also be evaluated for retroactive coverage.

How many months in advance should you apply for Social Security benefits?

four monthsYou can apply up to four months before you want your retirement benefits to start. For example, if you turn 62 on December 2, you can start your benefits as early as December, and apply in August. Even if you are not ready to retire, you still should sign up for Medicare three months before your 65th birthday.

Does Medicare coverage start the month you turn 65?

The date your coverage starts depends on which month you sign up during your Initial Enrollment Period. Coverage always starts on the first of the month. If you qualify for Premium-free Part A: Your Part A coverage starts the month you turn 65.

Is Medicare free at age 65?

You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if: You are receiving retirement benefits from Social Security or the Railroad Retirement Board.

What happens if you contribute to an HSA while on Medicare?

Once you enroll in Medicare, you're no longer eligible to contribute funds to an HSA. However, you can use existing money in an HSA to pay for some Medicare costs. You'll receive a tax penalty on any money you contribute to an HSA once you enroll in Medicare.

Does Medicare coverage start the month you turn 65?

The date your coverage starts depends on which month you sign up during your Initial Enrollment Period. Coverage always starts on the first of the month. If you qualify for Premium-free Part A: Your Part A coverage starts the month you turn 65.

What is the special enrollment period for Medicare Part B?

What is the Medicare Part B special enrollment period (SEP)? The Medicare Part B SEP allows you to delay taking Part B if you have coverage through your own or a spouse's current job. You usually have 8 months from when employment ends to enroll in Part B.

How do you pay for Medicare Part B if you are not collecting Social Security?

If you have Medicare Part B but you are not receiving Social Security or Railroad Retirement Board benefits yet, you will get a bill called a “Notice of Medicare Premium Payment Due” (CMS-500). You will need to make arrangements to pay this bill every month.

How many months in advance should you apply for Social Security benefits?

four monthsYou can apply up to four months before you want your retirement benefits to start. For example, if you turn 62 on December 2, you can start your benefits as early as December, and apply in August. Even if you are not ready to retire, you still should sign up for Medicare three months before your 65th birthday.

How long is Medicare Part A backdated?

This would work the same way when he finally enrolls in Medicare Part A and Part B in the future. His Medicare Part A will be backdated 6-months from the month he submits the enrollment to Social Security.

Is HSA deductible for Medicare?

Well, it depends.If you’re like many employees enrolled in a high deductible health plan (HDHP) that includes a Health Savings Account (HSA), you could run into a big surprise when Medicare-eligible. Here’s the deal...If you enroll in Social Security retirement benefits or Medicare benefits for the first time, and you’re beyond your Initial ...

How long is Medicare retroactive?

The Medicare website mentions the 6 months of retroactive coverage but is very vague as to how it applies. The answer is Medicare coverage can be retroactive up to 6 months, if you sign up after your 65th birthday. The rule is if you sign up after turning 65, the Medicare coverage will be retroactive to the lessor of 1) the first day of your birthday month or 2) 6 months. Of course the government makes such a cockamamie rule, but oh well. Here are some examples for someone whose birthday is March 30th: 1 Medicare starts June 1st – retroactive coverage until March 1st (birthday month) 2 Medicare starts September 1st – retroactive coverage until March 1st (birthday month) 3 Medicare starts December 1st – retroactive coverage until June 1st (6 months)

How long does Medicare coverage last after 65?

It states that if you sign up for Medicare Part A after you turn 65, the coverage will retroactively be applied up to 6 months into the past.

How long after a HSA is disqualified can you be retroactively disqualified?

In essence, you can be following the rules as an HSA eligible individual, and 6 months after the fact be retroactively disqualified (made HSA ineligible) due to Medicare Part A. If you are familiar at all with how HSA tax Form 8889 works, you know that this can pose some serious risks to your financial well being.

When did Paul get Medicare Part A?

Because Paul was 67 when he signed up for Medicare Part A on May 1st, 2017, the coverage retroactively applied 6 months prior to November 1st, 2016. This means that he was not HSA eligible from November 2016 – April 2017.

When does Medicare Part A coverage go into effect?

1) The first day of the month you turn 65. 2) The month before you turn 65 (if your birthday is on the 1st of the month). After turning 65, you’re coverage will be in effect (retroactively) the lessor of 1) 6 months or 2) your 65th birthday. It is that last clause that can really affect HSA holders. It states that if you sign up for Medicare Part A ...

Can Medicare Part A be retroactive?

Given the fact that Medicare Part A can retroactively disqualify you from being HSA eligible , it is best to prepare for such an event and plan accordingly. This involves a combination of 1) knowing if you are at risk for retroactive coverage and 2) planning your preceding and current HSA actions appropriately.

Does Medicare Part A end HSA?

While this not only ends your HSA eligibility (see next section), it may affect your HSA eligibility in previous months.

What does retroactive enrollment mean for Medicare?

Medicare is disqualifying coverage, which means that you can no longer contribute to your Health Savings Account or accept the company's contribution.

When to stop Medicare contributions?

As you plan your Social Security and Medicare enrollments, be sure to stop contributing to your Health Savings Account beginning six months before you enroll in Medicare. That way, you don't have to withdraw any contributions based on retroactive Part A coverage.

How to avoid a collision with Medicare?

First, enroll in Medicare at age 65. That way, there is no retroactive coverage. You'll be disqualified from contributing to your Health Savings Account for any month after your Medicare Part A enrollment is effective.

What is the maximum Medicare contribution for 2021?

If you end up retroactively enrolled in Medicare effective April 1, 2021, for example, your maximum 2021 contribution, based on your contract type, is $900 or $1,800, plus a $250 catch-up contribution (each of these figures is 25% of the $3,600, $7,200, and $1,000 contribution ceilings for 2021).

How much can I deposit into my health savings account at 55?

If you're age 55 or older, you can deposit up to an additional $1,000 annually. Here's the problem when Social Security, Medicare, and Health Savings Accounts collide: Medicare is disqualifying coverage that prohibits you from funding a Health Savings Account. Example: You're age 67 and working full-time.

How much will Social Security be in 2021?

The average monthly Social Security benefit in 2021 is about $1,543.

What age do you have to be to get Medicare?

If you're age 65 or older and collecting Social Security benefits, you're automatically enrolled in Medicare Part A (unless you must pay a premium for Part A, which is rare).

Your first chance to sign up (Initial Enrollment Period)

Generally, when you turn 65. This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.

Between January 1-March 31 each year (General Enrollment Period)

You can sign up between January 1-March 31 each year. This is called the General Enrollment Period. Your coverage starts July 1. You might pay a monthly late enrollment penalty, if you don’t qualify for a Special Enrollment Period.

Special Situations (Special Enrollment Period)

There are certain situations when you can sign up for Part B (and Premium-Part A) during a Special Enrollment Period without paying a late enrollment penalty. A Special Enrollment Period is only available for a limited time.

Joining a plan

A type of Medicare-approved health plan from a private company that you can choose to cover most of your Part A and Part B benefits instead of Original Medicare. It usually also includes drug coverage (Part D).

How long does Medicare coverage last?

Individuals who delay applying for free Medicare Part A are covered retroactively to the month they attained age 65 or for six months, whichever is less. The letter explains that the Code sets a zero-contribution limit for months of Medicare coverage and that rule has no exceptions, so months of retroactive Medicare must also reduce HSA ...

Is a 20 percent tax on a later distribution taxable?

Later distributions to correct the excess and stop the excise tax will be taxable income, but should not be subject to the 20% additional tax because an individual who is over age 65 can take non-medical distributions without paying the extra tax.

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Definition

Examples

  • The Medicare website mentions the 6 months of retroactive coverage but is very vague as to how it applies. The answer is Medicare coverage can be retroactive up to 6 months, if you sign up after your 65th birthday. The rule is if you sign up after turning 65, the Medicare coverage will be retroactive to the lessor of 1) the first day of your birthd...
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Retirement

  • On May 1st, 2017, Paul plays the last show of his final farewell tour and decides to officially retire. He takes some of the proceeds from the show and contributes 4 months worth of a contribution to his HSA for 2017. No longer working, Social Security seems like a good deal so he signs up to start receiving benefits. This also enrolls him in Medicare Part A, which seems like free governm…
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Controversy

  • The next year, Paul gets a call from his tax accountant telling him his HSA Form 8889 is a mess and he may owe penalties and taxes. Because Paul was 67 when he signed up for Medicare Part A on May 1st, 2017, the coverage retroactively applied 6 months prior to November 1st, 2016. This means that he was not HSA eligible from November 2016 April 2017. His accountant informs hi…
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Preparation

  • Given the fact that Medicare Part A can retroactively disqualify you from being HSA eligible, it is best to prepare for such an event and plan accordingly. This involves a combination of 1) knowing if you are at risk for retroactive coverage and 2) planning your preceding and current HSA actions appropriately. As such, we recommend the following:
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Prevention

  • If you are in your 60s, you should be thinking about when you will sign up for Medicare Part A coverage, keeping in mind that this is also triggered by beginning Social Security benefits. If this occurs when you are age 65 and 1/2 or older, you are in the danger zone of having retroactive coverage applied. If this is the case, you will want to work backwards 6 months to plan your HS…
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Risks

  • Retroactive Medicare Part A coverage wrecks the most havoc on HSA contributions that contain a Testing Period. These include the use of the Last Month Rule (to contribute more than normal in a partial coverage year) or the Qualified Funding Distribution (contribute to your HSA from an IRA). Both of these contributions require that you maintain HSA coverage for a given amount of time k…
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