Medicare Blog

why would insurance ask me if i have medicare

by Santina Boyle Published 2 years ago Updated 1 year ago
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Several reasons could be behind your health insurance company’s request for information. The first is to prove she is your wife. The company may permit spouses as dependents on the plan, but not girlfriends. Other personal information is likely used to make sure your wife isn’t confused with another person of the same name.

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Do you need Medicare if you already have health insurance?

You are able to sign up for Part B anytime you have current employer health coverage. Once employment ends, you will have eight months to sign up for Medicare Part B without having to pay a penalty. If you are enrolled in Medicare and another health plan, one of your insurers is the primary payer. The other is the secondary payer. While each insurer is a payer, your primary …

How does Medicare work with other insurance?

Medicare coverage for many tests, items and services depends on where you live. This list only includes tests, items and services (both covered and non-covered) if coverage is the same no matter where you live. If your test, item or service isn’t listed, talk to your doctor or other health care provider about why you need certain tests, items ...

What happens if my insurance company doesn't pay Medicare?

Types of insurance that require you to answer health questions. Insurance companies can ask you health questions when buying other types of insurance, such as: Dental insurance; Disability insurance; Life insurance; Long-term care insurance; Medicare Supplement and Medicare Advantage plans (under certain circumstances) Short-term medical plans ...

Can insurers ask you health questions when buying insurance?

This could be because: You’d have to pay a premium. You have a medical condition that qualifies you for Medicare, like end-stage renal disease (ESRD), but haven’t applied for Medicare coverage. You’re not collecting Social Security retirement or disability benefits before you’re …

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How many employees does Medicare pay first?

If you are covered under both Medicare and a current employer’s group health plan, your employer’s plan will pay first if your employer has more than 20 employees.

How long do you have to sign up for Medicare Part B?

You are able to sign up for Part B anytime you have current employer health coverage. Once employment ends, you will have eight months to sign up for Medicare Part B without having to pay a penalty. If you are enrolled in Medicare and another health plan, one of your insurers is the primary payer. The other is the secondary payer.

How much does Medicare Part B cost?

The standard premium for Medicare Part B, however, is $90.90 per month. From there, premiums are tied to annual income, so Part B coverage can cost anywhere from $99 .90 to $319.70 monthly.

Is Medicare your primary payer?

If you work for a smaller company and are covered under both Medicare and your current employer’s group health plan, Medicare will normally be your primary payer. If you are covered under both Medicare and a former employer’s group health plan, Medicare is your primary payer.

Is it a good idea to enroll in Medicare if you already have health insurance?

Is it to your advantage to enroll in Medicare if you already have health insurance? The short answer is yes. It usually doesn’t cost anything to enroll in Medicare Part A (hospital). The vast majority of people receive Part A benefits without paying any premiums at all.

What are the benefits of Medicare?

Expanded Medicare benefits for preventive care, drug coverage 1 Medicare benefits have expanded under the health care law – things like free preventive benefits, cancer screenings, and an annual wellness visit. 2 You can also save money if you’re in the prescription drug “donut hole” with discounts on brand-name prescription drugs.

Can you save money on a prescription drug?

You can also save money if you’re in the prescription drug “donut hole” with discounts on brand-name prescription drugs.

Is Medicare part of the Marketplace?

Changing from the Marketplace to Medicare. Medicare isn’t part of the Health Insurance Marketplace®, so if you have Medicare coverage now you don’t need to do anything. The Marketplace won’t affect your Medicare choices or benefits. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan (like an HMO or PPO), ...

Does the Shop Marketplace cover my spouse's health insurance?

Yes. Coverage from an employer through the SHOP Marketplace is treated the same as coverage from any job-based health plan. If you’re getting health coverage from an employer through the SHOP Marketplace based on your or your spouse’s current job, Medicare Secondary Payer rules apply. Learn more about how Medicare works with other insurance.

Is Medicare Advantage changing?

Yes. The Medicare Advantage program isn’t changing as a result of the health care law. Learn more about Medicare Advantage plans.

Does Medicare Part B meet the Medicare Part B requirement?

But having only Medicare Part B (Medical Insurance) doesn’t meet this requirement.

Can you get Medicare if you have ESRD?

You have a medical condition that qualifies you for Medicare, like end-stage renal disease (ESRD), but haven’t applied for Medicare coverage

What age do you have to be to get Medicare?

The age of eligibility for Medicare is 65, and some people are enrolled automatically while others need to sign up. If you're already receiving Social Security or Railroad Retirement Board (RRB) retirement benefits, you'll automatically be enrolled in Medicare Parts A and B on the first day of the month you turn 65.

How long does it take to sign up for Medicare?

The most convenient way to sign up for Medicare is online through the Social Security Administration's website. The application takes less than 10 minutes, there are no forms to sign, and there's usually no further documentation requirement. Try any of our Foolish newsletter services free for 30 days.

How long does the enrollment period for Medicare last?

Your initial enrollment period lasts for seven months and includes the month during which you turn 65, as well as the three months before and after. If you choose not to sign up during your initial enrollment period, the general enrollment period runs from January 1 to March 31 each year, but you may have to pay a penalty in the form of higher Part B premiums for enrolling late.

What to do if you are 65 and still covered by your employer?

The short answer is "it depends." If you're about to turn 65 and are still covered by your employer's plan (or your spouse's employer's plan), you should ask your benefits administrator if they require you to sign up.

How long do you have to sign up for Medicare?

In the year that you turn 65, you have seven months to sign up for Medicare Part A (if you have to pay for it) and Part B. You also have seven months to sign up for Part D unless you have other prescription drug coverage considered acceptable by Medicare (“creditable” prescription drug coverage). The initial enrollment period begins three months before you turn 65 and ends three months after, including the month of your birthday.

What happens if you miss your Medicare enrollment deadline?

If you miss your enrollment deadline, you may face penalties for signing up late— especially if you don’t have employer-provided coverage or drug coverage that Medicare considers comparable to its own.

How long do you have to enroll in Medicare Advantage?

3 You have eight months from the time your employment ends or your coverage ends (whichever comes first) to enroll in Part B. 10 You have two months after the month your coverage ends to join Part D or a Medicare Advantage plan.

What is a Medigap plan?

Medigap Plans: These plans are supplemental insurance sold by private insurance companies that can help fill gaps in Medicare coverage like copays, coinsurance (the amount you may have to pay toward a claim), and any deductibles. You must have Parts A and B to buy a Medigap plan. 6

What happens if you go without prescription coverage?

If you go without creditable prescription drug coverage for 63 consecutive days, you may owe a late enrollment penalty. The penalty is permanently added to your Part D premium. 12

How many parts does Medicare have?

Before diving into how Medicare works with your existing health coverage, it’s helpful to understand how it works on its own. Medicare has four main parts: A, B, C, and D. You can also purchase Medicare supplement insurance, known as Medigap.

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

If like most people, you qualify for premium-free Part A, there’s no late enrollment penalty should you not sign up during your initial enrollment period. If you don’t qualify, your monthly premium may increase up to 10%, to be paid for twice the number of years you didn’t sign up. 8 If you don’t sign up for Part B and you don’t have employer-provided health insurance, you could face an even stiffer penalty: a premium increase up to 10% for as long as you have Part B. 9

How much does Medicare cost if you don't qualify for Part A?

If a person has not qualified for free Part A, they will have to pay a hefty premium of up to $411 a month. Anyone in this situation will not have to sign up for Medicare, but can keep their exchange plan. Here’s HealthCare.gov’s explanation of the rules. If Mary does qualify for Social Security, she probably will have to sign up for Medicare during her seven-month initial enrollment period. This period includes three months before her 65th birthday, her birth month and the following three months.

When does Mary have to sign up for Medicare?

If Mary does qualify for Social Security, she probably will have to sign up for Medicare during her seven-month initial enrollment period. This period includes three months before her 65th birthday, her birth month and the following three months. Terry – N.Y.: I turn 65 in July. I am now receiving Supplemental Security Income.

What percentage of medical expenses are covered by Part B?

Part B covers not only doctor’s bills but other outpatient expenses plus durable medical equipment, which can be very expensive. Basic Part B covers only 80 percent of these changes.

How many quarters of earnings do you need to be disabled to get Social Security?

People who are not disabled will qualify for Social Security retirement benefits after they have accumulated at least 40 quarters of covered earnings. If Mary has not accumulated 40 quarters of covered earnings by the time she turns 65, she will not be eligible for free Part A insurance premiums.

Can private insurance be used to cover gaps in Medicare?

Because Medicare is the first, or primary, payer of health claims, your private insurance would at best be used to cover any coverage gaps in your Medicare coverage . But there already are Medicare products that do this.

Does Medicare Advantage have Part D?

Because money is tight, I suggest you look for a basic Medicare Advantage plan that has Part D coverage bundled into it. You’ll still have to pay your monthly Part B premium, but many Medicare Advantage plans charge a zero premium, so this will let you get your drug coverage at little if any cost.

When is open enrollment for Medicare?

Open enrollment runs each year from Oct. 15 through Dec. 7.

What are the common mistakes people make when enrolling in Medicare?

1. Not signing up for Medicare at the right time. Timing, as they say, is everything. It’s especially important when it comes to enrolling in Medicare.

What is the Medicare quiz?

Quiz: Medicare Basics. 2. Blowing the special enrollment period. If you are 65 or older, when you stop working and lose your health insurance coverage or when the insurance you have through your spouse ends, you’ll need to sign up for Medicare. Medicare has created a special enrollment period ...

What is a Medigap policy?

Medigaps are supplemental health insurance policies that work with original Medicare. If you have a Medigap policy, it pays part or some of the out-of-pocket costs that Medicare doesn’t cover, such as your Part A hospital deductible or the 20 percent coinsurance in Part B. Depending on where you live, you can choose from as many as 10 different Medigap plans. Each policy has a different letter name (for example, Plan A) and offers a different set of standardized benefits. Policies with the same letter name offer the same benefits, but premiums can vary from company to company.

What is the difference between Medicare and Medigap?

The vast majority of doctors in the country take this insurance. To help pay for your out-of-pocket costs, you can buy a Medigap policy, which has its own separate monthly premium. Original Medicare does not include Part D (prescription drug coverage), so you must sign up for a stand-alone Part D plan if you do not have other drug coverage. Original Medicare does not have a limit on your annual out-of-pocket costs.

How long do Medicare penalties last?

Note: Usually, these penalties last for as long as you have Medicare. But if you are paying this penalty and qualify for and enroll in a Medicare Savings Program or the Extra Help program — which helps low-income older adults pay for Medicare out-of-pocket costs — you will no longer have to pay the penalty.

When is the best time to buy a Medigap policy?

The best time to buy a Medigap policy is during your Medigap open enrollment period. That six-month window starts when you turn 65 years old and have enrolled in Medicare Part B.

How long can you use SEP after you no longer have health insurance?

Again, timing is everything. What many people don’t realize is that you can only use this SEP either while you are covered by job-based insurance or for eight months after you no longer have job-based insurance. Note: Medicare does not count retiree health insurance or COBRA as job-based coverage.

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