By Toni King
Hello Toni:
My husband, David, has been laid-off because of what is happening to the economy and rising gas prices. He is 68 and has never enrolled in Medicare. I am turning 65 this September and we both are covered under his employer’s health plan which is ending June 30th.
We have been told that he will get a penalty because he is over 65 and never enrolled in Part B. I really hope NOT! I will have to enroll in COBRA until I turn 65 in September. Please explain what our Medicare enrollment options are since we are different ages and have different enrollment situations. Thanks, Paula from Alvin, TX
Great Question, Paula:
There are 2 different rules regarding enrolling in Medicare Parts A and B in your household and I will keep how to enroll in Medicare for both you and David SIMPLE!
1) David needs to apply for a SEP (Special Enrollment Period) by downloading the form CMS-L564 (Request for Employment Information) from socialsecurity.gov or email [email protected] and we will email you a form.
Have David’s HR department sign off on the Request for Employment Information (CMS-L564) form and attach it to CMS- 40B (application for Medicare Part B). File both forms with your local Social Security office when applying for Medicare Parts A and B. Advise the Social Security representative that David is losing his company benefits and need his Medicare Parts A and B to begin July 1st.
This is an ALERT to the public because local Social Security offices which were closed due to the Pandemic and recently reopened. The wait is extremely long at the local offices. The public should call their local Social Security office direct for help filing forms to apply for Medicare Part B. Most Social Security direct 800# can be located by Googling online for that specific office’s 800#. Generally, the wait while holding is less than calling the main Social Security 800#.
2) Paula, your way to enroll in Medicare is simple and quite different from David’s because you are turning 65 in September. Go online to www.socialsecurity.gov/benefits/medicare at least 90 days prior to turning 65 and apply online for a September 1st effective date.
Below is a checklist for those enrolling in Medicare the easy way:
1) Original Medicare Part A covers: in-patient hospital stay, skilled nursing/rehab stay, blood transfusions, home health and hospice.
2) Original Medicare Part B covers: primary care or specialist, whether in the office or performing surgery, outpatient surgery, durable medical equipment, x-rays, CAT scans, MRIs, chemotherapy, etc.
3) Original Medicare/Medicare Advantage: discuss with your healthcare facilities and medical professionals which Medicare plans they accept such as Original/Traditional Medicare with a Medicare Supplement or a Medicare Part C (Medicare Advantage plan such as HMO, PPO or PFFS). Research Medicare Advantage plan’s hospital/provider online directory to be sure your physicians and hospitals are in that specific plan’s network. Call to verify they are currently in network.
4) Research Medicare Prescription Drug plans every year to see if your standalone Prescription Drug or Medicare Advantage Plan with prescription’s formulary covers all your brand name or generic prescription drugs.
5) Consider a Long-Term Care (LTC) option such as standalone LTC policies, hybrid annuities or life insurance with LTC riders, VA aid and attendant benefits or applying for financial help from your specific states Medicaid for LTC.
Remember, always make copies of every document given to the Social Security office or received from the Social Security office.
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Toni King, author of the 2022 Medicare Survival Guide® Advanced edition is giving a $5 discount on the Medicare Survival Guide® Advanced book at www.tonisays.com.
