Enrolling in Medicare Made Simple

Hello Toni:

My husband, David, has been laid off because of what is happening to the economy due to COVID-19. He is 68 and has never enrolled in Medicare, but I am turning 65 this June. We both are covered under his employer’s health plan and it is ending April 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 assume that I am fine since I turn 65 in June.  Please explain what our Medicare enrollment options are since we are of different ages and have different enrollment situations.

 Thanks, Peggy from Bellaire, TX.

Great Question, Peggy:

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 or OMB #0938 (Request for Employment Information) from socialsecurity.gov or email info@tonisays.com and we can email you a form.

Have David’s HR department sign off on the Request for Employment Information CMS-L564 form and take the form to your local Social Security agency to apply for Medicare Parts A and B. Advise the Social Security representative that he is losing his company benefits and need his Medicare Parts A and B to begin May 1^st.

This is an ALERT to the public because COVID-19 and social distancing issues have caused local Social Security offices to be closed with employees working from home. The public should call their local Social Security office direct for help filing forms to apply for Medicare Part B via fax. Most Social Security direct 800# can be located by Googling online that specific office 800# and the wait while holding is less than calling the main Social Security 800.

#2: Peggy your way to enroll in Medicare is simple and quite different from David’s because you are turning 65 in June. Go online to www.socialsecurity.gov/benefits/medicare at least 90 days prior to turning 65 and apply online for a June 1^st effective date.

Below is a checklist for those enrolling in Medicare the simple way:

• Learn that Original Medicare: Part A covers your in-patient hospital stay, skilled nursing/rehab stay, blood transfusions, home health and hospice. Original Medicare: Part B covers your primary care or specialist whether in the office or performing surgery, outpatient surgery, durable medical equipment, x-rays, CAT scans, MRIs, chemotherapy, etc.
• 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).
• Go to the specific Medicare Advantage plan’s hospital/provider online directory to be sure your physicians and hospitals are in that specific plan’s network.
• Seek Medicare Prescription Drug planning 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.
• Seek “Extra Help” with prescription drugs if you meet low-income qualifications.
• 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.

2021 Confused about Medicare Zoom webinar is Thursday, April 1^st at 4:00 PM. Visit www.tonisays.com to sign up for Toni’s new webinar event.

Toni King, Medicare author/advocate is giving a $5 discount to the Toni Says® readers on the new 2021Medicare Survival Guide® Advanced book at www.tonisays.com. Have a Medicare question? Call 832/519-8664 or email info@tonisays.com.