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Getting Started with Medicare

Well, here we are…the start of something big! Congratulations are in order, and I mean that in the truest sense! I am also extending my hand in appreciation for the roads you have traveled and paved for the next generation coming up. A “Baby-Boomer” myself, you have me as a trusted resource that understands and will remain in your corner. Now, getting started with Medicare can at times feel a bit confusing. That confusion may be warranted going at this on your own, which can also lead to frustration. Let’s not only eliminate those feelings but let’s also eliminate all those possible surprises that can arise just from the uncertainty and without having the advocate that you deserve.

Thank you for reaching out to me, allowing me to assist you with your Medicare options, or even just to review what is already in place to ensure you are where you belong and your plan worthy to have you as a member. Feel free to navigate and poke around my site….kick the tires so to speak. I am confident in all that I do concerning Medicare and those entities that surround Medicare…but that’s not good enough. I would want you to feel the same confidence in me, which in turn, solidifies our long-term relationship.

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Things You Should Know

Before You Enroll

Before you can enroll in a health plan that coordinates with Medicare, you will need to ensure your Eligibility and Entitlements as to both Parts A & B. Part A is known as a Hospital Benefit and is usually free of monthly premiums if you have paid into FICA for your 40 quarters or more. Part B is known as the Medical Benefit, and for 2020 the Part B eligibility has a monthly premium of $144.60 that accompanies this benefit, however those with higher income levels will pay more. We can have that conversation (Income Related Monthly Adjustment Amount: IRMAA). Consequently, those with lower income challenges are encouraged to reach out to me for further advice and direction. There are also those, exhausting their 24th-month of Social Security Disability that may be eligible no matter the age, and the same applies for those with ESRD, but is almost immediate with a short waiting period after the first dialysis treatment, which is the 1st day of the 4th month after you start dialysis treatments. If already drawing a monthly retirement benefit from Social Security, you will most probably be auto-enrolled into Part B, but let’s talk first. If you are not drawing Social Security Retirement Income, but wish to enroll in Medicare, I am asking you to please contact me. If drawing or if not, both scenarios are just as important to have the respected conversations. Whatever is present in your life, I’ve got you covered!

Medicare Part B

Medicare Part B premium starts at $144.60 per month for 2020 and could increase according to your household earning in 2018. Ask me to attach the IRMAA for more information.

Working the Required 40 Quarters

*Please keep in mind, that if you or your spouse has worked the required 40 quarters, you will automatically be enrolled into Part A and at no premiums. We should really have that conversation on this specific area that requires accurate direction the first time going in. Happy to help!! 

When Am I Eligible for Medicare?

Your Entitlements and Eligibility first become available for enrollment three months prior your 65th Birthday month, the month of your 65th Birthday, and then for three months after your 65th birth month providing Bebeficiaries seven full months to enroll. If you are planning on being employed or in a role as an employer, this has no bearing on eligibility outside of personal choice as to options. What is worthy of conversation is if you decide to remain on the employer’s plan. Please call me for direction before you do or don’t take any steps here. Remember…this is very important…just because you may have an employer plan in place, under no uncertain terms should that ever be viewed as being ok or being fine right now just to put it off. You may be doing yourself a massive disservice with comprehensive care ( care that is incredibly rich and quite frankly, astounding ), your rights, and of course your budget. How about saying good-bye to $5K and $10K deductibles, just for starters!? If this is you, I know your toes are tapping! If you have a spouse that needs your employer’s coverage and that is the or a reason for you hanging on to it, we can still look at your every concern. Whatever the conclusion, you will either be in a better position personally as well as from a family budget/quality of care focus, or you will have an understanding of why it makes sense to stay put for now. Regardless, you will have the knowledge as to the “why’s” and the “why nots”, what your game plan is for the future, along with my contact information!

What If I Waited and I Didn’t Apply When First Eligible?

If you intentionally postponed your Part B benefits because you were enjoying a robust employer plan, you did the right thing. Bravo!! Upon terming or retiring, you will need proof that you had “credible health plan coverage” since the month you turned 65. You can obtain this form from your employer’s HR department, or from a comptroller or whoever administers your employer’s health plan. These professional contacts should be well aware of what you need, and it should be almost automatic upon your request. What you need to do with this form (making certain your name appears on the form, as well as a spouse if they depended on the same plan and coverage) is to take it to Social Security as proof you have had continuous credible coverage since age 65 to avoid an LEP ( Late Enrollment Penalty) which is very pricey. Folks with LEP’s are penalized every month for the rest of their lives. If you have had VA Benefits, first and foremost, thank you deeply for your service, but please do not think that Medicare/Social Security views VA Benefits as an eligibility to avoid a Part B LEP. Thi sis something you should know circling back to eliminating surprise above here on this age. It will satisfy Part D LEP’s, but not Part B, and Part B LEP’s are very expensive. There is one way around it, but we would need to have a private conversation. Now, if you waited to enroll in Part B, “just because”, the prior statement may apply, but most likely you would need to court Social Security during the GEP (General Election Period) which falls between January 1st and March 31st, and then your Part B would be effective July 1st and yes…be prepared to have that LEP. Incidentally, LEP dollar amounts are subject to the length of time that passed since becoming eligible, and whenever exhausting the application process. Rule of thumb- the longer the period of time, the higher the monthly premium penalty.

When Will My Medicare Coverage Start?

Ok, now depending on the circumstance, effective dates on all Medicare plans always start the 1st day of the next month, be it a scheduled calendar start or a requested effective date start. If you are new to Medicare it will start the 1st day of your 65th Birthday month. There are many different scenarios concerning Medicare benefits becoming effective and not to get too far into the weeds, you can always contact me and your personal life circumstance. Just know this…Medicare never back-dates to absorb medical bills or benefits and never becomes effective on any other date than the 1st of a month, and the turn around time on average to receive your Red, White, and Blue Medicare card is about 3 weeks. Keep this in mind also…an average turn around time for a health plan that coordinates benefits with Medicare, from the point of application to receiving your actual Welcome materials and ID cards is approximately 15 days. It is always advisable to get together well enough in advance. This ensures prompt and timely receipt of said material and your ID cards so you can enjoy the confidence that you will be hitting the ground running come your requested effective date. With or without your ID card, you will still become effective, it’s just having your ID card in hand promotes that peace of mind.

You can conduct most of your initial qualifying business online with Social Securities secure and convenient online services. Their online services are available from anywhere and from any of your devices, and so it’s been stated if unaware, Social Security administers your Medicare enrollments and issues what is rightfully put into place with your Medicare Cards.

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Helpful Medicare Links

In addition to the above, you have other resources contained within The SS online site. You can:

They also have information to answer most of your Social Security questions online, without having to speak with a Social Security representative. Please visit our Frequently Asked Questions.

If needed, you are of course able to speak to a direct representative at Social Security, and the direct phone number is 1-800-772-1213 .

Please reach out to me with any questions at any stage, even if you are a year or so out. Forewarned is forearmed..isn’t that the expression! I am here for all of it! Your initial stages, looking to retire or recently have, recently moved, new and aging in, we can speak to your wisest options. It’s a conversation, with as much fact-finding as needed for what is important to you, and related to the smartest conclusion. If anything changes, a life change or new health concerns arise, I am here for all of that moving forward. Everything is about the relationship, and I’m in!

Welcome to Medicare!

Sincerely – Jim Schmidt