Medicare Help Archives - Page 24 of 28

Medicare Isn’t Mandatory, But There Is A Penalty

Medicare normally kicks in when you turn 65. You can enroll 3 months before you turn 65, the month you turn 65, and three months after the month you turn 65. While it is mandatory to enroll when you turn 65, you do have the option to opt out and push your enrollment into the program. However, when you do this, you are at risk of facing a penalty.

caucasian hand holding a bubble with a stethescope in it — *There are some ways to avoid the Medicare penatly, such as if you have employer’s health insurance.*

Having Coverage

If you are still employed, or have coverage, then you can opt out of signing up for Medicare. As long as your employer has 20 or more employees, then you can hold off on Medicare, and will not have to worry about the penalty. You can still sign up for Medicare Part A. It does not cost you anything and will cover hospital visits, and can act as a secondary insurance to your employer’s insurance.

Collecting Social Security

If you are collecting Social Security, then you will automatically be enrolled into Medicare Parts A and B. You have the option to cancel or opt out of Part B if you have coverage through an employer. However, if you opt out, then you will face a penalty. Medicare Part B covers doctors’ services, outpatient care, and medical equipment.

The Penalty

Opting out of Medicare Part B without a valid reason, such as being on an employer’s insurance, then you will pay a penalty fee. When you decide to finally sign up for Medicare Part B, then you will have to pay 10% to your monthly premiums. This penalty can remain as part of your monthly premiums for a long time.

Every full 12-month period (year) that you could’ve had Part B, but did not take it, you will pay a 10% penalty for as long as you have Part B. For example, if you opt out of signing up for Part B benefits for 2 years, then you will face a 20% penalty fee added onto your monthly Part B premiums forever. If you opt out for 4 years, then you will face a 40% penalty, as so forth.

caucasian hands holding open an empty wallet — *The Medicare penalty you will face is 10% for every year you opted out of Medicare.*

When You Are Safe From Penalties

If you miss your enrollment date, you have a General Enrollment Period, GEP, in which you can sign up if you missed signing up when you were eligible. It is a make-up time for Medicare enrollment and us January 1-March 31 every year. If fewer than 12 months have elapsed, then you will not pay a penalty fee. Other situations you can avoid the penalties are:

If you have Medicaid and Medicare. The state pays the Part B premiums.
If you qualify for assistance from your state in paying Medicare costs under a Medicare Savings Program.

It is not mandatory to sign up for Medicare when you turn 65, depending on your situation. If you do not sign up when you are supposed to, then you will be penalized, unless you have employer coverage or are in the aforementioned situations. It is best to go over your situation and make sure you are making the best decision. Talk to a Medicare agent beforehand so that you are aware of all of your options, and how you can avoid any extra fees.

EZ.Insure can help you with these kinds of situations. We offer specialized Medicare agents within your area that can go over all of your options and make sure you are in the best situation. If you would like to speak to an agent, call 888-753-7207 or email us at replies@ez.insure. Or if you would like an instant quote, enter your zip code in the bar above. Our services are free, because our goal is to help you, and make sure you are taken care of.

Beware This Faulty Medicare Tool!

The federal government designed a tool to help seniors navigate through all their possible Medicare choices. This was created for them to be able to choose their best option. There have been some bugs that needed to be fixed, so the Centers for Medicare and Medicaid Services, CMS, updated the Medicare Plan Finder tool in August. However, the tool is still currently giving seniors incorrect price estimates, and wrong coverage information.

older caucasian hands on the keyboard of a leptop — *The Medicare Plan Finder Tool is a tool on the Medicare.gov site that helps consumers navigate through Medicare plans and prices*

The Medicare Finder Tool

The Medicare Plan Finder Tool is a tool on the Medicare.gov site that helps consumers navigate through Medicare plans and prices before signing up. The tool was developed in 2005, but in August of 2019, it was revamped and redesigned.

The Issue With The Tool

Even with the revamp, Medicare beneficiaries have been just as confused as ever. The tool has been showing inaccurate premium estimates. Incorrect prescription drug costs, and inaccurate coverage costs. If a beneficiary chooses the wrong coverage due to the inaccurate information provided, it can cost them a lot of money for the whole year they are stuck with the plan until the next open enrollment.

Per ProPublica, a Medicare consultant in Wisconsin used the tool to research prescription drug plans for a client, and was shocked by the results. The consultant stated that when she searched for them, the comparison page showed all but one of her client’s medications would be covered. So the consultant dug deeper by clicking on “plan details” to find out which medication was left out. She then saw that the plan finder said all of the medications were covered.

She started checking the plans’ websites, and came across two versions of the same high blood pressure medication. One was covered, while the other was not. The difference in price was $2,700 a month.

In Nebraska, an insurance administrator flagged about 100 errors since she began working with the tool in October.

“Millions of people are going to be absolutely affected,” said Ann Kayrish, senior program manager for Medicare at the National Council on Aging. “And you hate to think about millions of people having the wrong plan. That’s kind of crazy.”

red sign with the words "wrong way" on it — *The Medicare Tool has been giving seniors the wrong information on coverage and prices.*

“It’s not like there’s one consistent problem that you can fix and then be addressed,” said David Lipschutz, associate director of the Center for Medicare Advocacy. “It’s really like a game of whack-a-mole.”

What You Can Do

CMS has spent $11 million dollars in order to revamp the tool. But the misinformation it gives is alarming, especially when seniors are struggling as it is to pay for Medicare costs and prescription drugs. Using the tool and enrolling into a plan that ends up costing a medicare beneficiary too much, they will struggle, and possibly end up with major financial issues.

The CMS is currently working on fixing the issues. In the meantime, if you are seeking Medicare advice, it would be best to contact a Medicare agent. A Medicare agent who is familiar with plans and their coverage can help guide you in a better, more accurate direction. EZ.Insure offers highly trained agents in your region that can offer you accurate quotes on plans available. If you would like to speak to an agent, call 888-753-7207 or email us at replies@ez.insure. Or if you would like an instant quote, enter your zip code in the bar above.

Surprise Bills Could Be Coming! Get To Know What’s Changing With Medicare in 2020

Big changes are coming for Medicare next year, affecting your coverage and wallet. Medicare Supplement plans C and F will disappear. Part B premiums and deductibles will rise. And for the first time since 2010, Medicare is changing the surcharges on high-income beneficiaries. Make sure you aware of all the changes ahead so you can make the necessary adjustments to fit both your needs and budget.

Part B

For 2019, the standard Medicare Part B premiums are $135.50 a month. Next year’s increase is projected to be about $144.30 a month.

Many seniors depend on Social Security to help pay for their premiums. For 2020, Social Security’s COLA, or cost of living adjustment, is expected to be about 1.6%. This would increase the benefit to $23 a month, which will in turn cover the increase in Part B premiums.

Medicare Premium and deductible prices for 2020 chart

The Part B deductible was $185 in 2019, and is now projected to increase to $197. In order to help pay for the deductible, Medicare beneficiaries will be forced to sign up for a Medicare Supplement plan.

Medicare Supplement Plans C and F

As mentioned, Medicare Supplement plans help beneficiaries pay for their Part B deductible. Plans C and F will no longer be available for purchase by newly-eligible Medicare beneficiaries.

As long as the beneficiary is enrolled in Medicare before 2020, they can keep their plan C or F, or can apply for them at a later date. These two plans are popular plans because they are the only ones that cover the Part B deductible in full.

Medicare Surcharges

With these monthly payments, Medicare covers 80% of charges, and the other 20% is up to the beneficiary. Some seniors have a higher income than others, and as a result, they also pay a higher price.

This higher price is referred to as a “surcharge”. The surcharges are imposed because these higher-income beneficiaries can afford to pay more for healthcare. The surcharge is called IRMAA, which stands for Income-Related Monthly Adjustment Amount.

For the past couple of years, high-income beneficiaries were in the set income bracket of $85,000 for an individual, and $170,000 for a married couple. Starting in 2020, the income brackets will be adjusted for inflation.

2019 & 2020 Medicare Surcharges chart — *2020 Medicare Surcharges*

The surcharge will now apply for those making an income of $87,000 as an individual, and $174,000 for a married couple. Premiums in 2019 range from $189.60 a month to $460.50 a month, depending on income. For 2020, these amounts are projected to range from $202 a month to $490.50 a month, depending on income.

The Centers for Medicare and Medicaid Services have not announced the actual increase in Part B premiums and deductibles yet. However, the projections are enough to make a Medicare beneficiary prepare for the upcoming changes. Seek out any Medicare Supplement plans you might want to get, especially if it is plan C or F.

Do not be in disarray or panic about the changes ahead. If you are enrolled in Medicare, signing up for a Medicare Supplement plan does not have to be a hassle. EZ.Insure can take care of the research of all the plans within your region, provide you with the best options that meet your coverage and price, and sign you up. You will be given your own personal agent who is highly trained within your region. We offer you all of these services for free! To get started, simply enter your zip code in the bar above, or to speak with an agent, email replies@ez.insure, or call 888-753-7207.

Wait! Before You Drop Medicare For Employer’s Healthcare Coverage Read This!

It is more common for retired seniors to work. Almost 27% of people aged 65-74 are in the workforce, and the projected stats are rising. Some seek extra money, while others do it to pass the time. When you turn 65, you are enrolled in Medicare Parts A and B. If you decide to go back into the workforce, you can opt to drop Medicare Part B coverage and expenses. Coverage of the benefits you receive from Part B will be replaced with the employer’s group health insurance. You can always opt to go back to Medicare at any point, but there will be some repercussions if not done at the right time.

What Medicare Covers

Medicare coverage is divided into two parts, Part A and Part B. Medicare Part A covers hospital care, and is usually free as long as you meet the Medicare guidelines: working at least 10 years before age 65, and being a US citizen. Medicare Part B covers outpatient care, including annual wellness visits every month, ambulance services, orthotics and prosthetics, medical equipment, and mental health care. (80% of costs covered by Medicare.) The monthly premium for Part B is

Clock with coins in 3 rows next to it growing with a green leaf sprout on each row. — *HSAs come with a triple tax benefit, but any contributions are tax-deductible.*

$135.50 for 2019. The cost might be higher depending on income..

What Employers Offer: HSA Plans

Employer’s offer health insurance coverage, and usually a health savings account, HSA, as well. If you are on Medicare Part A, you cannot make any contributions to an HSA. The employer’s coverage is considered a “high-deductible” plan. HSAs come with a triple tax benefit, but any contributions are tax-deductible, and withdrawals are untaxed as long as it is used for qualified medical expenses.

How It Will Cost You

If you drop your Part B plan for an employer’s plan, you can always sign up for Part B again during your Special Enrollment Period or SEP. This period is when you leave your employment, or the employment loses coverage. If you miss the 8-month SEP, you face a late-enrollment penalty, 10% of Part B’s monthly premium for each full year you should’ve been enrolled.

If you drop Part A, you might have to repay the government for any medical services under Medicare that you used. Also, if you collect social security, you will need to repay that back also.

Caucasian woman;s hand holding a pen ready to write on an openedbook with the page titled "my plan." — *If you drop Medicare, returning can be difficult, so think carefully and explore your options completely before making a decision.*

Some seniors buy a Medicare Supplement plan to support their Medicare Part B expenses. When you drop Part B and sign up for your employer’s coverage, then you will also have to drop your Supplement plan. If you decide to go back to Medicare Part B, buying a Medicare Supplement plan will not be as easy. Your coverage could be denied due to pre-existing conditions and health status.

If you plan to drop your Medicare and use your employer’s health insurance plan, it can cost you in the long run. Your decision should be based on how much your employer’s plan costs, your out-of-pocket expenses in a high-deductible plan, and your budget. If you drop Medicare, returning can be difficult, so think carefully and explore your options completely before making a decision.

How To Handle Medicare When Moving To Another State

After retirement, some seniors decide to embark on a new challenge: moving. You may want to relocate to a warmer place that is more “senior friendly.” A lot goes into planning when moving, and it can be quite chaotic. One major need is your Medicare coverage. You must notify your Medicare plan providers that you are moving, and then make sure your future doctors in the new state participate with Medicare. Make sure the Social Security Administration is updated as well. Aside from this, it is super important to know that if you are enrolled in a Medicare Supplement plan, your policy price may change depending on where you move to. Do not get stuck with extra charges. Make sure to get it all situated before the move.

Map of the United States — *When you are moving across states lines, it is important to make sure your Medicare plan is updated.*

Original Medicare

Medicare is a federal program and does not change no matter where you move to in America. Medicare Parts A and B do not change. Just make sure before you move, research to find doctors who accept Medicare in the new state.

Medicare Advantage

Medicare Advantage plans have networks depending on the state’s county you live in. You will need to change your Medicare Advantage plan. These plans assign specific doctors through their HMO or PPO plans, so you will have to choose a new plan and a new Primary Care Provider within the plan’s network. Some areas do not even offer Medicare Advantage plans. Notify your current plan before moving.

Medicare Supplement

Medicare Supplement plans help pay for the remaining 20% of the Medicare Part B costs. The plan’s price is determined by your zip code because it varies from state to state. In most states, you can keep your Medicare Supplement plan when you move, but you can apply for a different one if you want. Although you can remain on the same plan, your fees may go up (or down) depending on where you go.

If you do decide to change to a different plan, you might have to go through a health exam, also known as medical underwriting, and the plan may not accept your application. After you are accepted into the new Medicare Supplement plan, you have a “free look period” for 30 days to stay with the new plan. You will, however, have to pay for both plans during the 30-day period. If you decide to keep the new plan, then you can call your old plan and ask

Computer keyboard with a key that says "help" on it. — *If you are stressed out, or do not know where to start, then get help from a Medicare agent.*

for your coverage to be over.

If your Medicare Supplement plan increases when you move to a new state, then you can always contact a Medicare agent to help you search for a more affordable plan. EZ.Insure offers Medicare agents that are trained in your area, and within the state you are moving to. Your personalized Medicare agent will go over your current Medicare Supplement plan to make sure it will be a good fit for you in the new state. If it will be too costly, then our agent will go over all the plans within the new state, compare them, and provide you with quotes. There is no hassle and no obligation. To get started, you can enter your zip code in the bar above, or speak to an agent directly by emailing Replies@Ez.Insure or calling 855-220-1144. We promise to help you find, and sign up with the best Medicare Supplement plan that meets all of your needs within your budget.

Is Medicare Underwriting Necessary?

Medical underwriting is a process when a private insurance company reviews your medical history to determine whether they will provide you with coverage, how much to charge you, and whether to set a waiting period before coverage begins. If you have a lot of medical issues, you may have to pay more for coverage or even be denied approval. Pre-existing conditions will come up and can cost you greatly.

denied word in red — *After your Medicare underwriting is complete, companies decide whether to accept you, or deny you coverage due to your pre-existing conditions.*

Medicare Supplement plans help pay for out of pocket expenses such as copays, coinsurance, and deductibles. When

you sign up for a Medicare Supplement plan, you may need to go through the underwriting process. It all depends on when you decide to sign up for a supplement plan. To answer the question if Medicare underwriting is necessary, both yes and no. Find out how to avoid Medicare underwriting, and if you do have to go through it, then what it entails.

The Only Time To Avoid Medicare Underwriting

During the Medicare Supplement Open Enrollment Period is when you have “guaranteed issue rights.” Guaranteed issue means that you will be accepted into any plan regardless of your health condition or pre-existing conditions. During this time, you have a one-time guarantee when companies cannot deny you or charge you more due to a pre-existing condition. The Medicare Supplement Open Enrollment Period is a six month period that begins the first day of the month you turn 65 years old, and enrolled in Medicare Part B.

When You Need To Be Underwritten

If you apply for a Medicare Supplement plan after your Medicare Open Enrollment Period has passed, then you may have to go through the underwriting process. In addition, when you are switching Medicare Supplement plans, you may have to go through the underwriting process. If a Medicare Supplement plan accepts your application, the insurer can choose to make you wait 6 months before covering a pre-existing condition. This is known as a “look-back period,” or “pre-existing wait period.”

The Underwriting Process

Private insurance companies will have extensive health-related questions on their applications. It will go over your entire medical history, both past and present. If you have a pre-existing health condition that may be expensive for the company to cover, they can choose to deny your application.

white paper that says checklist with boxes down a line with checkmarks in them. — *During the Medicare underwriting process, companies will go through your medical history and check off which conditions may be considered an expensive health risk for them to cover.*

If you have a health condition that needs constant attention, chronic, or incurable, then you may be denied. Certain medications can also be a reason for denial, especially for the incurable or chronic health conditions, simply because it will be too expensive for the insurers to cover. Often times minor conditions such as BMI, high blood pressure, and cholesterol are not issues for carriers. If you have pending surgeries or treatments, then it is best to get them done before applying. Serious health conditions such as rheumatoid arthritis, dementia, chronic lung disorders, lupus, MS, major heart disorders, and kidney failure will be an automatic denial of coverage for the company.

If you are still within your Medicare Supplement Plan Open Enrollment Period, then great, no better time to get started and sign up for a plan. If you have passed this guaranteed issue window, you can still apply with caution. And if you get denied, then it is not the end of the world, our agents will search through all available Medicare Supplement plans and help you.

EZ.Insure has highly trained agents who will search through all the Medicare Supplement carriers in your region, whether you are within the open enrollment period or not. Your personalized agent will compare all the plans, their coverage, and their quotes. To get started, you can enter your zip code in the bar above, or speak to an agent directly by emailing Replies@Ez.Insure or calling 855-220-1144. We will be by your side throughout the process, walking you through it, while providing you with the best advice and options.

Tag: Medicare Help