When to & How to apply for — MediCare A & B!

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Call John's Google Voice #  —  (860) 451-9793 today to set up a meeting to eliminate the confusion and discuss signing up. 

The sections on this page to the right and below highlight the  —  correct steps:

First - Some background on MediCare:

  ● When you sign up for Part A & Part B [called original Medicare], it is essential to understand when receiving outpatient services, Part B  —  does not pay 100% of the amount Medicare approved for the treatment you receive. 

  ● The question then is —What to do about the part of the approved amount MediCare does not pay?    Answer —Buy either of these types of plans, which work with original MediCare and are available from private companies:  

    + a Medicare Advantage Plan.  —  Details on how they work and what you gain are on this page  

    + a Medicare Supplement approved for CT.  —  Details on how they work and what you gain are on this page   

Quick answer — Nothing!

 ● If you do decide to sign up the Social Security (SS) agency, not CMS manages  MediCare eligibility and develops enrollment regulations, which I like to call "rules" for Part A & Part B — They tell us: 

     -> A person becomes what MediCare calls — "eligible" for coverage on the 1st day of the month when 65! 

      Note: Individuals under 65 with a Social Security disability also become eligible after 24 months.

Remember  —  individuals working and covered by an employer medical plan — do not have to sign up at 65! 

There are specific times for individuals 65 or older to sign up for MediCare. 

Sign-up times are shown in the three bottom sections of this page.

First  — Since applications for MediCare are processed by SS I recommend calling the Local SS office in New London - it's (866) 643-3401:

  -> Ask to speak with or time to call a retirement person. 

      Note: They may suggest a telephone appointment. 

When your application is complete you are what MediCare calls "entitled". It's their name for the date coverage began, for:

    -> Part A for inpatient hospital services.

    -> Part B for medically necessary outpatient services.

Two or three weeks after applying an ID card will be mailed to you — Entitled is printed on the ID card above Part A and Part B to show the date an individual's coverage started. The dates for  A & B are often different!

Information about what is on the card and a picture can be seen here.

The IEP is a seven month period with the month the person is 65, which MediCare calls when eligible, in the middle. 

    Note: Eligible month is moved to the previous month when an individual's birthday is on the 1st.  

Want to sign up at 65 using the IEP? 

SS's sign-up rules, as of Jan 2023, are somewhat less complicated when turning 65. The new rules  made an improvement in when Part B's coverage is effective:   

An application for Part A & Part B can be submitted in:  

● Either of the three months before a person is eligible. If they do coverage for both parts will start the first day of their eligible month.  

     [This is the same as before.] 

● Their eligible month or during either of the last three months of their IEP. This results in: 

   ->  Part A starts the first of their eligible month.

   -> Part B, however, will start the first of the month after the date of the application. 

        Note: The rules for Part B's effective date were changed, so the effective date of coverage is similar to what employers use.

   -> When talking to the SS Retirement person about getting signed up ask about the options available to pay your share of Part B's monthly cost.

Call John's Google voice # today —  (860) 451-9793 if any questions about the IEP. 

One of the most common SEP is when an Individual who continued to work after 65 decides to sign up for Medicare's Part B.

The SEP rules say individuals over 65: 

● Can sign up anytime, IF covered by their or a spouse's employer's medical plan. 

● Can have Part B begin, whichever is first, the month after: 

    -> employment or 

    -> Employer coverage ends  

If apply while still on the employer plan: 

● Part B can start the first of any of the following three months.

If apply after leaving the employer plan, Plan B can start the first of:

 ● The month if applied in the month after leaving – thus, no days without coverage.

● Next month, if applied in any of the remaining eight months of their SEP: 

What are the — steps to use a SEP : 

● Call the Local Social Security office to set up a time to talk to a Retirement person about:

     -> Completing the Part B application. 

     -> The options available to pay your share of Part B's monthly cost.

     -> Getting Form CMS-L564 signed. Your employer fills in the dates covered by the medical benefit plan and signs.

● Returning the CMS-L564 to SS means the person:

      -> qualifies for the Part B SEP.  

      -> will not have to pay Part B's late enrollment penalty. 

● The signup forms are on this link –  CMS-40B, the form to apply for Part B, and  – CMS L56,4, the form to show you have coverage.

     Alert - If working past 65 and participating in an HSA, Part A will be back-dated six months from the date you select for Part B. This means HSA contributions must stop six months before Part B's date. 

     Note: If proof of prior employer medical coverage is unavailable, an additional 10% is added to Part B's cost for each 12 months after eligibility. 

Call John's Google voice # today —  (860) 451-9793  if any questions about this SEP.

The GEP is available for a person, who for some reason, did not apply during their IEP at 65 nor did not have a life change situation to qualify for an SEP

The GEP has special rules which limit when a person can apply for Part B:

 ● An application can only be submitted to SS between Jan 1st and March 31st.

SS's sign-up rules, as of Jan 2023< when using the GEP are no longer as complicated. Part B's effective date will now be the first of the month after applying. 

  [Individuals no longer have to wait for Part B's coverage to start July 1st]

OK! If a GEP has to be used what can a person do about medical treatment coverage? 

  ● If Part A was:

      ->  Just activated they have coverage for any hospital situations, can sign up for a Medicare Prescription Drug Plan, and have coverage for medications.

       ->  Previously effective they have coverage for any hospital situations.

The disadvantage of using a GEP is having to wait until Jan, Feb, or Mar to sign up for outpatient treatment coverage. 

Call John's Google voice # today —  (860) 451-9793  if any questions about the GEP  

You can also send a note —  John@MedicarePlansSECT.com