Medicare enrollment is NOT the same as Social Security! There seems to be a lot of confusion between the two.

By Ulla-Undine Merritt (Dee) National Producer Number (NPN) 8853366

Social Security – you can apply online at www.ssa.gov for retirement benefits or benefits as a spouse if you:
• are at least 61 years and 9 months old;
• are not currently receiving benefits on your own Social Security record;
• have not already applied for retirement benefits; and
• want your benefits to start no more than 4 months in the future. (We cannot process your application if you apply for benefits more than 4 months in advance.)

Medicare – you can apply online at www.medicare.gov for Medicare benefits for yourself 3 months before your 65th birthday month.  Example, June 20th birthday you can apply as early as March 1st.  If your birthday is any day of the month except the 1st, your Medicare will be effective the 1st day of your birth month.  For the June 20th birthday example above, your benefits would begin June 1st.  If your birthday is effective the 1st of the month then your benefits begin the month before, so a June 1st birthday your benefits would begin May 1st.  VERY important: if you DO NOT take Medicare Part B & Part D when you are eligible, when you do take it there is a penalty for each month you did not have them. That penalty will last for the rest of your life or for
as long as you take these services.  If you have employer coverage (not cobra) this is a valid waiver.  If you take these after you leave employment there is a special form your employer must fill out so that you are not charged a penalty.

Both Medicare and Social Security require you to be eligible by qualifying either through yourself or your spouse.

Most people that have worked in the United States of America receive Medicare Part A at no monthly cost to them.  This is because they have worked at least 40 quarters (approx. 10 years); this is based on a minimal earnings calculator (see www.medicare.gov for more information).

In general Medicare Part A covers:
• Hospital care
• Skilled nursing facility care
• Nursing home care (as long as custodial care isn’t the only care you need)
• Hospice
• Home health services

There is a Medicare Part A deductible of $1,288 for each benefit period for “inpatient” hospital stays.  In order for Medicare to cover skilled nursing facility care, you need to have a 3 day hospital stay.  You must make sure you are admitted and not just kept for observation, always ask.

In general Medicare Part B covers:
• Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
• Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

Part B covers things like:
• Clinical research
• Ambulance services
• Durable medical equipment (DME)
• Mental health
• Inpatient
• Outpatient
• Partial hospitalization
• Getting a second opinion before surgery
• Limited outpatient prescription drugs

Medicare Part B premium varies based on income. If you file an individual tax return and your income is less than $85,000 or filing joint and income is less than $170,000 your monthly premium is $134.00. For other income amounts, please visit www.Medicare.gov for Medicare costs.

Medicare Part D Drug Coverage these are administered through Insurance companies.

Your actual drug plan costs will vary depending on:
• The drugs you use
• The plan you choose
• Whether you go to a pharmacy in your plan’s network
• Whether the drugs you use are on your plan’s formulary
• Whether you get Extra Help paying your Medicare Part D costs

Once you have coverage the Medicare Annual Election Period is October 15th to December 7th, and during this time you can change your Medicare Part C or Part D.  The effective date will be January 1st of the following year.
*resource www.medicare.gov

Also remember when moving, getting married or divorced, adding to your family you have a special enrollment period to apply or change your health insurance coverage. Also check your wills, trusts, and make sure they follow Florida’s laws and guidelines. Establish yourself with a local attorney, CPA, Financial Planner / Insurance Agent.  An annual review is very important. Too many times people assume.  Don’t assume.  Ask a professional, most of the time your first consultation is at no charge.
To learn more or schedule an appointment contact: Logical Insurance Solutions – Dee Merritt www.Logicalinsurance.com 239-362-0855