Will I Get My Spouses Medicare If I Retire At Age 62
No. Even if your spouse has Medicare when you retire at 62, you arenât eligible for Medicare until you turn 65 .
If you retire before age 65, you may be able to continue to get health insurance through your employer, or you can purchase coverage from a private insurance company in the meantime.
What Happens When You Turn 65
When you turn 65, you essentially lose your entitlement to Medicare based on disability and become entitled based on age. In short, you get another chance to enroll, a second Initial Enrollment Period if you will.6
If you decided not to take Part B when you were eligible for disability under 65, when you do turn 65, youll now be automatically enrolled in Part B. Your Medicare card will then be mailed to you about 3 months before your 65th birthday.
You can also decide during this time to enroll in a Medicare Advantage or Part D prescription drug plan. Additionally, once you have Part B, you can enroll in a Medigap plan if you so wish.
Ways To Apply For Disability Benefits:
- If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
Once your disability benefits start, well mail you a welcome package with your Medicare card.
Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months after your Part A starts, you might have to wait to sign up for Part B and pay a monthly late enrollment penalty.
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Step By Step Instructions For Filling Out This Application
Get Benefit Verification Letter
Get a benefit letter to show that you receive benefits, have submitted an application, or don’t receive benefits.
This documentation is often needed for loan applications, housing assistance, and other processes that require verification of your income. It may be referred to as a “proof of income letter” or “benefit letter” and is personalized based on the status of your Social Security benefits, Supplemental Security Income, and Medicare coverage.
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Who Is Eligible For Medicare
Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease . Medicare has two parts, Part A and Part B . You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:
- You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
- You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
- You or your spouse had Medicare-covered government employment.
To find out if you are eligible and your expected premium, go the Medicare.gov eligibility tool.
If you did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:
- You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months.
- You are a kidney dialysis or kidney transplant patient.
While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.
Comparison With Private Insurance
Medicare differs from private insurance available to working Americans in that it is a social insurance program. Social insurance programs provide statutorily guaranteed benefits to the entire population . These benefits are financed in significant part through universal taxes. In effect, Medicare is a mechanism by which the state takes a portion of its citizens’ resources to provide health and financial security to its citizens in old age or in case of disability, helping them cope with the cost of health care. In its universality, Medicare differs substantially from private insurers, which decide whom to cover and what benefits to offer to manage their risk pools and ensure that their costs do not exceed premiums.
Medicare also has an important role in driving changes in the entire health care system. Because Medicare pays for a huge share of health care in every region of the country, it has a great deal of power to set delivery and payment policies. For example, Medicare promoted the adaptation of prospective payments based on DRG’s, which prevents unscrupulous providers from setting their own exorbitant prices. Meanwhile, the Patient Protection and Affordable Care Act has given Medicare the mandate to promote cost-containment throughout the health care system, for example, by promoting the creation of accountable care organizations or by replacing fee-for-service payments with bundled payments.
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Do You Need To Inform Social Security Of Any Group Health Plans After The Age Of 65
You will certainly have to inform Social Security about the dates you started and ended any group health plans for over 65-year-olds. Once you have gathered all this information, you can move on to start your application here. Do not worry if you think you have forgotten to tell them about anything. SSA employees will call you or send you an email to request extra information.
Sometimes people prefer to call rather than do the application online. You can usually call them from Monday to Friday. Remember that they start working at 8 a.m. and finish at 7 p.m. It is not possible to call 24/7. If you are not confident in English because you are from another country, you may have other languages available. You could call them at +1 800-772-1213 and tell them you would like to apply for Medicare.
If you are deaf or hard of hearing you have the possibility of calling a different number. Simply call TTY+1 800-325-0778. Once you have finished the process, you just need to wait. As soon as they approve it, it can take up to 30 days to get your Medicare card. You will get a notice telling you when your Medicare coverage starts. It could get before your card though. Do not forget to check the status of your application here.
Where Can I Find More Information
To find more information about Maryland programs for seniors, visit www.aging.maryland.gov. You can also call 410-767-1100, 800-243-3425 , or 410-767-1083 . The Centers for Medicare and Medicaid Services offer consumer resources at www.medicare.gov and 1-800-MEDICARE. The Social Security Administration has several helpful publications on its website, visit .
Medicare Part B Reimbursement
SERS retirees who are eligible for Medicare Part B and enrolled in SERS health care coverage are eligible to receive a Medicare Part B reimbursement. You must have SERS coverage to receive this benefit.
SERS currently reimburses eligible benefit recipients $45.50 per month to help pay Medicare Part B premiums. If your Medicare Part B coverage is cancelled, or your Part B premium is paid by any other source, such as your state, union, employer, Medicaid or other entity, you are not eligible for the reimbursement.
Reimbursement starts after SERS receives proof of Medicare Part B enrollment. The reimbursement is not retroactive.
Spouses and dependents are not eligible for this reimbursement.
I Want To Sign Up For Only Part A Or Both Part A & Part B
Once youre eligible to sign up for Medicare , you have 2 options:
Once you sign up , youll get a welcome package with your Medicare card.
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Medicare Initial Enrollment Period
If you are receiving a Social Security check prior to age 65:
- Social Security automatically enrolls you in Medicare Parts A and B, and
- Social Security mails you a Medicare card.
If you are not receiving a Social Security check:
- You will need to sign up for Medicare in person at a Social Security office or online at ssa.gov/medicare.
Medicare charges a lifetime penalty of 10% for each 12-month period you are eligible for Medicare Part B but do not sign up for it.
The penalty does not apply when you are enrolled in an employer health plan. See Working Past Age 65.
To have your Medicare coverage effective the month you turn 65, sign up as soon as you are eligible.
The Parts Of Medicare
Social Security enrolls you in Original Medicare .
- Medicare Part A helps pay for inpatient care in a hospital or limited time at a skilled nursing facility . Part A also pays for some home health care and hospice care.
- Medicare Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.
Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.
- Supplemental policies help pay Medicare out-of-pocket copayments, coinsurance, and deductible expenses.
- Medicare Advantage Plan includes all benefits and services covered under Part A and Part B prescription drugs and additional benefits such as vision, hearing, and dental bundled together in one plan.
- Medicare Part D helps cover the cost of prescription drugs.
Most people age 65 or older are eligible for free Medicare hospital insurance if they have worked and paid Medicare taxes long enough. You can sign up for Medicare medical insurance by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. To learn more, read .
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Medicare Prescription Drug Coverage
Medicare Prescription Drug Plans are sold by private insurance companies approved by Medicare. All people new to Medicare have a seven-month window to enroll in a PDP three months before, the month of and three months after their Medicare becomes effective. The month you enroll affects the PDPs effective date. All people with Medicare are eligible to enroll in a PDP however, unless you are new to Medicare or are entitled to a Special Enrollment Period, you must enroll or change plans during the Open Enrollment Period for Medicare Advantage and Medicare Part D, Oct. 15 through Dec. 7. There is a monthly premium for these plans. If you have limited income and assets/resources, assistance is available to help pay premiums, deductibles and co-payments. You may be entitled to Extra Help through the Social Security Administration. To apply for this benefit contact SHIIP at 1-855-408-1212 or the Social Security Administration at 800-772-1213 or www.socialsecurity.gov.
Check The Application Status
Once the application is complete, you can check the status of your enrollment anytime in your My Social Security account. Simply click the Benefit Verification Letter link to see if your Medicare enrollment has been completed or if an application for benefits is still processing.
If the letter shows your Part A and/or Part B start date and your Medicare # is visible, your Medicare card is on its way. Generally speaking, you can expect your Medicare card to arrive by mail within 4-6 weeks .
Note: The Benefit Verification Letter is proof of Medicare coverage, so you can use it to move forward with signing up for a Medicare Supplement plan, Part D prescription drug plan, or Medicare Advantage plan. You dont necessarily have to wait for your Medicare card to arrive by mail if your Medicare number and start dates are displayed on the Benefit Verification Letter.
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C: Medicare Advantage Plans
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With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were formally given the option to receive their Original Medicare benefits through capitated health insurance Part C health plans, instead of through the Original fee for service Medicare payment system. Many had previously had that option via a series of demonstration projects that dated back to the early 1970s. These Part C plans were initially known in 1997 as “Medicare+Choice”. As of the Medicare Modernization Act of 2003, most “Medicare+Choice” plans were re-branded as “Medicare Advantage” plans . Other plan types, such as 1876 Cost plans, are also available in limited areas of the country. Cost plans are not Medicare Advantage plans and are not capitated. Instead, beneficiaries keep their Original Medicare benefits while their sponsor administers their Part A and Part B benefits. The sponsor of a Part C plan could be an integrated health delivery system or spin-out, a union, a religious organization, an insurance company or other type of organization.
The intention of both the 1997 and 2003 law was that the differences between fee for service and capitated fee beneficiaries would reach parity over time and that has mostly been achieved, given that it can never literally be achieved without a major reform of Medicare because the Part C capitated fee in one year is based on the fee for service spending the previous year.
Enrolling In Medicare With A Disability
Just like when you become eligible for Medicare at age 65, when you are eligible with disability, you have an Initial Enrollment Period of 7 months.
Your Initial Enrollment Period will begin after you have received either disability benefits from Social Security for 24 months or certain disability benefits from the Rail Road Retirement Board for 24 months.1 In other words, your IEP starts on the 25th month of disability benefits.
You will be automatically enrolled in Medicare Part A and Part B, but if you decide you want to get a Medicare Advantage or Part D prescription drug plan, you will need to enroll yourself directly with the private plan provider. You will need to enroll during your IEP to avoid late enrollment penalties.
NOTE: If you become eligible for Medicare because of ALS or ESRD, your situation is different. See the below special sections for eligibility and enrollment for ALS and ESRD.
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Does Medicare Cover The Costs Of Durable Medical Equipment
Medicare does cover durable medical equipment, which is equipment that serves a medical purpose, is able to withstand repeated use, and is appropriate for use in the home. Original Medicare normally pays 80% of the Medicare-approved amount after you meet your Part B deductible and you are responsible for a 20% coinsurance. Medicare only covers durable medical equipment if your provider says it is medically necessary for use in the home. You must also order the equipment from suppliers who contract with Original Medicare or your Medicare Advantage Plan. If you have a Medicare Advantage Plan, your plan will have its own cost and coverage rules for durable medical equipment. For a more comprehensive list of what is covered, please visit Durable Medical Equipment section in the Medicare and You handbook.
Already Enrolled In Medicare
If you have Medicare, you can get information and services online. Find out how to .
If you are enrolled in Medicare Part A and you want to sign up for Part B, please complete form CMS-40B, Application for Enrollment in Medicare Part B . If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564, Request for Employment Information.
You can use one of the following options to submit your enrollment request under the Special Enrollment Period:
- State I want Part B coverage to begin in the remarks section of the CMS-40B form or online application.
- If possible, your employer should complete Section B.
- If your employer is unable to complete Section B, please complete that portion as best as you can on their behalf and submit one of the following forms of secondary evidence:
- Income tax form that shows health insurance premiums paid.
- W-2s reflecting pre-tax medical contributions.
- Pay stubs that reflect health insurance premium deductions.
- Health insurance cards with a policy effective date.
- Explanations of benefits paid by the GHP or LGHP.
- Statements or receipts that reflect payment of health insurance premiums.
Some people with limited resources and income may also be able to get .
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