I was laid off… What are my health insurance options? [The Times-Tribune, Corbin, Ky.] – InsuranceNewsNet

August 6—Editor’s Note: The Times Tribune is pleased to offer ‘Toni Says’, a new column featuring helpful Medicare information presented in an engaging Q&A format.

Hello Tony:

My husband, David, was laid off because of what’s happening to the economy and rising gas prices. He is 68 years old and has never been enrolled in Medicare. I will be 65 in September and we are both covered by his employer’s health insurance plan which is ending.

We were told that he will receive a penalty because he is over 65 and has never registered for part B. I really hope not! I will have to enroll in COBRA until I turn 65 in September. Please explain what our Medicare enrollment options are since we are of different ages and have different enrollment situations. Thanks

— Paul

Great question, Paula:

There are 2 different rules about enrolling in Medicare parts A and B in your household and I’ll keep how to enroll in Medicare for you and David SIMPLE!

1) David must apply for SEP (Special Enrollment Period) by downloading Form CMS-L564 (Employment Information Request) from socialsecurity.gov or via email [email protected] and we will send you a form by e-mail.

Have David’s Human Resources department sign the form and attach it to the CMS-40B (Application for Health Insurance Part B). Submit both forms to your Social Security office when applying for Medicare Part B. Notify the Social Security representing that David loses his benefits and needs his Part B to start the day after they end.

2) Paula, your way of enrolling in Medicare is simple and quite different from David’s because you will be 65 in September. Go to www.socialsecurity.gov/benefits/medicare at least 90 days before you turn 65 and apply online for a September 1st effective date.

This is an ALERT to the public because the Social Security the offices, which were closed due to the pandemic, have recently reopened. The public should call their local Social Security office directly for assistance in completing the Medicare Part B application forms. Most Social Security direct phone numbers can be located by searching online for the 800 number for that specific office. Typically the pending hold is less than the main call Social Security number 800.

Below is a checklist for those enrolling in Medicare:

1) Original Medicare Part A: Covers hospital stays, skilled nursing/rehab, blood transfusions, home care, and palliative care.

2) Original Medicare Part B: Covers primary care or specialists whether in the office or in surgery, outpatient surgery, durable medical equipment, x-rays, CT scans, MRIs, chemotherapy, etc.

3) Original Medicare/Medicare Advantage: Discuss with your healthcare institutions and healthcare professionals which Medicare plans they accept, such as Original/Traditional Medicare with Medicare Supplement or Medicare Part C (Medicare Plan Advantage such as HMO, PPO or PFFS). Search the Medicare Advantage Plan Hospital/Provider Directory online to make sure your doctors and hospitals are part of the network for that specific plan. Call to verify that they are currently on the network.

4) Medicare Prescription Drug Plans: Research drug plans each year to see if your prescription drug plan or Medicare Advantage standalone with prescription form covers all of your prescription or generic drugs.

5) Long Term Care (LTC): Consider an LTC option such as standalone LTC policies, hybrid annuities or life insurance with LTC riders, veterans affairs assistance and benefits or applying for financial assistance from your specific state’s Medicaid for long-term care.

6) Always make copies of each document given to the Social Security office or receipt from Social Security Desk.

Tony King is an author and columnist on Medicare and Medicare issues. She has spent over 27 years as a sales leader in the fields. For answers to Medicare questions, email: [email protected] or call 832-519-8664.


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