Medicare enrollment breakdown
Retirement brings many new issues to tackle, and one of the most confusing can be Medicare. Open enrollment is upon us and figuring out how to get coverage can be frustrating for even the most well-informed retirees.
In order to be eligible for Original Medicare, which includes Part A (hospital insurance) and Part B (supplemental medical insurance), you must be a U.S. citizen or permanent resident.
There are three ways to be eligible for Medicare: by reaching age 65; by being disabled before 65 and entitled to Social Security or Railroad disability benefits for at least two years; by having end stage renal disease with six work credits in the past three years.
You may qualify for premium-free Part A in any of three possible situations: You are eligible for Social Security retirement, disability, family or survivor payments; you are eligible for a pension from the Railroad Retirement Board; you have worked long enough (self or spouse) in government work and paid Medicare taxes. If you met any of those conditions, you, your qualifying spouse and your qualifying former spouse are eligible for Medicare, including free Part A.
Some individuals are automatically enrolled in Medicare: those getting payments from Social Security or the Railroad Retirement Board; those under 65 and getting Social Security disability payments for 24 months; and those with amyotrophic lateral sclerosis. Without these conditions, you must enroll in order to be covered.
At 65, you can sign up enroll in Medicare during the initial enrollment period for Part A and/or Part B during the seven-month period that beginning three months before the month you turn 65 and ending three months after the month you turn 65. If you sign up for Part A and/or Part B during the first three months of your initial enrollment period, in most cases your coverage starts the first day of your birthday month.
If your birthday is on the first day of the month, your coverage will start the first day of the prior month. If you enroll the month you turn 65 or during the last three months of your initial enrollment period, the start date for your coverage will be delayed. If you don't sign up for Part A (and don't qualify for free premium) or Part B when you are first eligible, you may have to pay a late enrollment penalty.
If you are covered under a group plan based on current employment (your own, a spouse's or, if you're disabled, a family member's) you can sign up for Part A and/or Part B anytime you are still covered by the group health plan, and during the eightmonth period after the employment ends or the coverage ends, whichever happens first. If you sign up during a special enrollment period, you can avoid a late-enrollment penalty.
The Center for Medicare and Medicaid Services has announced 2019 Medicare Part A and B premiums and deductibles. The Medicare Part A hospital inpatient deductible that beneficiaries will pay when admitted is $1,364 in 2019, an increase of $24 from 2018. Medicare Part A covers inpatient hospital, skilled nursing facility and some home health care services.
Individuals who have at least 40 quarters of Medicare-covered employment do not have to pay Part A premium.
The standard Medicare Part B monthly premium for 2019 will be $135.50, an increase of $1.50 per month over 2018. Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Part A.
Approximately 2 million Medicare beneficiaries will pay less than the full Part B standard monthly premium in 2019 because of the statutory hold harmless provision, which limits certain beneficiaries' increase in their Part B premium to be no greater than the increase in their Social Security benefits.
High earners pay significantly more. The modified adjusted gross income from a participant's tax return from two years ago determines premiums.
A fact sheet for 2019 premiums and deductibles is available at: https:// www.cms.gov/newsroom/factsheets/2019-medicare-parts-b-premiums-and-deductibles. Elliot Raphaelson welcomes your questions and comments at email@example.com.
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