Social Security & Medicare Questions: January 2015

Social Security & Medicare Questions: January 2015

Q: I turn 65 in two months. I recently received my Medicare card and a letter stating that I might be eligible for Extra Help with prescriptions. I'm going to apply, but I'm still worried. My Social Security benefit is only $800 per month and I don’t have much other income. I can’t afford the deduction of the Medicare Part B premium. What can I do? I'm currently enrolled in an "Obamacare" plan and pay only $17 a month after the subsidy.

A: Enrolling in Medicare is overwhelmingly confusing and stressful for almost everyone. In addition to enrolling in Medicare Part B, beneficiaries also need to choose supplemental health coverage like a Medigap policy with a separate drug plan, or enroll in a Medicare Advantage plan with drug coverage. There are a number of things you need to know and decisions you will need to make. All the while most soon-to-be 65 year olds are buried in confusing mailings from insurers. Here’s a short list of steps to take:

  • Apply for Medicare Extra Help. If your monthly income is up to $1,459 for individuals, or $1,967 for a couple and your savings and assets below the limit, Medicare Extra Help will cover most or all of your drug plan premium, deductibles and copays or co-insurance, in addition to providing valuable extra coverage in the Medicare Part D coverage gap. You can apply online by visiting SocialSecurity.gov or call Social Security at 1-800-772-1213. You can also apply by visiting your local Medical Assistance (Medicaid) office. If you qualify for Extra Help you must choose a drug plan to provide your coverage.
  • Choose between Medigap coverage with a Part D drug plan, or Medicare Advantage plan with drug coverage and enroll. You can check health and drug plan options in your area by using the Medicare plan finder. You can try this on your own at Medicare.gov, or you can get free unbiased one-on-one counseling through your state Health Insurance Assistance Program (SHIP) to help you sort through the best options and to discuss the right choice for you. There are pros and cons to each type of coverage, and plans vary widely. Many SHIP programs operate through local Area Agencies on Aging or senior services departments. Because your income is low we strongly recommend that you get SHIP counseling to ensure you get all the benefits that you’re entitled to.
  • Apply for a Medicare Savings Program as soon as your Medicare coverage becomes effective. Social Security automatically deducts the monthly Medicare Part B premium, $104.90 this year, from your monthly benefits. Because your income is low, however, you may qualify for a Medicare Savings Program that would pay for your Part B premium, saving you $104.90 per month. People with the lowest incomes might also qualify for help paying your Part B deductibles, co-insurance and co-payments so you wouldn’t need a Medigap or Medicare Advantage plan. You must wait until your Medicare coverage becomes effective to apply for Medicare Savings Programs through your local Medical Assistance Office or Medicaid office. A SHIP counselor can co-ordinate your complex application needs and help steer you through the process.
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