Basic Introduction to Medicare Pt 3

If a person can prove his case, the decision to deny Medicare eligibility or cover or to impose a sanction of surcharge may be lifted. Complaints are handled by the local social security office. It is important if you believe that you are unjustly denied Medicare coverage and that you insist on your right to object.

 

Registration is generally handled by the Social Security Administration through their local offices. Beneficiaries for the retirement of railway companies should contact the Railroad Retirement Board for registration.

 

Online registration: As of 2010 you can also register online at www.socialsecurity.gov. Just select the link “Retirement / Medicare” in the middle of the page. The application process may take less than 10 minutes.

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Working Elderly:

 

By the time the Medicare program was established in 1965, most people retired at the age of 65 and automatically began to participate in the program at that age. However, when people started working beyond the age of 65 and Medicare was trying to curb costs, Medicare coverage and the registration policy changed.

 

In the early 1980s, several laws were passed making Medicare benefits subordinate to benefits payable under an Employers’ Group Health Plan to workers and their spouses aged 65 and above. In addition, employers are prohibited from offering Medicare to eligible employees and their spouses a different health plan othan the other employees. Employers with fewer than 20 employees are exempted from these new laws but can volunteer.

 

These changes resulted in the creation of an additional “special enrollment phase” for the working seniors. Persons above the age of 65, who have an EGHP coverage due to their own activities or the employment of a spouse, have the freedom to enrolling in Medicare at the age of 65 without increment in premium.

 

Since EGHP is the main payer, many workers may not want to pay Medicare coverage, which may be duplication. Failure to sign up during this “Special Registration Period” may result in a premium surcharge and the individual may not be able to register until the next General Registration Period.

 

Originally, the SEP began on the first day of the first month, when the worker was no longer covered by the EGHP, and ended 7 months later. However, as of March 1, 1995, persons covered by an EGHP may enroll in Medicare while still under the EGHP. In addition, the period during which registration can take place after the end of EGHP cover has been extended from 7 to 8 months.

 

Under these new provisions, a person may enroll in Medicare while they are still covered by an EGHP and choose to start coverage this month or for one of the following 3 months.

 

Example:

Ms Mirabel. was 65 years old in 2007, but continued to work and was looked after by an EGHP. In April 2009, she applied for monthly social security benefits and Medicare, as she wanted to retire on 30 June 2009. It is up to her to choose to start Medicare either in April 2009 or in one of the following three months. She chooses to start reporting in July 2009, as she is currently working under her EGHP.