by Pat Ocheltree, MiCAFE Application Assistant
There is a lot of confusion about Medicare, what it covers, how individuals get coverage, etc. Generally, if you receive Social Security benefits, you will automatically become eligible to enroll in Medicare Part A (hospital coverage) and Medicare Part B (medical) during the 3 months before, the month of, and the 3 months following your 65th birthday. Medicare A is fully paid for unless you have a high income, while Medicare B is more often paid for by the individual (typically a premium of $121.80/month). You do have the right to elect not to accept Medicare. However, if you choose to decline coverage and then decide later that you want Medicare Part B, you will have to pay a penalty for every year you do not join the program unless you have other creditable health insurance coverage (such as employer provided coverage). For most folks, it is wise to take Medicare when initially eligible. More detail is available by calling the Medicare and Medicaid Assistance Program at 800.803.7174.
Here are some important tips for those who are enrolled in Medicare or who have friends/family who are enrolled in Medicare:
- Read the quarterly information you receive from Medicare in the form of Medicare Summary Notices;
- If you do not understand or agree with something you read in your Summary Notice, call the biller to make sure they billed Medicare correctly, then follow up with Medicare;
- If you receive a denial of payment for services, check to see if your supplemental insurance picked up payment, if you have such coverage; and
- If you have an extremely low gross income, you may be eligible to have your Medicare Part B premium paid for you as well as paying for a Part D Plan (for prescriptions). If you are having trouble affording your Part B or D premiums, contact the MiCAFE program at 866.400.9164 to schedule a benefits screening to see if you are eligible for these assistance program.