Selasa, 17 Agustus 2010

1. Individual Assignment: Evaluating Tools for Clients: Medicare Eligibility Test

Thank you. You have completed the questionnaire section of this tool. The following table contains personalized eligibility and enrollment information based on the information you entered. Please note that Social Security will make the final decision on your eligibility and enrollment.

General Enrollment
If you are age 65 or older, you may file an application for Medicare benefits. There are two parts to Medicare: Part A and Part B. Medicare Part A helps cover your inpatient care in hospitals, critical access hospitals and skilled nursing facilities. It also covers hospice care and some home health care. Medicare Part B helps cover your doctors’ services, outpatient hospital care, and some other medical services that Medicare Part A doesn’t cover, such as some of the services of physical and occupational therapists, and some home health care. Medicare Part B helps pay for these covered services and supplies when they are medically necessary. For more coverage information, please visit theYour Medicare Coverage section of our website. Note: You must enroll in Part B to get Part A coverage. You don't need to enroll in Medicare Part A to get Part B. To apply you will need to visit or call your local Social Security office or call Social Security at 1-800-772-1213.

Note: You will be eligible for Medicare when you turn 65 even if you are not eligible for Social Security retirement benefits. For more information, please visit our retirement age FAQ.

Part A Specific
You may not be eligible for premium-free Part A based on your (or your spouse's) work history, but you may be eligible to buy Part A for a monthly premium. If you have less than 30 quarters of coverage under Medicare covered employment your premium for Part A in 2010 will be $461.00 per month. The monthly Part A premium is $254.00 in 2010 for those individuals having 30-39 quarters of coverage under Medicare covered employment. For more information on buying Part A, please call Social Security at 1-800-772-1213 or visit or call your local Social Security office.

Special Enrollment Period
If you didn't sign up for Medicare Part A when you were first eligible because you or your spouse was working and had group health coverage through an employer or union based on this current employment, you may be eligible for a Special Enrollment Period. If this applies to you, you can sign up for Medicare Part A any time you are still covered by the employer or union group health plan through your (or your spouse’s) current or active employment, or during the eight months following the month the group health plan coverage or the employment ends (whichever is first). Your Medicare Part A coverage will begin:

The month you enroll in Medicare Part A if you enroll while you are covered under the group health plan based on current or active employment, or during the first full month after the coverage or employment ends (whichever comes first). You can also delay the start date for Medicare Part A coverage until the first day of any of the following three months; or
The month after the month you enroll if you enroll during the remaining 7 months of the Special Enrollment Period.
Note: If you are still working and plan to keep your employer's group health plan coverage, you should talk to your benefits administrator or your State Health Insurance Assistance Program to help you decide the best time to enroll in Medicare Part A.

General Enrollment Period
If you don't enroll in Medicare Part A during your Special Enrollment Period, you can sign up during the General Enrollment Period. The General Enrollment Period runs from January 1st through March 31st of each year. Your Medicare Part A coverage will start on July 1st of the year you sign up. You may have to pay a 10% premium surcharge for late enrollment. The surcharge is applied only for a period equal to twice the number of months in each full 12-month period you could have been but were not enrolled in premium Part A. For more information on buying Part A, please call Social Security at 1-800-772-1213 or visit or call your local Social Security office

Part B Specific
Most people pay monthly for Medicare Part B. The base premium for Medicare Part B is $287.30 in 2010. The monthly Part B premium is deducted from your Social Security, Railroad Retirement, or Office of Personnel Management annuity check. If you don't get any of these payments, Medicare will send you a bill for your Part B premium every 3 months.

Special Enrollment Period
If you didn't sign up for Medicare Part B when you were first eligible because you or your spouse was working and had group health plan coverage through an employer or union based on this current employment, you may be eligible for a Special Enrollment Period. If this applies to you, you can sign up for Medicare Part B any time you are still covered by the employer or union group health plan through your (or your spouse’s) current or active employment, or during the eight months following the month the group health plan coverage or the employment ends (whichever is first). Your Medicare Part B coverage will begin:

The month you enroll in Medicare Part B if you enroll while you are covered under the group health plan based on current or active employment, or during the first full month after the coverage or employment ends (whichever comes first). You can also delay the start date for Medicare Part B coverage until the first day of any of the following three months; or
The month after the month you enroll if you enroll during the remaining 7 months of the Special Enrollment Period.
Note: If you are still working and plan to keep your employer's group health plan coverage, you should talk to your benefits administrator or your State Health Insurance Assistance Program to help you decide the best time to enroll in Medicare Part B. When you sign up for Medicare Part B, you automatically begin your Medigap (Medicare Supplemental Insurance) open enrollment period. Once your Medigap open enrollment period begins, it can't be changed or restarted. For more details about Medigap policies, please visit Medigap Policy Basics.

COBRA (Consolidated Omnibus Budget Reconciliation Act) is a law that lets some people keep their employer group health plan coverage when their employment ends. If you are eligible for COBRA because you have stopped working or because you qualify for some other reason, you should consider enrolling in Part B even if you choose COBRA coverage because you won't get another Special Enrollment Period. If you are age 65 or over and you choose COBRA coverage, you must sign up for Part B during the first 8 months that you have COBRA coverage. If you don't sign up during the 8 month period, you must wait until the next General Enrollment Period. You should talk with your State Health Insurance Assistance Program to help you decide whether enrolling in COBRA or choosing a Medigap policy is the best choice for you.

General Enrollment Period
If you don't enroll in Medicare Part B during your Special Enrollment Period, you can sign up during the General Enrollment Period. This period runs from January 1st through March 31st of each year. During this time, you can sign up for Medicare Part B by calling Social Security at 1-800-772-1213 or by visiting or calling your local Social Security office. Your Medicare Part B coverage will start on July 1st of the year you sign up. The cost of Medicare Part B may go up 10% for each 12-month period that you could have had Medicare Part B but didn't take it. You will have to pay this extra amount as long as you have Medicare Part B. Go to the Part B Late Enrollment Penalty Calculator to calculate your Medicare Part B late-enrollment penalty if you delay enrollment.


Recap of Your Answers


Date of Birth: 12/25/1940
Marital Status: Married
Tax Filing Status: Joint
Type of Medicare Coverage: Not Enrolled
Do you have Medicaid: No
Are you living outside of the U.S.: No
Household Income Range: $320,001 - $428,000
Are you receiving health benefits from employer: Yes
Have you worked 10 years or more in Medicare covered employment: No
Spouse's Date of Birth: 4/4/1968


Page Last Updated: September 17, 2008

*Dragonfly Eyes*

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