Simply Medicare: Q&A
By Judith F. Bendersky
February 24, 2013
A1: It is a myth that everyone has to sign up for Medicare when they turn 65, although many people do. Everyone's situation is unique and each person needs to understand what their requirements are based on their unique circumstances. Factors that impact whether a person should enroll in Medicare at 65 include whether the person is actively working and has an Employer Group Health Plan, whether their spousal's working and health insurance coverage, whether they are collecting a Social Security Retirement Benefit, whether they have access to the V.A. or IHS health care systems and other considerations. The truth is that no one from the federal government will come to your front door or otherwise tell you that have to sign up for Medicare. But there certainly could be expensive consequences for not doing so. There are penalties for signing up months or years after one was eligible but chose not to enroll.
Your employer or former employer may send you a letter telling you that in order to utilize retiree health benefits you must enroll in Medicare, but that may lead to even more questions if you are re-employed or have coverage through a spouse or are perfectly happy with the insurance that you have. Likewise, things get confusing for people who receive Medicaid, because they may think that once they turn 65 they lose Medicaid and have to go on Medicare only. Medicare is health insurance and like all insurances there is a booklet or document that describes exactly what the benefits are that the policy holder gets. Anyone with health insurance should take time to review their summary of benefits booklet and get a grasp of how that insurance interacts with Medicare when the person turns 65. We offer free “Getting Ready for Medicare” seminars at the Loussac Library every quarter and are also happy to answer questions over the phone or by appointment.
Q2: I’ve been on Medicare for three years and I never signed up for Prescription Drug Coverage. I’m going to the doctor next week and I’m pretty sure she’s going to prescribe a blood pressure medication for me. I’ve been paying out of pocket for some skin cream and it’s killing me at $30 for a small tube. What are my options?
A2: With the cost of prescriptions these days and the unknown of what medications you may have to take in the future, I encourage everyone to consider signing up for MEDICARE Prescription Drug coverage when they first enroll in Medicare – whether they’re 65 older when they enroll. To be clear, some people who have retiree health coverage such as Federal Blue Cross/Blue Shield, TRICARE, Alaska Care, etc. may already have a source of prescription coverage and would not likely want to enroll in yet another prescription plan. But everyone on Medicare that has either Part A (hospital) or Part B (outpatient medical) or both is eligible to sign up for prescription PART D coverage during certain enrollment periods. So your options are: wait until the next Annual Enrollment Period of October 15 to December 7 OR see if you might be eligible for the federal Extra Help Program paying for Prescription Drugs. This Extra Help program is available to people with a very limited income ($1,746/month for singles and $2,365 for married people) with limited savings and assets. People who qualify for this program have a continuous open enrollment period and can squeak into a Part D plan anytime. Give us a call to help you navigate this very confusing aspect of MEDICARE. We’ll ask you a number of questions about your income and assets to see if you might qualify for the Extra Help Program and we can schedule you for an appointment in October if you know you want to enroll next time you can!
About: Judith F. Bendersky has a Masters in Public Health from Loma Linda University. She is a Certified Health Education Specialist and Gerontologist working for Seniors and Disabilities Services in the Alaska Department of Health and Social Services.
Email: Judity F. Bendersky