Tag Archives: medicare part a and b

Your Questions About Medicare Part A

William asks…


My grandma has medicare part a and b would she be covered for home health care nursing?

3 to 4 times per week. Assistance with getting out of bed and diabeties management. She is bed bound mostly.

Medicare Insurance AZ staff answers:

Before Medicare made their nation wide cost saving cuts back in the 1990′s, it was common for the elderly to be covered for those services sometimes indefinitely. Now it is much different. If someone on medicare comes out of the hospital they would be covered but not indefinitely. If the Dr. Recommends skilled nursing for diabetes management that may be a real possibility. Check with her Doctor. Personal care, bathing, assistance getting out of bed and meals, and laundry, falls under private duty care and is paid for by the individual through the home health agency. Some states offer help under their programs of medicaid and state assistance programs. Check with your state programs to see if your grandmother qualifies under income guidelines.

Mark asks…

How can a company pay an individual’s Medicare Part B premium?

Hi. I have a very specific and obscure question. I am interested in how a company, a health plan for instance, could go about paying an individual’s Medicare Part B premium. Does anyone know where the rules governing this are housed?

Medicare Insurance AZ staff answers:

This is a good question! A local organization was considering implementing a policy whereby it would pay the insurance premiums for Medicare-eligible employees about a year ago and did some checking through attorneys. The rules discovered were that a private employer that offers a health care plan to employees must offer the same plan to all employees– even those eligible for Medicare. There was no way found for the employer to pay the Medicare premiums for the employees eligible to enroll in Medicare.

I understood that the reason this could not be done was due to a state rule–but actually, the barrier is probably a federal rule. Allowing this practice would increase costs to Medicare and probably reduce the costs of employer health insurance plans. Congress probably is concerned enough about soaring Medicare costs. Of course, there is probably a plethora of other political reasons…

Some feel this rule engenders employers’ discrimination against older workers. The fact is, more health problems develop the older we get and the American workforce is aging quickly. Paying for health insurance is a big problem for most employers–and especially small business. Many choose not to provide a health insurance plan at all due to these plans’ costs–which is a major reason why there are so many uninsured Americans today.

Suggestion: check with someone in your State’s Insurance Commissioner’s office. There is someone there who might be very familiar with this question–or would know someone else who would have the information you seek. Or check with an attorney familiar with health insurance and employment law in your state.

Good luck and best wishes!

Ken asks…

Question on Medicare Part B premiums for low income?

My mother just passed away and in her papers I found that she has been paying medicare Part B premiums for years. I think it was something like $92.40. I can’t remember the exact amount.

My question though, is that her monthly income was only $700 a month. Should she have been paying these premiums? She had no dependents in the home with her. Seems like she should have been exempt since she is considered low income.

If she should not have paid these monthly premiums, can her estate been reimbursed for all the years she paid?

Medicare Insurance AZ staff answers:

If you want Medicare part B coverage – which covers gaps in Medicare part A – you have to pay for it. The premium is $93.50 per month if your income is under $80,000 a year.

The major benefit under Part B is payment for physicians’ services. In addition, home health care, durable medical equipment, outpatient physical therapy, x-ray and diagnostic tests are also covered.


Donna asks…

I am looking for a Medicare part D plan that offers dental and vision. Can anyone help me?

I have Medicare A and B, but am looking for additional coverage for my prescriptions, and ideally one with Dental and Vision….More so the dental, but vision would be great, too…..

Medicare Insurance AZ staff answers:

Dental and Vision aren’t covered – unless you have a medical eye condition. Regular vision issues, exams, glasses, contacts, etc, aren’t covered at all.

Maria asks…

how do I know if I should have medicare part D?

I currently am enrolled in parts A & B, but not D. I am currently spending approx $50.00 mo. for prescriptions, would I benefit from haveing part D? I’m not even sure how part D works, does it pay all of the prescriptions, or a portion and then I pay the rest? I don’t know how much part D costs either. I tried to log onto medicare.gov, but could not figure out how to navigate through all the stuff to get the answers I need. Any help is greatly appreciated, thanks.

Medicare Insurance AZ staff answers:

It depends on if you are on a Medicare Advantage plan (like an HMO, PPO etc). If you are on plan or program they will cover your medications. If you are on original Medicare (you only use the white card with the red white and blue stripes at the top) then you have no prescription coverage and should look to enroll in one. You only have until friday to enroll otherwise you will have to wait until next year’s open enrollment.

Each part D plan is a different cost. Some cost as low as $14 per month – some cost over $100 per month. If you are having trouble finding a list of plans you can always ask your pharmacy if they know of good plans or just call 1 800 Medicare for help.

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Your Questions About Medicare Part A And B

Joseph asks…

Help with medicare part B?

I want to cancel my medicare part B . My questions are When can I cancel part B? and will I be penalized for it? My husband has very good dental and medical insurance on me but because there are less than 100 employees at his work, then Medicare has to pay first. It’s always a huge fight with hospitals and doctors offices because Medicare says my husbands insurance needs to pay first and of course my husband’s insurance says Medicare must pay first. While they are arguing, we are the ones that are responsible for paying the bills. I went to the Medicare site and it’s just as confusing . I am on Social Security for disability. I am 47 years old. I’ve heard that if you cancel part B you will be penalized and you can only cancel part B at a certain time of year. I could use the extra money they take out for part B to pay my own medical bills and it will be easier to have one insurance (my husbands) so my bills will get paid fast and without arguments and long holds on the medicare line.

Medicare Insurance AZ staff answers:

First, there is no need to cancel your part b.

Contact the Coordination of Benefits (COB) Contractor’s Customer Service Department toll-free at 1-800-999-1118 or TTY/TDD: 1-800-318-8782 for the hearing and speech impaired with any questions you have. Representatives are available to assist you Monday through Friday, from 8:00 a.m. To 8:00 p.m., Eastern Time, except holidays.

If you did not (or have not) completed this questionaire, please call and have one sent to you. It is not downloadable on-line. It should solve your COB problems. There is a sample questionaire on the link below if you want to take a look at it.

William asks…

Medicare part B, assisted living & hospice: HELP? (In Wisconsin)?

My Uncle was in rehab in a facility for 100 days, covered by Medicare part B. He had to move, and we chose an assisted living, and with his level of care, it is costing him $5400/ month. BUT: he was admitted there on a HOSPICE classification. They paid for some meds, a hospital bed & linens, and for a nurse 30 minutes a week and an aide twice a week for a shower. He received wound care for a pressure ulcer. Some of his meds were paid for by medicare, and the concentrator was $740/month. I was told that medicare was paying over $10,000 a month, and I saw one list of charges that said it was paying $249 a day to someone, it didn’t specify if it was the assisted living facility.

His status was upgraded and he was no longer on hospice for about 2 months. Now his doctor found liver cancer, so he will be back in the hospice classification. Should he have to be using all of his own money (which is almost gone) to pay his $5400 a month for room, board, and medical? He also owns a house, which is for sale, AND a car, which will be sold. Main point is, how is it he should pay $5400 a month while the nursing home rakes in an additional $6k to $10k a month, when hospice is only there 3X a week? Is this right? His private pay is $2850 for the room, and the rest for medical. A regular skilled nursing home would cost around $1000 more a month, and he would be self pay there, also. EXCEPT: Why isn’t hospice covering his room and board?

I think this time around, they will pay for more of his meds, but it’s MY feeling they should also be paying for his room and board. He has a private room, which I feel they should pay a large portion of. This time around, I think he will get a little more hospice care, also, but how can the nursing home keep charging him the full $5400 while Medicare pays hospice so much money. I think his hospice costs will go up this time, he will have more care and meds from them.

I just think the nursing home is wrong, and his rent AND medical should have been less on hospice.

This a brand new assisted living. One time the head nurse told me: “We can benefit him, and he can benefit us.” Yesterday, she was also playing POA with him–she doesn’t even want him to go in for Xrays & CAT. I think he would like to know if his cancer is just one spot on the liver (primary) or if it has spread. Surgery may or may not be an option. He might not make it, and if he DID make it, he would probably be sick with chemo afterwards. But, faced with those odds, if he DID make it through surgery and chemo, would he suffer less than doing NOTHING and suffering all the pain and illness at the end. Which is worse–the horrific pain at the end, or illness from chemo?

He’s 82, has been diabetic for over 20 years, and has chronic CHF and Renal disease. His kidneys are pretty bad.

I just want to spare him as much pain and suffering as possible, and I would like him to do the scans and talk to the Dr. Once he goes on hospice, they don’t let him even SEE his doctor.

I think the head nurse would keep him around for years if she could get that medicare payback for the facility. She also was his former medicare insurance agent, and is still in the insurance business. This is railroad medicare.

Medicare Insurance AZ staff answers:

You are confused about what is being covered by what. Medicare A covers rehab days not Medicare B. Medicare doesnt cover any skilled or long term nursing stays in a nursing home. Assisted living is all private pay and Medicare doesnt pay for it. Hospice is covered under Medicare A and doesnt cover housing. It covers nursing visits, aide visits, meds and DME. Under hospice you cant seek treatment to cure the disease that qualified you for hospice(such as chemo or radiation if you have cancer) but you can be treated for other conditions like pneumonia, heart disease etc. Hospice is palliative care to keep the person from suffering in during the later part of their life and disease process. You qualify for hospice if you are determined to have 6 months or less to live. You can improve and go off hospice and then have a set back an again go back on hospice. You need to talk with a good social worker or geriatric care manager. The hospice company should have assigned a social worker to him who can answer all these questions. If you want an unbiased thrid party check out www.caremanager.org to find a professional certified geriatric care manager.

Ken asks…

Medicare Part B & Private Health Insurance?

My mom is 67 and still works. She has a group health policy through her job. She declined Part B since she is an active employee with group coverage. She works for a small employer, with under 20 employees, so Medicare is primary. The problem is that her group health plan is denying ALL of her claims incurred outside of the hospital, including doctor’s visits, telling her that she should have enrolled for Part B.

She was advised by SSA to not take Part B since she was still working and has major medical insurance for charges outside of the hospital. But, now, her private insurance is not covering her claims. She feels deceived by her insurance company.

I have always heard that it was best to decline Part B when you are actively working and have group health insurance. Can someone help?

Medicare Insurance AZ staff answers:

If the group policy is under 20 employees that does not allow you to postpone Part B because Medicare will be primary and if Medicare doesn’t pay, neither will the group. This is a federal Medicare guideline and SSA should have known. Proving that the government employee at SSA told her that she didn’t need it will be difficult if not impossible. (does anyone here see a problem that will plague univeral healthcare?)

The bad news: since she has declined Part B there are time restrictions and penalties for when she does get on the plan. She will have to apply between Jan 1 and March 31 of next year and Part B will become effective July 1. She will have a 10% penalty for each 12 month period she was without Part B and she will have to pay that penalty for as long as she is on Medicare.

Wish I had better news for you.

Daniel asks…

Medicare part B elucidation from social security check?

Alright been trying to help someone get answers on the phone for this but haven’t had any luck and neither have they.

Basically a friend of mine just got their medicare card a few months of the time it will be active , basically got it four months ahead of time.

So the question they had is when does the deduction for the part b from their social security check start before the card is active or once then month the card becomes active.

They also got pre-approved for extra help and are going to be getting duel-eligibility from medicaid and medicare they are very low income and wonder if that matters.

Sorry if there any typos in this just trying to help someone get answers and figure I would give a shot here. Siince state and federal government lines are not always helpful.

Medicare Insurance AZ staff answers:

The Part B deduction will start the month the card is active. But if your friend has Medicaid, her state may be paying her Part B and if that is the case she will not be paying any monthly premium for Part B. This depends on how much her Share of Cost, if any, is, and only her Medicaid case worker knows that. If her Share of cost is below a certain amount, the state will pay her Medicare Part B. Extra help refers to Part D covered medications, so her co-payment is less with Extra Help. But Medicaid may cover the entire price also.

George asks…

Questions with assistance with medicare part B premiums through medicaid?

Ok, so i recently signed up for additional help with my part b premium with medicare and i received a letter in the mail saying that im ELLIGABLE. does this mean that i should be approved based on my income 1,260/mo. also, what do they mean by resources. Thats what the lady told me that she needed to determine if im approved. I am not married. Also, will i recieve back money and be refunded for past medicare premiums that came out of my social security check? Thanks :)

Medicare Insurance AZ staff answers:

You are eligible based on income but that doesn’t mean you will be approved. Resources would be cash, savings, or anything that can readily be converted to cash such as stocks, bonds, IRA or 401K accounts. Some states will also count the value of your real property. There are limits to these resources and if you have too much you’ll be expected to use those resources prior to getting the extra help. When you are approved you will not receive any past premiums.

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Your Questions About Medicare Part A And B

James asks…

Would you enroll in Medicare part B now at $100 a month?

knowing they are going to cut benefits, or wait to see what the Obama bunch does, and go without, or what? Its a damn mess.

Medicare Insurance AZ staff answers:

Even if this costly free health bill passes – it does not take effect immediately. I hear it will take effect in 2012,

My husband and I both have Medicare part A and B and a supplement insurance.

My husband had a heart attack last summer and had a stint out in – in the last 4 years I have been in ICU once and hospitalized 3 times for 6 days each time.

Medicare and the supplemental has paid for nearly everything.

We pay over $200.00 for our prescription’s each month – with out our insurance it would be close to $3,000.

Call Medicare and you supplemental if you have one – they will help you sort it out.

Yes – it is a damn mess and they are wanting to make it worse.

Every ones situation is different – I would like it if the Government stayed out and leave our insurance like it is – we are satisfied. We do have to watch our spending and that is – as it should be.

They need to help those who need the help.

Good question.
DeeJay.

Chris asks…

I am trying to understand Medicare Part B. Neuro-Muscular and or electrical stimulation. ?

Does the PT have to be present during the actual treatment? Or, can the or a DR. do the evaluation and then a tech do the treatment? Does the PT or DR have to be present during the treatment?
Can it be only a tech doing the treatment?

Medicare Insurance AZ staff answers:

Electrical stimulation code G0283 is an untimed code and presence of the clinician is not necessary. If it’s being billed under 97032 then it is a timed code and the clinician should be present and there should be something other than just the e-stim going on such as cycling with e-stim to the quads.

Ruth asks…

I’m a young mom on social security and i would like to kow if i should choose the medicare part b?

ok i have no idea how this works but fromthe sounds of it i pay a premium and then through the nose for any medications. well if i don’t really have any to take maybe some anti depressions or something like that but not what the older people this plan is made for ? please help i don’t want to mess this up!

Medicare Insurance AZ staff answers:

Yes, you should pick up Part B. After you do so, you can then also choose a ‘gap’ plan for additional coverage and a Part D plan which pays for medication. You can talk this over with someone at social security as to what gap plan and Part D plan to chose. There is only one part B to chose (that makes things a little simpler for you). If you are on Soc. Sec. And disabled, your premiums, I believe, come out out of your income benefit. Go to Medicare.gov for more information. They have tried to make things simple for medicare recipients to understand there. You can also see exactly what Parts A and B cover at that site. Good luck, sweetie!

Charles asks…

Medicare Part B/Social Security Confusion?

My mom had initially turned down Part B of Medicare in April 2010 because she can’t afford to have $110 taken out of her Social Security benefits check every month. Her Part A started in May 2010, the month she turned 65. The first week of June, she found out she had a large abdominal mass during a routine doctor’s visit at a reduced-cost clinic; at the ER, the CT scans revealed a tumor so she decided to sign up for Part B. Medicare directed us to call Social Security. The SS rep told us that because we called in June, Part B would normally start 2 months later in August. However, she said she would make an exception for us and let Part B start in July. She even filled out the application for us and wrote in the “Remarks” box that Part B was to begin July 1, 2010 with the initials “IEP.” The only thing my mom had to do was sign the form.

The next week, we called Social Security and spoke to another rep who confirmed that they received the application and that July 1 was the first day of my mother’s Part B coverage so my mother made an appointment to see a new doctor – one who was affiliated with the hospital – about her tumor on July 1. The receptionist said without proof of Part B coverage, the bill would most likely be in the thousands because of lab tests, etc. so we called Medicare for proof of Part B coverage. The rep confirmed again that Part B would begin on July 1 and put in the request for a letter to be sent out.

Today, we got the letter and it states that Part B will actually start on August 1. I called Social Security and they said they had no records of whom I spoke with that made the exception for me even though I have the application filled out in the rep’s handwriting. They also apparently do not have a way of making notes in the system on individual cases.

What should we do? How can we prove whom we spoke with? My mother needs medical attention now, but we don’t have money.
I only know the first name of the person I spoke with. When I called Social Security today, a man named Todd said there was no way of tracking who that was. He said SS does not even track who calls when so there is no record of me ever calling.

Medicare Insurance AZ staff answers:

Your mother signed for responsibility in the event it was not covered by medicare, right? (Read the forms she signed).

If so, you are in a very serious spot, if you don’t know the name and/or the location of the person you spoke to. Your best bet is to take the paperwork that you think proves their approval to the medicare office closest to you and try to speak to an advocate. If you can convince someone that your story is accurate AND it isn’t a violation of medicare law (I actually think it is), you might get the date revised.

Otherwise, you need to run the numbers and speak to a lawyer. Depending on the seriousness of the diagnosis and the treatment options, you can probably wait for the Aug 1 start date to continue treatment and drag the unpaid bills along through collections forever. It they threaten you too much, you can pursue bankruptcy.

Whatever you do, you should not sign ANYTHING for your mother. As long as it is just her responsibility and her assets are limited, their options are also limited.

Paul asks…

I need help with Medicare Part B billing.?

I am a pharmacy technician in Sand Springs, OK, and we have recently started billing DME, diabetic, and asthmatic supplies to Medicare Part B. We didn’t receive a whole lot of instruction and any help anyone may have would be greatly appreciated.

Medicare Insurance AZ staff answers:

I did a quick google search and found this site

http://www.hcmarketplace.com/prod-5372.html

Can’t you also contact the appropriate govt office and ask them?

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Your Questions About Medicare Part A Enrollment

Charles asks…

I am currently enrolled in medicare part A and B, I am in open enrollment I think, How do I enroll in part C?

Medicare Insurance AZ staff answers:

I would talk to your physician’s insurance personnel (the person who can answer questions about different insurances) so you can get an honest answer. They can assist you on what you need to do.

James asks…

Is it possible to collect SOCIAL SECURITY benefits and NOT be enrolled in MEDICARE at all?

I obviously wish to keep recieving benifits from Social Security, but the Medicare has really messed up my enrollment into Tricare Prime.

I have Medicare part “A“, but refused part “B”. Now that I want to enroll in Tricare Prime, I have to pay a surcharge ad wait unti next year before I can enroll.

It was so much easier before I collected Social Security because I was enrolled in Prime before and simply paid the quarterly premiums. Then, when I started collecting Social Security, I got tossed from Tricare Prime because I didn’t know any better at the time and disenrolled in part “B” Medicare.

So, if I could, I would rather just completely ditch Medicare if I can just so I can requalify for Tricare Prime and not pay so much out per month.

Can it be done?

Thanks.
Thanks for the answers so far! I am well under 65, and I had TRICARE PRIME first before I got SS, then when I got SS, they automaticially enrolled me in PART B Medicare, then I dis-enrolled to save money because I figured I didn’t need that as I can go to the VA Hospital as well.

Medicare Insurance AZ staff answers:

Social Security, Medicare and Tricare are all government agencies. For those that don’t know Tricare is the military health plan.

This is a confusing situation.

You said you refused part B but then said you were disenrolled from part B. Did you refuse it within the time limits? It sounds like you didn’t. If you refused it in time you couldn’t have been enrolled in it to become disenrolled. You become automatically enrolled in part B. Social Security and part B have no correlation. It doesn’t matter what health plan you have to get SS and getting SS will not affect any health plan.

Tricare acts as a supplement to Medicare. You are still on Medicare but you get your services from Tricare.

You will need to contact Tricare to find out what you need to do to get back on. You should also contact Medicare. There are rules about when you can enroll in any plan so that is why you need to wait.

Mark asks…

Medicare is screwing my Grandma?

Anybody eligible for Medicare Part A and B, has to enroll in a new Part D. They sent my Grandma a letter in 2006 saying it was manditory to enroll, little did she know that if she didn’t there would be a penalty of a percentage each month for the REST of her life.

“There will be a penalty for those who do not enroll in Medicare Part D by May 15,
2006. Enrollment in Medicare Part D begins November 15, 2005. You can begin to
use the program on 1/1/06. The penalty for late enrollees will be a 1% per month
cumulative penalty. For example, if you choose to enroll 3 years after the May 15, 2006 date,
your penalty will be 36% of the Part D premium charged by the PBM you select – 36 months x
1%. What this means to late enrollees with a $35 a month premium is an additional $12.60 per
month in penalty charges. Or a total monthly cost of $47.60. The penalty will be applied to your
monthly fees for the rest of your life. Late enrollment into the Medicare Part D program can be
very costly to late enrollees.”

She was a year late and pays 3.50/month because she enrolled late, sh didn’t even see the letter they said they mailed to her, and now because they didnt have their system up to date they sent her an 80 dollar bill for the 3 years it’s been.

My question is how do i go about fighting this unfair practice against senior citizens. I’m sure there are seniors that would be devistated by an 80 dollar bill and monthly late fee forever. (essentially they are saying here we sent you this mail, oh you didn’t get it, well you owe monthly fee for the rest of your life).

longtermcare.state.wi.us/home/Press%20release%207.pdf

Medicare Insurance AZ staff answers:

You might be more effective as part of a group with the same goal.

AARP is involved with these kinds of issues and is large enough to have some influence. This is a link to contact AARP regarding consumer issues. Social security is at top of their list.

Http://www.aarp.org/about_aarp/contact/a2003-01-28-contact-consumerform.html

Your Grandma is lucky to have you, keep up the good work!

Mandy asks…

Wait for Part B to avoid SS deduction?

I’m about to turn 65. I have excellent medical coverage from my wife’s employer. I don’t wish to pay for Part B, so I assume I must opt out of Part A as well, in order to avoid paying the deduction from my SS check. When she is near retiring can I then apply for Medicare Parts A and B during open enrollment and only then start having the deduction for Medicare.

Medicare Insurance AZ staff answers:

You can’t opt out of Part A. It doesn’t cost anyway. Depending on your insurance at your wife’s company they may require you to pay for Part B. My company does. If you opt out of Part B, they deduct what Part B would have paid. So check first. You can opt out for Part D. But make sure to get a “qualifying letter” from the employer plan for Part D so when you do apply for it you don’t get the late enrollment penalties.

Laura asks…

Medicare Part D- do you think it’s messed up?

I work for a “health care” company if that’s what you want to call it. The problem with it a horrible combination of government inflexibility and corporate greed.
Problem 1: Enrollment/Disenrollment. You have to enroll from November 15th to December 31st. If you don’t like your plan, you can disenroll from January 1st to February 15th. That means if your plan doesn’t do what you need it to do, which is very often, you have to wait 10 months to get a better plan.
Which brings me to point 2
POINT 2. your health care company is not required to tell you when you are automatically placed in a different plan during the enrollment period. That means if you are placed in a more expensive plan (a plan designed to be profitable for the company), you won’t know about it until you get a letter in the mail AFTER the enrollment period ends.
POINT 3: even if you are an informed consumer, even if you constantly call your health care company to check up on your plan so you can get the best one possible, there’s no gaurentee that you’ll even get a good deal. For example, you may be able to get an estimate from a salesperson or a customer service rep that your drug will only cost you a $10 copay on plan X and $40 copay on plan Y, however even though most up to date estimates are subject to change radically.

Also, the salesmen are deceptive and the customer service are poorly trained at my company, but that should go without saying.
Do any of you have Medicare Part D horror stories?

Medicare Insurance AZ staff answers:

From a patient’s perspective using Part D, I have no complaints except every year fewer drugs are on the formulary. Being low income I have Extra Help so I dont pay a lot for certain drugs. However, many things I end up paying full price for if doctor prescribes and there is no generic or it is not on formulary. My Part D is included in my Advantage plan. I am quite satisfied.

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Your Questions About Medicare Part A And B

Susan asks…

Should I be paying for Part B Medicare if I am working?

I am paying for part B Medicare for a long time. I am 74 now and employed full-time and someone told me that you can get a refund check every August if you pay for Medicare while you are working. i do have full insurance from my job?

Medicare Insurance AZ staff answers:

In California you don’t receive a refund check if you pay Medicare while working because you actually have the option of enrolling or not. People who delay enrollment in Medicare Part B often do so to save money on their monthly premiums. However, it depends on your plan. If your employer plan acts as your primary insurer and has high cost sharing, having Medicare as your secondary insurer may help pay some of your costs.

However, if your employer plan includes comprehensive medical with low cost sharing, you may decide it’s not worth paying the monthly Medicare Part B premium ($96.40 in 2009).

Generally, if a Medicare beneficiary is covered by employer-provided health insurance as an active worker or spouse of an active worker, then that plan pays first and Medicare pays second. However, the rules may be different if your employer has fewer than 20 employees in which case Medicare is automatically the primary payer of claims and your employer-sponsored health plan is secondary.

Sandy asks…

Does anyone know where I can download a Medicare Part B enrollment form?

I contacted my SS office and they told me I can find it online… but I can’t.

I’m trying to help my grandmother out because she CANT go down there herself. I need the actual form. Any help?

Medicare Insurance AZ staff answers:

Here is the form:

http://www.cms.hhs.gov/cmsforms/downloads/CMS4040-English.pdf

Jenny asks…

Should I keep my Medicare Coverage part B?

I am a disabled veteran. I was disabled during a heart bypass operation in a VA hospital. I am classified as service connected disability as a result of this. Therefore the VA provides me with a primary doctor and outpatient care with no charge. As I understand it medicare B pays for these 2 things but I am covered by the VA instead. I pay $98 a month for the medicare part B.
Am I wasting $2000 a year or can someone give me a valid reason to keep the part B coverage. I am 60 yrs old and have had this coverage for 12 yrs and I think the only time I ever used it was for some chiropractic work.
All my other medical needs are covered by the VA also.
TIA,
Akz238
I meant $1200,not $2000,sorry.

Medicare Insurance AZ staff answers:

The VA will only cover you at VA facilities and under their terms. A lot of people keep their Medicare, paying that part B, and add on a supplement or Medicare Advantage plan (usually without the Prescription benefit) so they can have additional coverage beyond their VA benefits. This allows them to see non VA doctors, or go to other hospitals/providers than the VA.

Some do it because it is more convenient to go outside of the VA for routine or basic services closer to home. Some do it for better coverage while traveling. Some do it because they aren’t satisified with their coverage from the VA or their local facility. If any of these reasons seem like something important to you, then keep the part B, and maybe look at a $0 premium Medicare Advantage plan like a PFFS w/out Rx. You may have to wait until November 15th to add that if you are outside of your initial enrollment period.

Another very important reason to keep the part B is because if you change your mind and want to have additional coverage beyond the VA, you wont be able to add it right away. You may need to wait a few months to add part B, and then possibly longer for a MA or supplement plan.

The ONLY time people really should do without part B is when they are enrolled in a qualifying large group plan from an employer. This allows them to postpone part B enrollment until they leave that plan, and is without penalty.

Lizzie asks…

medicare part b gap insurance ny state?

I need a medicare part B gap insurance. I live in ny state.
Can anyone recommend a good and cheap gap insurance ?

Medicare Insurance AZ staff answers:

Medicare questions can be confusing! Getting the best supplemental coverage and/or a a Medicare Part D plan, for example, depends on several factors, what kind of plan you are willing to accept, and whether the plan you want will pay for the specific medical concerns you have.

Unlike Medicare Part D plans that cover prescription drugs, supplemental plans and options are standardized, however interpreting these benefits can still be very confusing!

If you want to talk to “real people” who will listen carefully to your questions and who aren’t “selling anything” I would highly recommend that you call your local Area Agency on Aging. Folks at the Area Agency on Aging can help you sort Medicare supplemental insurance options and choices. Area Agencies on Aging are one of the best kept secrets around for older Americans and their families who are seeking information on Medicare, Medicare supplemental policies and other kinds of consumer questions. There is one where you live, since this is a national network. The staff there will visit with you and guide you to information you need to answer your question. Since they talk with seniors every day–and answer lots of questions about Medicare–they will know the “scoop” on the supplemental policies and plans available where you live. They will be able to help you compare the pros and the cons of the plans you have identified as options and suggest other information to check out before you “sign on the dotted line.”

You can call toll-free 1-800-677-1116 to find how to contact the Area Agency serving you. When you call your local Area Agency on Aging, ask for the staff who provide “Information and Assistance.”

If you do contact your local Area Agency on Aging and like the help that they give you, let your local county officials and your folks in Congress know. Area Agencies on Aging don’t have big budgets–their funding comes from the Older Americans Act–and funding for most parts of this Act has not increased significantly in about 25 years! Your voluntary financial contribution of any amount–which is absolutely not required to get the help you need to answer this question–would certainly be appreciated and would be used to help your older friends and neighbors.

Hope this helps! Best wishes and good luck

Donald asks…

Does anyone really know what type of extra medical plan beyond Part B and drug plan to take with Medicare?

I am a disabled male in my early 50′s, and will soon be getting Medicare Part A & B. What are the realities of what is good to choose for a plan? Which type? Medigap? Advantage? Etc? Also, what about a drug plan? Should I get one that is part of a Medical Plan or a stand-alone? Does it matter? Please help me! I’m drowning in all of the details!

Medicare Insurance AZ staff answers:

I hear you…they picked one for me. Its Humana, no co-pays, no nothing, you just go see your doc and this part takes care of the drug part, like i said no co-pays a good place to start when trying to decide this is does the plane cover the medications you need hope this helps

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