I’ve been laid-off … What are my Medicare options? | Life


Hello Toni:

My husband, David, has been laid-off due to what is going on to the economy and rising gas prices. He’s 68 and has never enrolled in Medicare. I’m turning 65 this September and we each are covered under his employer’s health plan, which is ending.

Now we have been told that he’ll get a penalty because he’s over 65 and never enrolled in Part B. I actually hope NOT! I can have to enroll in COBRA until I turn 65 in September. Please explain what our Medicare enrollment options are since we’re different ages and have different enrollment situations. 




Great Query, Paula:

There are two different rules regarding enrolling in Medicare Parts A and B in your household, and I’ll keep enroll in Medicare for each you and David SIMPLE!

1. David needs to use for a SEP (Special Enrollment Period) by downloading the shape CMS-L564 (Request for Employment Information) from socialsecurity.gov or email info@tonisays.com and we’ll email you a form.

Have David’s Human Resources department log out on the shape and fasten it to CMS- 40B (application for Medicare Part B). File each forms along with your local Social Security office when applying for Medicare Part B. Advise the Social Security representative that David is losing his company advantages and wishes his Part B to start the day after they end.         

2. Paula, your option to enroll in Medicare is easy and quite different from David’s because you’re turning 65 in September. Go to www.socialsecurity.gov/advantages/medicare not less than 90 days prior to turning 65 and apply online for a Sept. 1 effective date.

That is an ALERT to the general public because local Social Security offices, which were closed because of the pandemic, recently reopened. The general public should call their local Social Security office directly for help filing forms to use for Medicare Part B. Most Social Security direct phone numbers may be situated by searching online for that specific office’s 800-number. Generally, the wait while holding is lower than calling the fundamental Social Security 800-number.

 Below is a checklist for those enrolling in Medicare:

1. Original Medicare Part A: Covers in-patient hospital stay, expert nursing/rehab stay, blood transfusions, home health and hospice.                                                         

2. Original Medicare Part B: Covers primary care or specialist, whether within the office or performing surgery, outpatient surgery, durable medical equipment, X-rays, CAT scans, MRIs, chemotherapy, etc.

3. Original Medicare/Medicare Advantage: Check with your health care facilities and medical professionals which Medicare plans they accept similar to Original/Traditional Medicare with a Medicare Complement or a Medicare Part C (Medicare Advantage plan similar to HMO, PPO or PFFS). Research the Medicare Advantage plan’s hospital/provider online directory to ensure your physicians and hospitals are in that specific plan’s network. Call to confirm they’re currently in network.

4. Medicare Prescription Drug plans: Research drug plans every yr to see in case your standalone Prescription Drug or Medicare Advantage Plan with prescription’s formulary covers all of your brand name or generic pharmaceuticals.

5. Long-Term Care (LTC): Consider an LTC option similar to standalone LTC policies, hybrid annuities or life insurance with LTC riders, Veterans Affairs aid and attendant advantages or applying for financial help out of your specific state’s Medicaid for LTC.

6. At all times make copies of each document given to the Social Security office or received from the Social Security office.

— Toni King is an creator and columnist on Medicare and medical insurance issues. She spent greater than 27 years as a top sales leader within the fields. For answers to Medicare questions, email: info@tonisays.com or call 832-519-8664.


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