1 / 15

Medicare Unraveled: What your Employees Need to Know

Medicare Unraveled: What your Employees Need to Know. [presentation location] [presentation date]. Topics. What is Medicare? When should an employee enroll? How does other coverage work with Medicare? Who can help?. What is Medicare?.

jerzy
Télécharger la présentation

Medicare Unraveled: What your Employees Need to Know

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Medicare Unraveled:What your Employees Need to Know [presentation location] [presentation date] [Insert Regional Office and Phone Number Here]

  2. Topics • What is Medicare? • When should an employee enroll? • How does other coverage work with Medicare? • Who can help? [Insert Regional Office and Phone Number Here]

  3. What is Medicare? • Established in 1965, a federal health insurance program • Enroll through SSA • Managed by CMS • Who can get Medicare? • People 65 years of age and older • People under 65 with certain disabilities • People with ESRD and other specific diseases [Insert Regional Office and Phone Number Here]

  4. Components of Medicare • Part A • Inpatient hospital coverage • Part B • Outpatient coverage (including doctors’ services, labs, tests, etc.) • Part C (Medicare Advantage) • Combines all benefits into a single plan • Similar to an HMO or PPO • Part D • Prescription drug coverage [Insert Regional Office and Phone Number Here]

  5. For Comprehensive Coverage • Medicare has premiums, deductibles, and co-payments • To offset these costs, beneficiaries may purchase additional coverage • Retiree coverage • Medigap policies • Medicare Advantage Plans (Part C) • Veterans’ benefits or TRICARE [Insert Regional Office and Phone Number Here]

  6. When Should an Employee Enroll? • First opportunity approaching 65th birthday: [Insert Regional Office and Phone Number Here]

  7. What Parts Should an Employee Choose? • 65 years old; continuing to work covered by EGHP (through self or spouse) • Part A • Can defer Parts B & D • Does not apply to same-sex marriages • 65 years or older and retiring • Parts A, B, & D • May have retiree coverage • May purchase additional coverage [Insert Regional Office and Phone Number Here]

  8. What if Part B was Deferred? • If deferred Part B due to coverage through active employment • 8-month enrollment period • Begins at separation or loss of EGHP coverage (whichever is first) • Enrollment beyond 8-month period may result in a lifetime late enrollment penalty and a waiting period for coverage to begin [Insert Regional Office and Phone Number Here]

  9. What if Part D was Deferred? • If deferred Part D due to creditable coverage • 2-month enrollment period • Begins after loss of creditable coverage • Beneficiary must provide proof of creditable coverage (provided by employer/EGHP) • Enrollment beyond 2 month period may result in lifetime late enrollment penalty and a waiting period for coverage to begin [Insert Regional Office and Phone Number Here]

  10. When Should an Employee NOT Defer? • COBRA • Not coverage through active employment • Medical Security Program • Health coverage through Department of Unemployment Assistance • Active employment coverage through same-sex spouse • Federal programs cannot recognize same-sex marriages Will not prevent a late enrollment penalty! [Insert Regional Office and Phone Number Here]

  11. How does Medicare work with other coverage? [Insert Regional Office and Phone Number Here]

  12. Medicare and HSAs • An individual who is entitled to Medicare is no longer able to contribute to a Health Savings Account (HSA) • Even if beneficiary only enrolls in Part A and defers Part B • If a Medicare beneficiary has an HSA, he/she can still use existing funds in the account • Funds can even be used to pay Medicare premiums, deductibles, or co-payments [Insert Regional Office and Phone Number Here]

  13. Who Can Help? • Medicare • 1-800-MEDICARE • www.medicare.gov • Social Security • 1-800-772-1213 • www.ssa.gov For questions related to Medicare benefits For questions related to eligibility and Parts A & B enrollment [Insert Regional Office and Phone Number Here]

  14. SHINE • Funded by Medicare, administered by Massachusetts Executive Office of Elder Affairs in partnership with local agencies • 13 Regional Offices and one statewide (Greater Boston Chinese Golden Age Center) • 600 certified counselors in almost every city or town in Massachusetts • 1-800-AGE-INFO, press 3 (1-800-243-4636) [Insert Regional Office and Phone Number Here]

  15. What does a SHINE Counselor Do? • Provides free, and unbiased health insurance counseling to Medicare beneficiaries of all ages and their caregivers • At a local site, on the phone, or via email • Home visits are available for homebound clients • Assists clients in finding coverage that meets their needs • Answers questions regarding Medicare eligibility, enrollment periods, and benefits • Assists with Medicare appeals and billing issues • Screens for public assistance programs [Insert Regional Office and Phone Number Here]

More Related