1. Medicare prescription drug coverage for transplant (immunosuppressive) drugs

1. 1. Medicare prescription drug coverage for transplant (immunosuppressive) drugs

2. Mrs. Williams Medicare prescription drug coverage for transplant (immunosuppressive) drugs Your immunosuppressive drug was covered, but not your two new prescriptions. Do you have any other drug coverage? I only have Medicare. I was told that if I wanted Medicare prescription drug coverage, I’d have to pay a penalty because I didn’t get it when I first got Medicare.

3. Mrs. Williams’ Profile Medicare prescription drug coverage for transplant (immunosuppressive) drugs • Has had Medicare Part A and Part B based on End-Stage Renal Disease for 5 years • Chose not to get Medicare Part D when she enrolled in Medicare • Had a Medicare-covered kidney transplant at a Medicare-approved facility 8 months ago • Is about to turn 65

4. 2. Medicare Advantage Open Enrollment Period (MA OEP)

5. Mrs. Allen Medicare Advantage Open Enrollment Period (MA OEP) Senior Center I enrolled in an MA Plan after I enrolled in Medicare Part A and Part B. I’m worried that my doctors or medications won’t be covered.

6. Mrs. Allen’s Profile Medicare Advantage Open Enrollment Period (MA OEP) • Turns 65 on April 15 • Just retired • Went to her local Social Security office to enroll in Medicare Part A and Part B on February 20 • Went online and enrolled in an MA Plan on February 21

7. 3. Income Related Monthly Adjustment Amount (IRMAA)

8. Ms. Garcia Income Related Monthly Adjustment Amount (IRMAA) Why do I have to pay higher premiums? My income isn’t that high anymore. IRMAA Determination Notice Social Security

9. Ms. Garcia’s Profile Income Related Monthly Adjustment Amount (IRMAA) • Recently turned 65 • Divorced in 2018 • Enrolled in Original Medicare (Part A and Part B) and a Medicare Prescription Drug Plan (Part D) • Still working and decided to delay getting Social Security retirement benefits

10. 4. Health Savings Accounts (HSAs) and Medicare considerations

11. Mr. Kingly Health Savings Accounts (HSAs) and Medicare considerations My accountant told me I was no longer eligible to contribute to my HSA because I have Medicare. And I could be assessed a 6% penalty for excess contributions. HSA Contributions Federal Taxes

12. Mr. Kingly’s Profile Health Savings Accounts (HSAs) and Medicare Considerations • Is 65 • Has had Medicare for 4 months • Has been getting Social Security retirement benefits for 9 months • Was automatically enrolled in Medicare • Has an HSA with a family high-deductible health insurance plan through his former employer • Currently contributes to his HSA through an automatic deposit each month

13. 5. Marketplace and Medicare enrollment options

14. Ms. Stone Marketplace and Medicare enrollment options Can I keep my Marketplace plan, or should I enroll in Medicare?

15. Ms. Stone’s Profile Marketplace and Medicare enrollment options • Has a Marketplace plan and likes it • Qualifies for a premium tax credit and cost-sharing reductions with her Marketplace plan • Turns 65 next month • Is a U.S. citizen • Doesn’t have a work history • Married for 15 years; divorced for 12 years. • Former spouse is 63; worked for over 40 years; paid Federal Insurance Contributions Act taxes • Neither is getting Social Security benefits

16. 6. Medicare secondary payer, Medicare Part B Special Enrollment Period (SEP), and late enrollment penalties

17. Mr. Roberts Medicare secondary payer, Medicare Part B Special Enrollment Period (SEP), and late enrollment penalties Talking to Dr. Smith’s office… Talking to the Social Security office… I’m not enrolled in Medicare Part B. I’ll call Social Security to enroll. I’m sorry, Mr. Roberts. You can’t enroll in Part B retroactively. You need to wait until the Medicare General Enrollment Period. It starts January 1 and ends March 31 each year. Mr. Roberts, your group health plan denied the payment. They also recalled 2 additional claims for visits after your wife retired. We can refile all 3 as Medicare claims for you. Can I enroll in Medicare Part B now? BILL Payment Due Dr. Smith’s Office

18. Mr. Roberts Medicare secondary payer, Medicare Part B Special Enrollment Period (SEP), and late enrollment penalties • Got Part A at 65 • Has had Medicare Part A for 2 years • Has a group health plan (from an employer) through his wife • His wife retired 10 months ago

19. 7. Medigap changes for 2020

20. Mr. and Mrs. Perry Medigap changes for 2020 Hello! I’m over 65 and retired. I got an ad for your Medigap company. My husband and I won’t need Medigap until he retires at 65 in 2020. Will we both be able to get Plan F? Well, Mrs. Perry, there are changes coming to Plan F in 2020. Let’s talk about what that means for you and Mr. Perry.

21. Mr. and Mrs. Perry’s Profile Medigap changes for 2020 • Both are covered by Mr. Perry’s group health plan based on his current employment. His company has 5,000 employees. • Mrs. Perry turned 65 on May 14, 2019. She has Medicare Part A. • Mr. Perry turns 65 on July 20, 2020. • Both plan to enroll in Medicare Part B when Mr. Perry retires in December 2020. • Both are interested in enrolling in Medigap Plan F, which has the most benefits, including Part B deductible coverage.

22. 8. Medicare coverage for ambulance transportation

23. Mr. Greene Medicare coverage for ambulance transportation My dad got an air ambulance bill for $31,000. Help!

24. Mr. Greene Medicare coverage for ambulance transportation • Is 80 • Is enrolled in Medicare Part A and Part B • Lives with his daughter Lisa, who has power of attorney to act on his behalf