Basic introduction to Medicare Pt 4

Mirabel could have opted to postpone her application for Medicare till July 2009 because she was not covered by an EGHP for the first full month. This would also lead to Medicare coverage becoming non-effective on 1st July 2009, which is the 1st day of the month when she lost coverage from the EGHP. However, if Ms. M. postponed the Medicare application until August 2009, the coverage would not take effect until September 2009.

 

The reason is because the registration with Medicare occurs in the seven months after the first full month in which a person is no longer covered. In the case of an EGHP, coverage is made from the first day of the month following the month of registration. In order to prevent coverage gaps, it is recommended that you register either 3 months before or the month in which your employment terminates.

 

It is imperative to note that the amendments to the law did not change the fact that the SEP is only available to persons covered by an EGHP on the basis of their own or the employment of a spouse.

 

Failure to enroll:

 

It can have serious consequences for persons who failed to sign up for Medicare within their regular enrollment period. The Part B premium will be charged a supplement of 10% per annum for each year that an individual does not sign up. More seriously, non-enrollment during the first enrollment period may result in the person being unable to enroll in Part B of Medicare by the general enrollment period in the first three months of a year. The coverage of Part B would then start in July of this year.

 

As a result, it may take several months for an individual who has no Part B Medicare insurance cover to be prone to expensive medical expenses out of pocket.

 

It is important to know that a person entitled to social benefits or a retirement pension can enroll in Part A at any time and receive up to six months retroactively without penalty. Only for part B the scope of the enrollment period and a markup applies. Exceptions are persons who are not entitled to Part A but who decide to pay the premium and voluntarily participate. They are subject to the registration restrictions and the mark-up.

 

Complaints:

 

The decision to deny Medicare permission or cover for any reason can be appealed to the Social Security Administration or the Railroad Retirement Board. If a person’s enrollment rights have been adversely affected by the act, inaction, misrepresentation or error of the federal government, it cannot be punished or get into trouble.

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If a person can prove that this is the case, the decision to deny Medicare eligibility or cover or to impose a sanction surcharge may be lifted. Complaints are handled by the local social security office. If you believe that you are unjustly denied Medicare coverage, it is important that you insist on your right to object.