Medicare and You_1 Flashcards
General Enrollment Period
Special Enrollment Period, you can sign
up during the General Enrollment Period from January 1–March 31 each
year
Coverage based on current employment doesn’t include:
COBRA (or similar continuation coverage after employment ends)
* Retiree coverage
* VA coverage
* Individual health insurance coverage (like through the Health Insurance Marketplace®)
TRICARE
If you have TRICARE (health care program for active-duty and retired service members and their families), you must sign up for Part A and Part B when you’re first eligible to keep your TRICARE coverage. However,
if you’re an active-duty service member or an active-duty family member, you don’t have to sign up for Part B to keep your TRICARE coverage.
If you have Medicaid and don’t have Part B
Medicaid may help you sign up for it. Medicare will pay first, and Medicaid will pay second. Medicaid may be able to help pay your Medicare out-of-pocket costs (like premiums, deductibles, coinsurance, and copayments).
If you have Marketplace coverage:
Once you’re considered eligible for premium-free Part A, or already have Part A with a premium, you won’t qualify for help from the Marketplace to pay your Marketplace plan premiums or other medical costs. If you continue
to get help paying for your Marketplace plan premiums after that point, you may have to pay back some or all of the help you got when you file your federal income taxes.
Health Savings Account (HSA)
You aren’t eligible to make contributions to an HSA after you have Medicare. To avoid a tax penalty, you should make your last HSA contribution the month before your Part A coverage begins
If you have retiree health coverage (like
insurance from your or your spouse’s former
employment)…
Medicare pays first
If you’re 65 or older, have a group health plan
coverage based on your or your spouse’s
current employment and the employer have
20 or more employees…
Your group health plan pays first.
If you’re 65 or older, have a group health plan
coverage based on your or your spouse’s
current employment and the employer have
fewer than 20 employees…
Medicare pays first.
If you’re under 65 and have a disability, have
group health plan coverage based on your or a
family member’s current employment, and the
employer has 100 or more employees…
Your group health plan pays first.
If you’re under 65 and have a disability, have
group health plan coverage based on your or a
family member’s current employment, and the
employer has fewer than 100 employees…
Medicare pays first.
If you have group health plan coverage based
on your or a family member’s employment or
former employment, and you’re eligible for
Medicare because of End-Stage Renal Disease
(ESRD)…
Your group health plan pays first for the first
30 months after you become eligible for Medicare. Medicare pays first after this 30-month
period.
If you have TRICARE…
Medicare pays first, unless you’re on active duty,
or get items or services from a military hospital
or clinic, or other federal health care provider.
If you have Medicaid…
Medicare pays first.
What’s the Part A late enrollment penalty?
If you aren’t eligible for premium-free Part A, and you don’t buy it when you’re first eligible, your monthly premium may go up 10%. You’ll have to pay the higher
premium for twice the number of years you could have had Part A but didn’t sign up. For example, if you were eligible for Part A for 2 years but didn’t sign up,
you’ll have to pay a 10% higher premium for 4 years.
