2003-02-08 / Community

The Medicare Window Is Open

"The Medicare enrollment window is wide open. That’s good news for people who want to apply for "medical insurance" under the federal health program now because they chose not to do so when they turned 65. They have until March 31 to apply for this coverage by contacting the Social Security Administration."

Those words of advice came from James M. Glasser, Social Security District Manager in Far Rockaway.

"The first three months of every year are traditionally set aside as open season for anyone who didn’t sign up for Medicare medical insurance, usually called Part B, when they turned 65," Glasser said.

"If you initially thought you didn’t need Part B coverage but have since learned you should have it, you’ve got to make use of this once-a-year opportunity or go another whole year without full Medicare coverage."

Glasser explained there are two parts to Medicare. Part A of Medicare helps cover inpatient hospital costs, some skilled nursing care and limited other expenses. Part B helps pay doctors’ fees, outpatient hospital charges and many other expenses not associated with an inpatient hospital stay.

"Most people take Part A, or hospital insurance coverage, when they turn 65 because that part of Medicare is free. Part A is actually funded by a tax deducted from workers’ paychecks," stated Glasser.

"However, Part B coverage, or medical insurance, is funded by a monthly premium usually deducted from Medicare recipients’ Social Security checks. That deduction is $58.70 per month in 2003 for those who elect coverage during their initial enrollment period when they attain age 65. Some people don’t take Part B because they think they don’t need the coverage, or they figure they will be covered by other insurance, but then they later learn that Medicare is generally the primary insurance for most people 65 and older, and they are required to have both parts."

Glasser also noted that people who refused Part B during their initial enrollment period and then later decide to take the coverage can do so only during an open season, or "general enrollment period, January through March of each year. There is a penalty for delayed enrollment.

"It’s an extra 10 percent for each year you could have had Part B, but didn’t take it. In 2003, instead of paying $58.70 per month, you would pay $64.60 per month for Part B coverage if you delayed your enrollment by one year."

Glasser said that, as a general rule, the only people age 65 and older for whom Medicare Part B coverage is not the primary insurance are those still working and covered by an employer’s health plan or those covered by an insurance plan of a spouse who is working. When they lose this coverage, they will get a "special enrollment period. As long as they file during the seven-month period following either the end of their employment or the loss of their health insurance coverage (whichever happens first), there is no penalty or late enrollment fees.

To learn more about the Medicare program and the coverage policies of both Parts A and B, visit www.medicare.gov or call 1-800-Medicare. People who want to apply for Part B should call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).

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