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NevadaMedicare.health is a valuable resource for Medicare-eligible individuals looking for expert, localized assistance and support in navigating their healthcare options in Nevada.

NevadaMedicare.Health FAQ

What is Medicare Advantage?

Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare (Part A and Part B) offered by private insurance companies approved by Medicare. These plans provide all the benefits of Original Medicare but often include additional coverage, such as prescription drugs, dental, vision, and hearing services. Medicare Advantage plans may also offer extra perks like wellness programs and gym memberships. Each plan typically has its own network of doctors and hospitals, and may require referrals for specialist visits. Medicare Advantage plans aim to provide comprehensive, coordinated care with an annual out-of-pocket maximum, offering financial protection and potentially lower overall healthcare costs for beneficiaries.

Do I need Medicare Prescription Drug coverage if I don't have any prescriptions?

Even if you don't currently have any prescriptions, enrolling in Medicare Prescription Drug coverage (Part D) is generally recommended. Here are a few reasons why:

Future Needs: Your health status can change, and you might need medications unexpectedly. Having Part D ensures you're covered if you need prescriptions later.
Late Enrollment Penalty: If you decide to enroll in Part D later, you may face a late enrollment penalty. This penalty is added to your monthly premium for as long as you have Part D coverage.
Lower Costs: If you enroll when you're first eligible, you can take advantage of lower premiums and avoid higher costs later.
Comprehensive Coverage: Having Part D coverage ensures that your healthcare needs are fully met, providing peace of mind and financial protection.
Overall, enrolling in Medicare Prescription Drug coverage even when you don't have current prescription needs can help you avoid penalties, ensure coverage for future needs, and provide financial security.

How do I apply for Medicare?

How to Apply:

Online: Visit the Social Security Administration (SSA) website and apply online. This is the fastest and easiest method.

- Go to ssa.gov/medicare and follow the instructions to complete the

application.

By Phone: Call the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778).
In Person: Visit your local Social Security office. You can find the nearest office using the SSA Office Locator tool on their website.
By Mail: Complete a paper application and mail it to your local Social Security office. You can download the application form from the SSA website.

If you have specific concerns or questions, Nevada Medicare. NevadaMedicare.Health can help you apply. CALL 702-706-6564, EMAIL [email protected], or use the calendar at the bottom of the page to arrange an appointment.

Is it a good idea to get Medicare if you're still working at 65?

Deciding whether to get Medicare while you're still working at 65 depends on your individual circumstances, including your current health insurance coverage and your employment situation. Here are some considerations to help you decide:

If You Have Employer-Sponsored Health Insurance

1. Employer Size Matters:

- Employer with 20 or more employees: Your employer’s insurance will be your primary coverage, and Medicare will be secondary. In this case, you can delay enrolling in Medicare Part B without penalty. You can sign up for Part B later during a Special Enrollment Period (SEP) when you retire or lose your employer coverage.

- Employer with fewer than 20 employees: Medicare will be your primary coverage, and your employer’s insurance will be secondary. In this situation, it's usually advisable to enroll in Medicare Part B to avoid coverage gaps and potential late enrollment penalties.

2. Coverage and Costs:

- Compare Costs: Compare the cost and coverage of your employer’s insurance with Medicare. This includes premiums, deductibles, co-pays, and the coverage of services and medications you need.

- Prescription Drug Coverage: Check if your employer’s insurance provides creditable prescription drug coverage (as good as Medicare Part D). If not, you may need to enroll in a Part D plan to avoid future penalties.

If You Have Health Savings Account (HSA)

- HSA Contributions: If you are contributing to a Health Savings Account (HSA), enrolling in Medicare Part A or B will stop you from making further HSA contributions. However, you can still use the HSA funds for qualified medical expenses.

General Considerations

1. Premium-Free Part A: Most people get Medicare Part A without paying a premium, so enrolling in Part A while working usually makes sense as it can help cover hospital expenses without additional costs.

2. Medicare Part B Premiums: Since Part B has a monthly premium, you might choose to delay enrolling if you are satisfied with your employer coverage and it’s cost-effective.

3. Special Enrollment Period (SEP): When you retire or lose employer coverage, you will have an 8-month SEP to sign up for Part B without penalty.

Steps to Take

1. Consult with Your HR Department: They can provide specific information about how your employer's insurance works with Medicare.

2. Review Your Current Coverage: Look at the details of your current health insurance and compare it to Medicare.

3. Contact Social Security or Medicare: They can provide personalized advice based on your situation.

Making an informed decision will help ensure you have the coverage you need without unnecessary costs or penalties.

Why are you forced to get Medicare at 65?

You are not strictly "forced" to get Medicare at 65, but there are strong incentives and potential penalties that make enrolling a wise choice for most people. Here are the reasons why many people choose to enroll in Medicare at 65:

Reasons for Enrolling in Medicare at 65

1. Avoiding Late Enrollment Penalties:

- Part B: If you don’t enroll in Medicare Part B when you’re first eligible and you don’t have qualifying employer coverage, you may have to pay a late enrollment penalty. This penalty is an additional 10% on your premium for each 12-month period you were eligible but didn’t enroll, and you will pay this penalty for as long as you have Part B.

- Part D: If you go without creditable prescription drug coverage for 63 consecutive days or more after your Initial Enrollment Period, you may have to pay a late enrollment penalty if you decide to join a Medicare drug plan later. The penalty is calculated as 1% of the national base beneficiary premium multiplied by the number of full, uncovered months you were eligible but didn’t join.

2. Health Coverage:

- Primary Health Insurance: For those who do not have employer-sponsored health insurance or other credible coverage, enrolling in Medicare ensures you have health coverage, which is crucial as you age and health issues become more common.

- Coordination with Employer Insurance: If you have employer insurance from a small company (fewer than 20 employees), Medicare is typically primary, meaning it pays first. Without enrolling in Medicare, you might face coverage gaps.

3. Access to Benefits:

- Hospital Insurance (Part A): Most people get premium-free Part A if they or their spouse paid Medicare taxes while working. This can help cover hospital stays, skilled nursing facility care, and some home health services.

- Medical Insurance (Part B): Enrolling in Part B provides coverage for doctors’ services, outpatient care, preventive services, and medical supplies.

Scenarios Where You Can Delay Enrollment

1. Creditable Employer Coverage:

- If you have health insurance through your current employment or your spouse's employment (with a company that has 20 or more employees), you can delay enrolling in Part B without penalty. When this coverage ends, you’ll have a Special Enrollment Period to sign up for Part B.

2. Active Military Duty:

- If you or your spouse are actively working and covered by a health plan through that employment, you can delay enrolling without penalty.

Summary

While you are not legally forced to enroll in Medicare at 65, the structure of the program, including penalties for late enrollment and the need for continuous health coverage, makes it advantageous for most people to sign up when they first become eligible. This ensures you have adequate health coverage and avoid financial penalties in the future.

Do I need both A and B Medicare?

Whether you need both Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) depends on your specific circumstances, including your current health insurance coverage, your financial situation, and your healthcare needs. Here’s a breakdown of what each part covers and considerations for enrolling in both:

Medicare Part A (Hospital Insurance)

- Covers:

- Inpatient hospital care

- Skilled nursing facility care

- Hospice care

- Home health care

- Cost: Most people qualify for premium-free Part A. If you do not qualify, the premium in 2024 is up to $506 per month.

Medicare Part B (Medical Insurance)

- Covers:

- Doctor visits

- Outpatient care

- Preventive services

- Durable medical equipment

- Cost: The standard monthly premium for Part B in 2024 is $174.70, with higher premiums for higher-income beneficiaries.

Scenarios to Consider

1. If You Have Employer-Sponsored Health Insurance:

- Large Employer (20+ employees): You can delay Part B without penalty if you have coverage through your or your spouse’s current employment. Part A can usually be enrolled in without cost, so it might be beneficial to enroll in Part A while delaying Part B.

- Small Employer (<20 employees): Medicare becomes your primary insurance. It’s usually advisable to enroll in both Part A and Part B to avoid gaps in coverage.

2. If You Have Retiree Health Insurance:

- Many retiree plans require you to enroll in both Medicare Part A and Part B to get full benefits. Check with your plan administrator.

3. If You Have COBRA or Marketplace Insurance:

- COBRA and Marketplace plans do not qualify as creditable coverage for delaying Part B without penalty. Enrolling in Part B is generally advisable to avoid penalties and ensure comprehensive coverage.

4. If You Have a Health Savings Account (HSA):

- Once you enroll in Medicare, you can no longer contribute to an HSA. If you are still working and have an HSA, you might delay Part B (and Part A if you want to keep contributing to the HSA).

5. If You Don’t Have Other Coverage:

- Enrolling in both Part A and Part B provides comprehensive coverage. Without other insurance, you would be responsible for all medical costs out-of-pocket, which can be very expensive.

Key Points

- Penalties: Delaying Part B without having creditable coverage can result in a late enrollment penalty.

- Primary vs. Secondary Coverage: If you have other health insurance, check whether it will be primary or secondary to Medicare to make an informed decision.

- Financial Considerations: Weigh the costs of Part B premiums against the potential out-of-pocket costs of not having comprehensive medical insurance.

Conclusion

While Medicare Part A is often beneficial and comes at no additional cost for most people, the decision to enroll in Part B should be based on your individual situation. If you have other credible health insurance, you may be able to delay Part B. However, if you do not have other coverage, enrolling in both Part A and Part B will ensure you have comprehensive health insurance and avoid potential late enrollment penalties.

Can you sign up for Social Security and Medicare at the same time?

Yes, you can sign up for Social Security and Medicare at the same time, especially if you are planning to start receiving Social Security benefits when you turn 65. Here's how the process works:

Signing Up for Both Social Security and Medicare

1. Timing:

- Social Security Benefits: You can start receiving Social Security retirement benefits as early as age 62, but the full retirement age (FRA) varies based on your birth year (ranging from 66 to 67). If you wait until after your FRA, your benefits will increase until age 70.

- Medicare: You are eligible for Medicare when you turn 65. Your Initial Enrollment Period (IEP) for Medicare starts three months before your 65th birthday, includes the month you turn 65, and ends three months after your 65th birthday.

2. Automatic Enrollment:

- If you are already receiving Social Security benefits at least four months before you turn 65, you will be automatically enrolled in Medicare Parts A and B. You will receive your Medicare card in the mail about three months before your 65th birthday.

- If you are not receiving Social Security benefits, you will need to sign up for Medicare yourself. You can sign up for both Social Security benefits and Medicare at the same time if you plan to start receiving both when you turn 65.

How to Sign Up

1. Online:

- You can apply for both Social Security benefits and Medicare online through the Social Security Administration’s (SSA) website. The online application process is straightforward and can be completed in one session.

2. By Phone:

- Call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778). Representatives can help you apply for both Social Security benefits and Medicare.

3. In Person:

- Visit your local Social Security office to apply in person. It’s a good idea to schedule an appointment in advance to avoid long wait times.

Considerations

1. Medicare Part B Premiums:

- If you are automatically enrolled in both Medicare Parts A and B, and you don’t want Part B (which has a monthly premium), you can follow the instructions on your Medicare card to opt out of Part B.

2. Enrollment Periods:

- Be mindful of your enrollment periods to avoid penalties. Enrolling in Medicare Part B late without creditable coverage may result in a late enrollment penalty.

3. Health Insurance:

- If you have health insurance through your employer or your spouse’s employer, check how it coordinates with Medicare. You may be able to delay Part B enrollment without penalty if you have credible coverage.

4. Financial Planning:

- Consider how starting Social Security benefits at age 65 versus waiting until your full retirement age or later will impact your overall retirement income. Your monthly benefit amount increases for each month you delay receiving benefits, up to age 70.

Summary

Yes, you can sign up for Social Security and Medicare at the same time, and doing so can streamline the process if you plan to start receiving both when you turn 65. Make sure to understand the implications of your choices regarding the timing of your Social Security benefits and the coordination of Medicare with any other health insurance you may have.

Can I enroll in Medicare Part A anytime?

Yes, you can enroll in Medicare Part A anytime after you turn 65, but there are specific enrollment periods and rules that you should be aware of to avoid any gaps in coverage or potential penalties. Here’s a detailed overview:

Initial Enrollment Period (IEP)

- When: This is a 7-month period that starts three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.

- What to Do: During this period, you can sign up for Medicare Part A (and Part B if you choose). For most people, it’s beneficial to enroll in Part A during this period since it’s usually premium-free.

General Enrollment Period (GEP)

- When: January 1 to March 31 each year.

- What to Do: If you didn’t sign up during your Initial Enrollment Period, you can enroll during this time. Coverage will start on July 1 of the year you enroll. This is typically used for Part B, but you can also enroll in Part A if you didn’t do so earlier.

Special Enrollment Period (SEP)

- When: If you are working and have health insurance through your or your spouse’s employer, you can delay Medicare enrollment without penalty. The SEP is an 8-month period that starts the month after your employment ends or your group health insurance ends, whichever happens first.

- What to Do: Enroll in Part A (and Part B if you need it) during this period to avoid late penalties.

Continuous Enrollment

- For Part A Only: If you qualify for premium-free Part A, you can enroll at any time after your Initial Enrollment Period without penalty. This flexibility is particularly useful for those who may not need Part A immediately at age 65 but decide to enroll later.

Key Points to Consider

1. Premium-Free Part A: Most people qualify for premium-free Part A if they or their spouse paid Medicare taxes for at least 10 years (40 quarters). There is no penalty for delaying enrollment in premium-free Part A.

2. If You Don’t Qualify for Premium-Free Part A: You can still purchase Part A, but you might want to carefully consider the timing to avoid late enrollment penalties. The premium can be up to $506 per month in 2024, and the late enrollment penalty is an additional 10% on your monthly premium, applied for twice the number of years you were eligible but did not enroll.

3. Coordination with Other Insurance: If you have other health insurance (like employer-sponsored insurance), check how it works with Medicare. In some cases, delaying Medicare Part A (and Part B) might make sense, but ensure you are covered adequately to avoid gaps.

How to Enroll

- Online: Visit the Social Security Administration (SSA) website to sign up.

- By Phone: Call SSA at 1-800-772-1213 (TTY 1-800-325-0778).

- In Person: Visit your local SSA office.

Summary

You can enroll in Medicare Part A anytime after turning 65, especially if you qualify for premium-free Part A. It’s generally advisable to enroll during your Initial Enrollment Period to ensure you have coverage and avoid any future issues. If you have special circumstances, such as employer coverage, you may have additional flexibility through a Special Enrollment Period.

Do I call my local social security office to apply for Medicare?

Yes, you can call your local Social Security office to apply for Medicare, but there are several other convenient ways to apply as well. Here are the options:

Applying for Medicare

1. Online:

- How: Visit the [Social Security Administration (SSA) website](https://www.ssa.gov/benefits/medicare/) and follow the instructions to apply online.

- Why: This is often the most convenient and quickest method. You can apply from the comfort of your home and at any time.

2. By Phone:

- How: Call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778).

- When: Representatives are available Monday through Friday, from 7 a.m. to 7 p.m.

- Why: This method is useful if you have questions or need assistance during the application process.

3. In Person:

- How: Visit your local Social Security office. You can find the nearest office by using the [Social Security Office Locator](https://secure.ssa.gov/ICON/main.jsp) on the SSA website.

- Why: This option is good if you prefer face-to-face assistance or if you have complex questions about your situation.

- Note: It’s advisable to schedule an appointment to reduce wait times.

4. By Mail:

- How: You can call the Social Security Administration to request a paper application, which you can then complete and mail back.

- Why: This method might be preferred if you are not comfortable using online services or need a physical copy for your records.

Information You’ll Need to Apply

When applying for Medicare, you may need to provide the following information:

- Your Social Security number

- Birth certificate or proof of birth

- Proof of U.S. citizenship or lawful residency status if not born in the U.S.

- Employment information, if you are still working

- Details about your current health insurance, if any

- Your bank information if you choose to set up direct deposit for any payments

Enrollment Periods

- Initial Enrollment Period (IEP): The 7-month period around your 65th birthday (three months before, the month of, and three months after your 65th birthday).

- Special Enrollment Period (SEP): If you are still working and have health insurance through your employer, you can enroll in Medicare during an 8-month SEP after your employment ends or your health insurance ends, whichever comes first.

- General Enrollment Period (GEP): If you miss your IEP, you can enroll between January 1 and March 31 each year, with coverage starting on July 1.

Summary

You can call your local Social Security office to apply for Medicare, but there are other convenient methods such as applying online, by phone, or in person. Choose the method that best suits your needs and preferences.

What if I don't enroll in Medicare at 65?

If you don't enroll in Medicare when you turn 65 and you don't have other qualifying coverage, you could face penalties and gaps in coverage. Here are the potential consequences and considerations:

Medicare Part A (Hospital Insurance)

- Penalty: If you don't qualify for premium-free Part A and you don't enroll when you're first eligible, you may have to pay a late enrollment penalty. The penalty is an additional 10% on your monthly premium, and you will have to pay this penalty for twice the number of years you were eligible but didn't enroll.

- Exceptions: If you qualify for premium-free Part A (based on your or your spouse’s work history), there is no penalty for enrolling late. You can enroll at any time.

Medicare Part B (Medical Insurance)

- Penalty: If you delay enrolling in Part B without having other creditable coverage (such as employer-sponsored health insurance), you will likely have to pay a late enrollment penalty. This penalty is an additional 10% for each 12-month period you were eligible for Part B but didn’t enroll. You will pay this penalty for as long as you have Part B.

- Exceptions: You can delay enrolling in Part B without penalty if you have coverage through your or your spouse’s current employer (with 20 or more employees). You will have a Special Enrollment Period (SEP) to sign up for Part B when this coverage ends.

Medicare Part D (Prescription Drug Coverage)

- Penalty: If you don’t enroll in a Medicare Part D plan (or other creditable prescription drug coverage) when you're first eligible, you may have to pay a late enrollment penalty. The penalty is calculated as 1% of the national base beneficiary premium ($32.74 in 2024) multiplied by the number of full, uncovered months you were eligible but didn’t join. This penalty will be added to your monthly premium for as long as you have Part D.

- Exceptions: If you have other creditable prescription drug coverage, you can delay enrolling in Part D without penalty.

General Considerations

1. Gaps in Coverage: Without Medicare, you may have to pay out-of-pocket for healthcare services that could otherwise be covered.

2. Enrollment Periods: If you miss your Initial Enrollment Period (IEP), you can enroll during the General Enrollment Period (GEP) from January 1 to March 31 each year, with coverage starting on July 1. However, you may still face penalties and a delay in coverage.

3. Special Enrollment Periods (SEPs): SEPs are available for those who have other qualifying coverage, such as employer-sponsored insurance. This allows you to enroll in Medicare without penalties when your other coverage ends.

Steps to Take

1. Evaluate Your Current Coverage: If you have health insurance through an employer or another source, determine if it is creditable coverage that allows you to delay Medicare without penalties.

2. Understand Penalties: Be aware of the potential financial penalties for delaying enrollment in Medicare Parts A, B, and D.

3. Plan for Future Coverage: If you decide to delay enrollment, plan for when you will need to enroll to avoid coverage gaps and penalties.

Summary

If you don't enroll in Medicare at 65 and you don’t have other qualifying coverage, you may face late enrollment penalties and gaps in healthcare coverage. It's essential to evaluate your current insurance situation, understand the potential penalties, and plan your enrollment accordingly.

Can I drop my employer health insurance and go on Medicare Part B?

Yes, you can drop your employer health insurance and switch to Medicare Part B, but there are a few important considerations and steps to follow to ensure a smooth transition:

Steps to Drop Employer Health Insurance and Enroll in Medicare Part B

1. Confirm Medicare Eligibility:

- Ensure you are eligible for Medicare Part B and that you meet the criteria to enroll. Your Initial Enrollment Period (IEP) for Medicare begins three months before you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.

2. Review Your Employer Insurance:

- Before dropping your employer health insurance, review how it coordinates with Medicare. If you have insurance through your own or your spouse’s current employment (with 20 or more employees), Medicare will be secondary, and you might be able to delay Part B enrollment without penalties.

3. Enroll in Medicare Part B:

- If you are dropping your employer insurance, you should enroll in Medicare Part B as soon as possible to ensure you have health coverage. You can sign up online through the [Social Security Administration (SSA) website](https://www.ssa.gov/benefits/medicare/), by phone at 1-800-772-1213, or in person at your local SSA office.

4. Notify Your Employer Health Insurance Provider:

- Once you are enrolled in Medicare Part B, inform your employer health insurance provider that you are dropping their coverage. This will ensure you are no longer billed for premiums or coverage.

5. Consider Medicare Part A and Part D:

- If you haven’t already, consider enrolling in Medicare Part A (which is typically premium-free) and Medicare Part D (for prescription drug coverage). If you are only enrolling in Part B, you will still need to have Part A and, optionally, Part D to have full Medicare coverage.

6. Monitor Coverage Start Dates:

- Ensure that your Medicare Part B coverage starts as soon as your employer coverage ends. You should be careful about the timing to avoid any gaps in health insurance coverage.

7. Understand Coverage Differences:

- Be aware that Medicare may not cover all the services or may have different coverage rules compared to your employer’s insurance. Review your Medicare benefits and understand any potential out-of-pocket costs or coverage limitations.

Considerations

1. Late Enrollment Penalties:

- If you did not enroll in Part B when first eligible and you are dropping your employer coverage, you should have a Special Enrollment Period (SEP) to avoid late enrollment penalties. This SEP is available for 8 months after your employer coverage ends.

2. Health Savings Accounts (HSAs):

- If you have a Health Savings Account (HSA), you should know that enrolling in Medicare Part A or Part B will stop you from making new contributions to the HSA. However, you can still use the HSA funds for qualified medical expenses.

3. Plan for Coverage Gaps:

- Ensure that there are no gaps in your health insurance coverage during the transition from employer insurance to Medicare.

Summary

You can drop your employer health insurance and switch to Medicare Part B, but make sure to enroll in Medicare Part B before ending your employer coverage to avoid any gaps in insurance. Be aware of potential penalties, understand the coordination of coverage, and plan for any additional coverage needs such as Medicare Part D.

Can I have Medicare and Medicaid?

Yes, you can have both Medicare and Medicaid. This is known as being "dual eligible." If you qualify for both programs, Medicare serves as your primary insurance and covers most of your healthcare costs, while Medicaid acts as secondary insurance to cover additional expenses that Medicare does not, such as long-term care, some prescription drugs, and out-of-pocket costs like premiums, deductibles, and copayments. Being dual eligible can significantly reduce your overall healthcare expenses and ensure you receive comprehensive coverage. Dual Eligibles (Medi-Medi's) usually receive much more than those on Medicaid or Medicare alone.

How much does a Medicare Supplement cost?

The cost of a Medicare Supplement plan, also known as Medigap, can vary widely based on several factors:

1. Plan Type

Medigap plans are standardized and labeled A through N, each offering a different level of coverage. More comprehensive plans (like Plan F or G) typically have higher premiums than less comprehensive ones (like Plan A).

2. Location

Premiums can vary by state and even by zip code due to differences in local healthcare costs and regulations.

3. Age and Gender

Some insurers use age and gender to determine premiums. Generally, premiums can be higher for older individuals and women.

4. Tobacco Use

Smokers may pay higher premiums than non-smokers.

5. Insurance Company Pricing Method

Community-rated: Everyone pays the same premium regardless of age.

Issue-age-rated: Premiums are based on your age when you first buy the policy. Premiums won't increase because of your age but may go up due to inflation or other factors.

Attained-age-rated: Premiums are based on your current age and will increase as you get older.

6. Discounts and Promotions

Some insurers offer discounts for things like paying annually, being married, or being part of a group.

Estimated Costs

On average, Medigap premiums can range from $50 to $300 per month, but these rates can be higher depending on the factors mentioned above. Here are some approximate average monthly premiums for different plan types:

Plan A: $50 - $150

Plan B: $120 - $300

Plan C: $150 - $350

Plan D: $125 - $250

Plan F: $150 - $400 (Note: Plan F is not available to new Medicare beneficiaries who became eligible after January 1, 2020)

Plan G: $120 - $350

Plan K: $50 - $150

Plan L: $75 - $200

Plan M: $100 - $250

Plan N: $100 - $200

Shopping for Medigap

To find the best Medigap plan at the most affordable price:

Compare Quotes: Obtain quotes from multiple insurance companies to compare premiums and coverage.

Consider Your Healthcare Needs: Evaluate how much coverage you need based on your health conditions and expected medical expenses.

Look for Discounts: Ask insurers about available discounts that might apply to you.

Review Rate Increases: Check the history of rate increases for the plan to understand potential future costs.

Consulting with an insurance agent or using online comparison tools can also help you find a plan that fits your needs and budget.

Does Medicare work outside the United States?

Medicare coverage is generally limited to the United States and its territories, including Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. However, there are a few specific circumstances where Medicare may provide coverage outside the United States:

Emergency Situations:

If you’re in the U.S. when a medical emergency occurs, and a foreign hospital is

closer than the nearest U.S. hospital that can treat your condition, Medicare

may cover your care at the foreign hospital.

If you’re traveling through Canada without delay on the most direct route

between Alaska and another state and a medical emergency occurs, Medicare

may cover your care in a Canadian hospital.

Cruise Ships:

Medicare may cover medically necessary services provided on a cruise ship if

the ship is within the territorial waters adjoining the land areas of the U.S.,

meaning within 6 hours of a U.S. port.

Foreign Hospitals in Certain Situations:In rare cases, Medicare might pay for

inpatient hospital care in a foreign hospital if it’s closer to your home than the

nearest U.S. hospital that can treat your medical condition, regardless of

whether it's an emergency.

What Medicare Does Not Cover:

Routine care or elective procedures outside the U.S.

Prescriptions filled outside the U.S.

Care received on a cruise ship more than 6 hours away from a U.S. port.

Any other services received in a foreign country under normal circumstances.

Additional Coverage Options:

For those who travel frequently or plan to live abroad, there are options to

consider:

Medicare Advantage Plans:

Some Medicare Advantage plans may offer coverage for emergency care

abroad. Check with your plan provider for details.

Medigap Plans:

Some Medigap plans (C, D, F, G, M, and N) offer limited foreign travel

emergency health coverage. Typically, these plans cover 80% of billed

charges for certain medically necessary emergency care outside the U.S.

after you meet a $250 deductible, with a lifetime maximum benefit of

$50,000.

Travel Insurance:

Consider purchasing travel insurance that includes health coverage for

emergencies abroad. This can provide additional protection and peace of mind

when traveling outside the United States.

While Medicare coverage outside the U.S. is very limited, understanding these exceptions and considering additional coverage options can help ensure you're protected during your travels.

What is the income limit for Medicare in Nevada?

Medicare is a federal program, so its eligibility criteria are uniform across all states, including Nevada. It primarily provides health coverage for individuals aged 65 and older, as well as certain younger people with disabilities. Importantly, Medicare eligibility does not depend on income limits.

What are the requirements to qualify for Medicare?

To qualify for Medicare, you generally need to meet one of the following requirements:

1. Age-Based Eligibility:

- Age 65 or Older: Most people become eligible for Medicare when they turn 65. You can enroll during your Initial Enrollment Period, which starts three months before your 65th birthday and ends three months after your birthday month.

- Work History: Typically, you qualify for premium-free Part A (hospital insurance) if you or your spouse have paid Medicare taxes for at least 40 quarters (10 years) through working.

2. Disability-Based Eligibility:

- Under Age 65: If you are under 65 but have been receiving Social Security Disability Insurance (SSDI) benefits for 24 months, you will automatically be enrolled in Medicare. There is a 24-month waiting period from the time you start receiving SSDI benefits before you become eligible for Medicare.

3. Specific Medical Conditions:

- End-Stage Renal Disease (ESRD): If you have ESRD and need regular dialysis or a kidney transplant, you may qualify for Medicare regardless of your age. You can apply for Medicare coverage as soon as you know you need dialysis or a transplant.

- Amyotrophic Lateral Sclerosis (ALS): If you have ALS (Lou Gehrig’s disease), you will be automatically enrolled in Medicare once you begin receiving SSDI benefits, without the 24-month waiting period.

Additional Points:

- Citizenship/Residency: You must be a U.S. citizen or a legal resident who has lived in the U.S. for at least five years to qualify for Medicare.

- Enrollment: Even if you are eligible, you need to enroll during specific periods to avoid penalties or gaps in coverage. The key enrollment periods include:

- Initial Enrollment Period (IEP): Around your 65th birthday.

- General Enrollment Period (GEP): January 1 to March 31 each year if you missed your IEP.

- Special Enrollment Periods (SEPs): For qualifying life events such as losing employer health coverage.

For more detailed information tailored to your specific situation, you can CALL 702-706-6564, EMAIL [email protected], or use the calendar at the bottom of the page to set an appointment.

What information do you need to sign up for Medicare?

To sign up for Medicare, you'll need to provide some key information to ensure the process goes smoothly. Here’s a list of what you typically need:

1. Personal Identification:

- Full Name: As it appears on your legal documents.

- Date of Birth: To confirm eligibility based on age.

- Social Security Number (SSN): For identification and enrollment purposes.

2. Proof of Citizenship or Legal Residency:

- U.S. Citizenship: You may need to provide proof if it's not already on file with Social Security.

- Legal Residency Status: For non-citizens, proof of lawful presence in the U.S. may be required.

3. Work and Earnings Information:

- Employment History: To verify your work history and determine if you qualify for premium-free Part A. This information is often pulled from your Social Security records.

- Tax Records: In some cases, you may need to provide information about your income if you're applying for income-based assistance programs like Extra Help.

4. Health Insurance Information:

- Current Health Insurance Details: If you have other health insurance, especially if it’s through an employer, it’s helpful to provide this information. It helps determine how Medicare will coordinate with your other insurance.

5. Bank Account Information (for Premium Payments):

- Bank Account Details: If you choose to have your Medicare premiums deducted directly from your bank account, you’ll need to provide these details.

6. Contact Information:

- Mailing Address: Where you receive your correspondence.

- Phone Number: For any follow-up questions or clarifications.

Enrollment Process:

- Online: You can sign up for Medicare online at the Social Security Administration (SSA) website.

- By Phone: Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).

- In Person: Visit your local Social Security office for assistance.

It's a good idea to gather all these documents and information beforehand to streamline the enrollment process. If you need personalized help, contacting Medicare or the Social Security Administration directly can provide additional guidance.

NevadaMedicare.Health can help you apply. CALL 702-706-6564, EMAIL [email protected], or use the calendar at the bottom of the page to set an appointment.

What documentation is required for Medicare?

When enrolling in Medicare, you'll need certain documentation and information to complete the process. Here’s a detailed list of what you might need:

1. Personal Identification:

- Social Security Number (SSN): For identification and to link your Medicare coverage with your Social Security records.

- Date of Birth: To verify age and eligibility.

2. Proof of Citizenship or Legal Residency:

- U.S. Citizenship: Proof of citizenship might include a U.S. passport, birth certificate, or naturalization certificate.

- Legal Residency: For non-citizens, acceptable documents include a Permanent Resident Card (Green Card) or other documentation proving lawful presence in the U.S.

3. Employment and Earnings History:

- Work History: Information about your employment history is used to determine if you qualify for premium-free Part A. This information is usually pulled from Social Security records, but having details about your work history can be helpful if there are any issues.

- Tax Records (if applicable): In some cases, you might need to provide information about your income, especially if you are applying for income-based assistance programs.

4. Current Health Insurance Information:

- Details of Existing Health Insurance: If you have other health insurance (such as through an employer or another source), provide details so Medicare can coordinate benefits appropriately.

5. Bank Account Information (for Premium Payments):

- Bank Account Details: If you opt to have your Medicare premiums deducted directly from your bank account, you will need to provide your bank’s routing number and your account number.

6. Contact Information:

- Mailing Address: To ensure you receive all correspondence related to your Medicare coverage.

- Phone Number: For follow-up communications or inquiries.

7. For Specific Situations:

- If Applying Due to Disability: Documentation of your disability status, such as approval letters for Social Security Disability Insurance (SSDI).

- For End-Stage Renal Disease (ESRD): Medical records or documentation of your condition and treatment plans.

Enrollment Methods:

- Online: Use the Social Security Administration’s (SSA) website to enroll and provide necessary information.

- By Phone: Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778) for assistance and to enroll.

- In Person: Visit your local Social Security office to submit documentation and complete the enrollment process.

It's a good idea to gather and review these documents before starting your application to ensure a smooth enrollment process.

What is the highest income to qualify for Medicaid 2024 in Nevada?

If you do qualify for Medicaid, there is no limited-enrollment period, meaning you can enroll at any time. In Nevada, households with annual incomes of up to 138% of the federal poverty level may qualify for Medicaid. This is $16,753 per year for an individual, or $34,638 per year for a family of four.

How much do I have to pay for Medicare when I turn 65?

When you turn 65, the costs for Medicare can vary depending on the parts of Medicare you enroll in and your income level. Here's a general overview of the costs for 2024:

Medicare Part A (Hospital Insurance)Premium: Most people don't pay a premium for Part A if they or their spouse have paid Medicare taxes for at least 10 years. If you don't qualify for premium-free Part A, you could pay up to $506 per month.

Medicare Part B (Medical Insurance)Premium: The standard monthly premium for Part B in 2024 is $174.70, but it can be higher based on your income. However, here's a breakdown for higher income brackets:

Individual income up to $103,000 or joint income up to $206,000: $174.70

Individual income $103,001-$129,000 or joint income $206,001-$258,000: $244.60

Individual income $129,001-$160,000 or joint income $258,001-$320,000: $309.60

Individual income $160,001-$183,000 or joint income $320,001-$366,000: $396.00

Individual income $183,001-$500,000 or joint income $366,001-$750,000: $485.50

Individual income above $500,000 or joint income above $750,000: $560.50

Deductible: The Part B deductible for 2024 is $240.

Coinsurance: After you meet the deductible, you typically pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment.

Keep in mind that these are general figures and actual costs can vary. It's always a good idea to review your options and possibly consult with a Medicare advisor to find the plan that best suits your needs.

Can I get Medicare if I never worked but my husband did?

Yes, you can qualify for Medicare based on your spouse's work history. If your spouse has paid Medicare taxes for at least 10 years (40 quarters), you can receive Medicare benefits even if you never worked. Here’s how it works:

Medicare Part A (Hospital Insurance)

- Premium-Free Part A: If your spouse qualifies for premium-free Part A based on their work history, you can also qualify for premium-free Part A when you turn 65, provided they are at least 62 years old when you apply for Medicare.

- Premium Part A: If you don’t qualify for premium-free Part A through your spouse, you can buy Part A. The premium in 2024 is up to $506 per month, depending on the number of quarters your spouse worked.

Medicare Part B (Medical Insurance)

- Premium: Everyone pays a premium for Part B. The standard premium for 2024 is $174.70 per month, but it can be higher based on your income.

Medicare Part D (Prescription Drug Coverage)

- Premium: Varies by plan, but you will need to pay a premium for this coverage.

To enroll in Medicare based on your spouse’s work history, you’ll need to provide certain documentation, such as your marriage certificate and proof of your spouse’s work history. It’s best to contact the Social Security Administration (SSA) to get specific guidance on what documentation you will need and to start the enrollment process.

For more personalized information and to start the enrollment process, you can contact the SSA directly or visit their website.

Do you automatically get Medicare with Social Security?

Yes, in most cases, if you are receiving Social Security benefits, you will be automatically enrolled in Medicare when you turn 65. Here’s how it works:

Automatic Enrollment

- If you are already receiving Social Security benefits: You will be automatically enrolled in both Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) when you turn 65. You should receive your Medicare card in the mail about three months before your 65th birthday.

- If you are not yet receiving Social Security benefits: You will need to sign up for Medicare. The initial enrollment period begins three months before your 65th birthday, includes the month of your birthday, and ends three months after your birthday month (a total of seven months).

Opting Out of Part B

Since Part B requires a monthly premium, some people may choose to delay enrolling in Part B if they are still working and have health coverage through an employer or a spouse’s employer. You can opt out of Part B by following the instructions on the Medicare card you receive. If you do this, you can enroll in Part B later during a Special Enrollment Period (SEP) without facing a late enrollment penalty.

How to Enroll if You Need to Sign Up

If you need to sign up for Medicare because you’re not receiving Social Security benefits yet:

1. Online: Visit the Social Security website and apply online.

2. By Phone: Call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778).

3. In Person: Visit your local Social Security office.

It's important to be aware of your initial enrollment period to avoid any late enrollment penalties, especially for Part B and Part D.

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