Planning for 2021 Medicare for me; ACA for DW

[fh2000]

DW and I are on ACA for 2020 as family of 2. I will be 65 in January, 2021. I understand that I will need to apply for my Medicare starting on 10/1/2020. DW will need to apply for a new ACA individual plan for her 2021 plan during open enrollment starting on 10/15/2020.

We are trying to see how much travel should be planned next year.

For my Medicare application, what is the normal process and how long does it take to get approval? Does it take a number of weeks and will I need to submit more documents along the way? Do I need Medicare approval first before applying for DW's new ACA plan since we need to calculate the family income for that plan? Our income will be mainly Roth Conversion.

 

[Teacher Terry]

I didn’t have to send any documents for Medicare and it took a few weeks. You can apply 3 months before 65.

 

[Sarah S]

I haven’t done it yet but as long as you have an online account at ssa it looks really easy https://www.ssa.gov/hlp/isba/10/isba-checklist.pdf

 

[SumDay]

It was really easy, and no documents needed. I suspect they already have every document you could ever dream of.

 

[jpeter1093]

I haven’t done it yet but as long as you have an online account at ssa it looks really easy https://www.ssa.gov/hlp/isba/10/isba-checklist.pdf

Any idea what the checklist means by MEDICAID number if not on MEDICAID?

 

[fh2000]

I just read through the sticky thread:

http://www.early-retirement.org/forums/f38/medigap-plans-to-rule-out-93148.html

I have a rough idea of what I will need to do. I first went to Medicare.gov and did a search of all Medicare Advantage plans within my zipcode, and there is only one PPO plan. Kaiser Senior Advantage plan (HMO) is also listed. But since we do a fair amount of international travel so I will likely choose a Medigap plan.

If I go with Original Medicare + supplemental + Part D, I understand that I will need to do these steps:

Step 1. On 10/1/2020, go to SSA site (I already have an account) to sign up for Medicare only benefit that begins on 1/1/2021. This will provide Part A, and Part B for me.

Step 2: Since my birthday is in January, I will simply let my 2020 ACA insurance finish in December, 2020 and not renew. I will make sure that I call Covered California on 10/15/2020 before their auto-renew process kicks in.

Step 3. I will call boomerbenefits.com, to find a Medigap Part G policy, and a Part D policy. I will then call each insurance and purchase the policy and pay the first premium.

So, for Step 3, per Medicare.gov;

https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap

"Buy a policy when you're first eligible
The best time to buy a Medigap policy is during your 6-month Medigap open enrollment period. During that time you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the month you're 65 and enrolled in Medicare Part B (Medical Insurance). After this enrollment period, you may not be able to buy a Medigap policy. If you're able to buy one, it may cost more."

Does that mean, I will first sign up in SSA, and wait for my Medicare Part B to be created, then buy Medigap policy in January, 2021 when I turn 65?

 

[MBSC]

Step 3. I will call boomerbenefits.com, to find a Medigap Part G policy, and a Part D policy. I will then call each insurance and purchase the policy and pay the first premium.

Boomer Benefits can enroll you in the Medigap and Part D policies. No need for separate calls to the insurance companies. If you should have any issues with Medicare or these policies after enrollment, you call Boomer Benefits to get resolution not the insurance company.

What’s the benefit of using Boomer Benefits as your Medicare insurance broker?

A dedicated Client Service Team for our existing policyholders to immediately fix very common Medicare hiccups which are otherwise stressful for you. We fix billing errors. We write Medicare appeals. We solve pharmacy exceptions when you can’t get your medication.

Boomer Benefits guides you through all of this to resolution so that you are never alone in dealing with Medicare.

Reference: https://boomerbenefits.com/faq/why-do-i-need-an-agent/

"Buy a policy when you're first eligible
The best time to buy a Medigap policy is during your 6-month Medigap open enrollment period. During that time you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the month you're 65 and enrolled in Medicare Part B (Medical Insurance). After this enrollment period, you may not be able to buy a Medigap policy. If you're able to buy one, it may cost more."

Does that mean, I will first sign up in SSA, and wait for my Medicare Part B to be created, then buy Medigap policy in January, 2021 when I turn 65?

Once you have your Medicare number (November 2020), you can call Boomer Benefits to enroll in the Medigap and Part D policies with an effective date of 1/1/2021, the first day of your Medigap OEP. If you wait until January 2021 to buy, the effective date will be February 2021.

 

[Midpack]

It was really easy, and no documents needed. I suspect they already have every document you could ever dream of.

+1. I applied for the first time this year, and it was easy. I applied 3 months in advance and had approval and a Medicare # within a month IIRC. Good thing as I needed a Medicare # to apply for Medigap and Part D. I had everything in place well before my May 1 effective date. So far so good, but only 1 minor claim.

 

[fh2000]

Another question is related to how IRMAA is calculated.

https://www.investmentnews.com/arti...rease-and-irmaa-surcharges-announced-for-2020

If I apply for Medicare in October 2020 for 1/1/2021 start date, which year's household income is used to calculate my monthly premium whether I need to pay IRMAA surcharge or not? If our 2018 income is used, that will put me in solid 4th tier and pay a lot more premium.

 

[pb4uski]

Another question is related to how IRMAA is calculated.

https://www.investmentnews.com/arti...rease-and-irmaa-surcharges-announced-for-2020

If I apply for Medicare in October 2020 for 1/1/2021 start date, which year's household income is used to calculate my monthly premium whether I need to pay IRMAA surcharge or not? If our 2018 income is used, that will put me in solid 4th tier and pay a lot more premium.

Its two years different, so your 2021 Part B will be based on the income on your 2019 tax reurn. Even if you are in the second tier, if you income is lower you can appeal, explain that it is lower with documentation and get the lower premium.

 

[Katsmeow]

I never applied for Medicare. I basically received a card in the mail and I was enrolled unless I rejected coverage. I was already on SS so I didn't have to do anything with them.

I signed up for my supplemental plan before my birthday month and it was effective the first of that month.

 

[fh2000]

For those who applied online, SSA site has a pdf instruction, "How to Apply online for Medicare Only."

It only asks for personal information, and other benefits.

Page 1 is for personal information:
Information About You
• Name;
• Social Security number;
• Date of birth; and
• Gender.

Page 2 asks for the current health benefits (see attachment)
Questions About Your Health Benefits
• Other health insurance coverage;
• Group health plan information;
• Employment information; and
• Dates of coverage information.

If I am on ACA, I should enter 'no' for Group Health Plan Information, and skip Employment Information. I should just fill out Health Insurance Information section and enter my current ACA start and end dates. Correct?

 

[audreyh1]

That is super useful. Thank you!