From the time she was a teenager waiting tables at the local pancake house, Shirley always worked. Later in life, she managed some pretty impressive restaurants. Because the benefits were not always great, Shirley relied on the medical insurance provided by the trucking company for which her husband drove. When he died, Shirley became one of the roughly 20 million Americans covered under the Affordable Care Act (ACA). More than half of those covered by the ACA use the health insurance marketplace option, and there Shirley found a reasonably priced, subsidized plan.
But as Shirley approached her 65th birthday, she did not realize that when she became eligible for Medicare, her ACA subsidies would end — and that she had to shift her coverage to Medicare immediately, even if it cost her more. And she did not know that she needed to enroll in Medicare in a specified time period or face penalties that could last a lifetime.
This is an error many people make: Though they enroll or are automatically enrolled in the usually premium-free Medicare Part A, the hospital component, many of them opt to keep their marketplace coverage instead of signing up for Medicare Part B, not knowing they are no longer eligible for tax credits or cost reductions in the marketplace.
For people 65 and older, and those with a disability, Medicare Part B is the only government-subsidized option. As the organization Justice in Aging explained: “Many people who … kept their marketplace coverage and did not enroll in Medicare … mistakenly believed that their marketplace subsidies would continue. As a result, they now face Medicare Part B late-enrollment penalties and, for many, gaps in coverage.”
To inform and assist those making this transition, the Centers for Medicare and Medicaid Services (CMS), which is part of the U.S. Department of Health and Human Services, has launched an initiative to provide what it calls “equitable relief.” This helps individuals sign up for Medicare Part B with no enrollment penalties as long as the application is submitted by Sept. 30. And those already enrolled in Part B but who have encountered penalties can still apply for relief.
The Medicare Rights Center in Washington has a step-by-step guide to help individuals determine whether they are eligible for the initiative. The website is here. To be eligible, a person must be currently enrolled in a qualified health plan certified by the marketplace, have already enrolled in the premium-free Part A, and have had an initial enrollment period that began on April 1, 2013, or later (or have been notified of retroactive premium-free part A on Oct. 1, 2013, or later). These criteria may be confusing, and for those unsure of eligibility there is free confidential help in understanding the options. For more information and assistance with equitable relief, here is a list of resources:
- The Center for Advocacy for the Rights and Interests of the Elderly (CARIE) at 800-356-3606.
- The Medicare Rights Center helpline at 800-333-4114.
- The State Health Insurance Assistance Programs (SHIPS) at 877-839-2675 or shiptacenter.org. In Pennsylvania, the state SHIP is called APPRISE and the number is 800-783-7067.
- The Social Security Administration at 800-772-1213 or socialsecurity.gov.
Again, it’s important to note that the opportunity to request relief lasts only until Sept. 30.
CMS is also issuing new Medicare cards that will not have Social Security numbers on them, thereby preventing possible identity theft. The plan is to start sending out those cards in April, free of charge. This initiative will continue for a year. (Note: Medicare and Social Security will not call to confirm a person’s identity. If you receive a call from someone saying they need to confirm your Medicare number, it’s a scam. Hang up immediately and report the call.) When you receive your new card, shred your old one. It’s also important to make sure your address on file with Social Security is correct.
Rebecca Nurick is the Pennsylvania Senior Medicare Patrol (PA-SMP) program manager at the Center for Advocacy for the Rights and Interests of the Elderly. Nurick@carie.org