Cohen & Oalican answer: Can enrollment in Medicare Part B be delayed without having to pay a higher premium?

Can enrollment in Medicare Part B be delayed without having to pay a higher premium?

Enrollment in Medicare Part B can be delayed without paying a higher premium under certain circumstances. If you or your spouse was employed and had group health plan coverage through the union or your respective employer and therefore did not enroll in Medicare Part B when you were first eligible, you can sign up for it during a Special Enrollment Period. You can sign up for Medicare Part B:

• While you still have health plan coverage provided by your employer or group plan coverage offered by the union, during your period of employment or that of your spouse

• In the eight-month period after the health plan coverage given by your employer or union ends or your employment ends, whichever happens first

The rules for Special Enrollment in Medicare Part B are also applicable if you have any disability and are working, or if you have health plan coverage provided by an employed member of your family. If you enroll for Medicare Plan B during the Special Enrollment Period, the effective date for commencement of coverage differs depending on when you enroll:

1. If you are covered by the group health plan or you enroll in Medicare Part B in the first month after the group health plan coverage ends, the coverage provided by Medicare Part B would begin on the first day of the month of enrollment. If you wish to postpone the coverage, you can designate the starting date to the first day of any of the three months immediately following the enrollment.

2. If you enroll any time during the remaining seven months of the Special Enrollment Period, your coverage under the Medicare Part B will begin the month following your enrollment.
If you are unable to enroll in the Medicare Part B during your Special Enrollment Period, you cannot enroll again until the next General Enrollment Period, which is scheduled on January 1st through March 31st of each year. If you enroll during this period, you may have to make a higher premium payment for the Medicare Part B health coverage, since you had the opportunity to enroll earlier and chose not to.

For more information on enrollment, please contact Social Security Administration at 1-800-772-1213.

Make sure you will be protected, call Cohen & Oalican, LLP to discuss your Medicaid Plan.

Medicare coverage for Nursing Treatment, Long-Term Treatment and Expert Nursing Care

What is the amount of coverage that the current Medicare plans offer for nursing home treatment, long-term treatment and expert nursing care?

Normally, Medicare does not offer any help for long-term treatment and care. Treatment on a long-term basis is referred to as “custodial care,” as it can be carried out in various forms and locations. Long-term treatment and care can be rendered at a nursing home, another location in the community and even at home.

Personalized care, which cannot be categorized as skilled care, includes supportive service for daily activities like bathing, eating and other general support which does not fall under the category of skilled medical treatment. Therefore, Medicare will not pay for this type of care.

Medicare offers monetary help only for treatment, classified as vital and proficient medical or nursing care. If you are ill and need constant care under the eye of trained medical personnel who will have the responsibility for your remedial care, you would fall into this category.

Trained medical personnel like doctors and nurses managing your treatment differ from the long-term care given at home or elsewhere by your family members or care-givers. Medicare will only pay for treatment given at a medical facility by qualified and experienced staff.

To make sure you will be protected, call Cohen & Oalican, LLP to discuss your long-term care and Medicaid Plan.

Cohen & Oalican : New Health Care Law and Medicare

Cohen & Oalican answer:

Will the new health care law have any influence on my current benefits and coverage from Medicare?


You may rest assured that there will be no adverse impact on your current Medicare coverage due to the new health care law. On the contrary, this new law signed by the President ensures increased access to health insurance and provides considerable improvements to current policy, thereby providing enhanced protection for you and your family through Medicare coverage plans.

While you may keep your current plan intact, the President’s new law improves Medicare coverage exponentially. For example, the new law ensures the gap in prescription drug coverage (otherwise known as the “donut hole”) will close gradually by 2020. Each year, Medicare recipients will be offered new savings under the law. In 2010, a one-time rebate of $250 will be offer to Medicare recipients This amount will be given to those Medicare recipients who are not already receiving extra help to pay for prescribed medicines. You do not have to submit any personal information to obtain this check like bank account numbers, Social Security details or even Medicare coverage details. If anybody calls you regarding this $250 check and asks for any information, we advise you not divulge any personal facts.

The new health care law would also help reduce the costs of preventive services from the year 2011 moving forward.

If you have further questions please contact Cohen & Oalican LLP, elder law attorneys in Boston, Andover and Raynham.

Cohen & Oalican : New Health Care Law and Presciption Drugs

Cohen & Oalican answer:

Does the new health care law have any provisions to deal with the coverage gap in prescription drugs?

Medicare’s drug coverage was inadequate for approximately 8 million people in 2007. Most Medicare plans have a prescription drug coverage gap or “donut hole” , which forces you seniors to pay out of pocket for your prescription medicines to a certain limit before the plan will begin to cover medication costs. Coinsurance, private payments and annual deductible amounts are all taken into account for each plan’s limit within the coverage gap, however, even these high costs do not always translate to cost savings for many Medicare recipients.

2010: Coverage Gap Rebate of $250

In March, the President signed a new health care law, which offers discounts and savings for seniors during the coverage gap period. The rebate is designed to assist Medicare recipients with prescription drug costs while in the donut hole.

Here’s how it works—Beginning in 2010, Medicare will send you a check for $250 as a one-time payment, three months after the end of the quarterly period when you reached your prescription drug coverage limit. It is important to note that the coverage gap rebate only applies to Medicare recipients who are eligible for the drug coverage and are not currently receiving assistance from another source. Seniors should also be advised that no personal information has to be provided to receive the rebate check, like the number of your bank account, your Social Security number or your Medicare information. If you are contacted by regarding the rebate payment who asks for personal information, please do not divulge any
essential or pertinent facts about yourself. For more information about the coverage gap rebate check, call the designated location dealing with your particular plan.

If you have further questions please contact Cohen & Oalican LLP, elder law attorneys in Boston, Andover and Raynham.