How Medicare Works With Your Strs Ohio Coverage
Medicare Parts A & B do not replace your STRS Ohio coverage. Instead, Medicare works with your STRS Ohio plan to provide maximum hospital and medical coverage. In general, when you enroll in Medicare Parts A & B, Medicare becomes the primary payer of your hospital and medical expenses STRS Ohio becomes the secondary payer. If youre enrolled in a Medicare Advantage plan, such as the Aetna Medicare Plan, AultCare PrimeTime Health Plan or Paramount Elite, the plan assumes responsibility for paying for covered services and receives payment from Medicare.
After you enroll in Medicare, you will pay two separate monthly premiums a premium for STRS Ohio coverage and a premium for Medicare Part B coverage .
Aging In To Medicare Coverage
As soon as you or anyone else covered by your health insurance becomes eligible for Medicare, that person must enroll in both Part A and Part B . You must have Medicare parts A and B to enroll in retiree insurance and prescription drug programs. If you, your spouse, or your dependents don’t enroll in Medicare Part B when first eligible, the insurance for that person will be canceled and there is a six-month wait to reenroll.
Tell ORS your Medicare number and effective dates for parts A and B
Once you are enrolled in Medicare you will receive your Medicare card from Social Security. As soon as you receive your card, tell ORS your Medicare number and effective dates for parts A and B.
- Log in to miAccount and send a secure message on Message Board, using the Submit My Medicare Number category. Include the name, Medicare number, and effective dates for parts A and B in your message for the individual going on Medicare.
- Use miAccount to update your Medicare information and complete a plan change to enroll in the Medicare health and prescription drug plan. Print the confirmation page and mail or fax it to ORS.
- Make a copy of your Medicare card. Write your name, member ID, address, and date of birth on the copy and mail or fax the copy of your card.
- Mail or fax a completed Insurance Enrollment/Change Request form to ORS with your Medicare information.
Medicare enrollment is automatic for most people if:
- You have paid into Medicare for 10 years.
- You are turning 65.
How Do I Check On My Online Medicare Application
You can check on the status of your Medicare application at any time using your My Social Security account. You can use the confirmation number you received when you submitted your application.
Youll be able to see when your application has been received, is processing, and is approved. You can also call Social Security at 800-722-1213 to check on your status.
Youll receive a decision letter in the mail when Social Security is done processing your application.
Youll also receive your Medicare card in the mail, as long as your application was approved. It generally takes less than a month from the time you apply to the time you receive your card in the mail.
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How Do I Know If Im Enrolled In Medicare Easy Pay
When processing for Medicare Easy Pay is complete, you will receive what looks like a Medicare Premium Bill, but it will be marked, This is not a bill. This is just a statement notifying you that the premium will be deducted from your bank account.
From that point on, you will see your Medicare premiums deducted from your bank account automatically. These payments will be listed on your bank statement as Automatic Clearing House transactions, and occur around the 20th of each month.
Will Full Retirement Age Change My Benefit Amount
Standard full retirement benefits from the SSA are calculated on what a worker contributed to the Social Security system over the course of their employment. Disability benefits are as well, so the amount of your monthly benefit payment is not affected by the transition from SSD to retirement benefits.
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When Do Disability Benefits Convert To Retirement Benefits
SSDI benefits convert at full retirement age, but that may not be when you reach age 65. Its a common mistake that people make about Social Security retirement benefits.
Your full retirement age depends on the year when you were born. If you were born in 1960 or later, you must wait until you are 67 years old before reaching full retirement age. The Social Security Administration website features a chart showing the full retirement ages for different birth years. Use it to discover how long to expect disability benefits after 65.
Its Not Automatically 65
Many people think that their SSDI benefits will automatically change to retirement benefits when they reach age 65. Some of these people are correct, but only those who were born before 1937. Anyone born after 1937 does not reach full retirement age at exactly 65 years of age so their SSDI benefits will not change to retirement benefits as soon as they turn 65 years old. When will these benefits convert? It depends on the year you were born. The following outline will help you understand at what age your SSDI benefits will convert to retirement benefits:
- 1938 65 years and 2 months
- 1939 65 years and 4 months
- 1940 65 years and 6 months
- 1941 65 years and 8 months
- 1942 65 years and 10 months
- 1943 through 1954 66 years
- 1955 66 years and 2 months
- 1956 66 years and 4 months
- 1957 66 years and 6 months
- 1958 66 years and 8 months
- 1959 66 years and 10 months
- 1960 and later 67 years
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Returning To Work With Medicare Disability Enrollment
You are allowed to keep your Medicare coverage for as long as a medical professional deems you medically disabled.
If you under age 65 and return to work, you wont have to pay a premium for Part A for the next 8.5 years.
If youre still younger than age 65 once that 8.5-year time period as passed, youll begin paying the Part A premium. In 2021, the standard Part A premium is $259.
Your Medicare costswill depend on your specific circumstances. Its important to know that unlikestandard insurance plans, each Medicare part has its own costs and rules.
Medicare Vs Medicaid Disability
As a disabled person, you can qualify for medical coverage under Medicare or Medicaid. Medicare is a federal program that offers affordable Medicare coverage to individuals over 65 years and disabled people who qualify under the guidelines set for disability. To qualify for Medicare as a disabled person there are no income limits. However, you need to have a qualifying illness or have received Social Security Disability Insurance benefits for at least 24 months.
Medicaid is a needs-based program meaning that it is designed to cater to people with limited income with no age restrictions for eligibility. Unlike Medicare, Medicaid disability has certain income and asset limits since eligibility is assessed on a needs basis. If you are disabled you can apply for Medicaid through the state agency for your local area. You will be required to provide proof of your income and assets which will be the main rating factors used to determine your eligibility. Medicaid coverage typically covers hospitalization, doctor services, family planning, nursing services, dental services, clinic treatment, pediatric services and screening services.
What Happens To Ssi When I Turn 65
Turning 65 doesnt affect your SSI benefits. The main reason is that SSI, unlike SSDI, receives funding from the general fund of the US Department of the Treasury and not from Social Security taxes.
As long as there is no change in your income or resources, your SSI benefits will not change just because you reach retirement age. Furthermore, The state pays Medicare health insurance premiums to people who receive SSI benefits if they are eligible for Medicaid insurance benefits.
Suppose you have an SSI and are enrolled in Medicare. In that case, youre eligible for Extra Help with Medicare prescription drug insurance assistance without submitting a separate application.
If You Go Back To Work
Medicare coverage linked to receiving SSDI will end if benefits stop because your condition improves to the point that Social Security no longer considers you disabled. The SSA does periodic reviews to determine your continuing medical eligibility for benefits.
SSDI can also end if, while still meeting the medical criteria for disability, you are able to work and your income exceeds a limit known as substantial gainful activity . In 2022, the limit is $1,350 per month, or $2,260 if you are blind. If you earn more, you can lose your benefits.
In that circumstance, however, you may not lose Medicare coverage, due to the suite of work incentives Social Security offers to help disabled beneficiaries make the transition back to the workforce.
For example, you will not lose SSDI or Medicare benefits during a trial work period, an incentive that lets you earn more than the SGA limit for any nine months over a five-year period. If you are working at or above SGA level when the trial period ends, you lose SSDI but can remain on Medicare and pay no Part A premiums for 93 consecutive months , as long as you still have a qualifying disability.
After that, you can remain on Medicare but will have to pay for Part A, at least until you turn 65 and become Medicare-eligible based on age.
Keep in mind
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Whats Required For Me To Make The Transition To Full Retirement
Transitioning from receiving Social Security disability insurance payment to collecting Social Security retirement benefits is automatic when you reach full retirement age.
Your monthly benefit payments will not change however, you will no longer be subject to any of the rules for SSI disability payments. You will not need to have any further case reviews after reaching full retirement age. You will still get your monthly payments when you reach retirement age, even if your disability improves.
Medicare Part B Enrollment: Theres Still Time To Sign Up
Most people get Medicare Part B when they turn 65. If you didnt sign up for Part B then, nows the time to decide if you want to enroll.
During Medicares General Enrollment Period , you can enroll in Part B and your coverage will start July 1.
Deciding to enroll in Part B is an important decision. It depends on the type of coverage you have now. Its also important to think about the Part B late enrollment penaltythis lifetime penalty gets added to your monthly Part B premium, and it goes up the longer you wait to sign up. Find out if you should get Part B based on your situation.
If you only have Medicare Part A , adding Part B can help you get the most out of your Medicare coverage. Part B helps cover:
- Services from doctors and other health care providers
- Outpatient care
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Medicare Coverage For Working People With Disabilities
If you have a disability and are working, your Medicare coverage can fall into one of three plans.
The Benefits Do Convert
The first thing you need to understand when receiving SSDI benefits is that the benefits do convert from Social Security Disability benefits to Social Security Retirement benefits once you reach retirement age. Nothing will change. You will continue to receive a monthly check and you do not need to do anything in order to receive your benefits. The SSA will simply change your disability benefit to a retirement benefit once you have reached full retirement age. When you reach that age, however, can vary depending on which year you were born in.
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Can I Switch From Social Security Retirement Benefits To Social Security Disability Benefits
Yes, it is possible to switch from Social Security retirement benefits to Social Security disability benefits under certain circumstances. Suppose you filed for early retirement benefits and started receiving Social Security payments when you were only 62. Then, you became disabled.
Since you are not yet full retirement age, you may receive a higher payment if you are qualified as disabled. The difference is that disability payments would be at your full retirement age, which are up to 30% higher than early retirement payments.
In this special circumstance, it is worth evaluating if you should apply for disability for the few years between the early retirement age of 62 and your full retirement age based on your birth year that could be from 65 to 67 years old.
If you retire early and then later realize that a medical condition qualifies you for disability benefits, it is possible to claim disability payments retroactively.
Disability claims may take many months, sometimes years, for approval and might face denial. You may want to apply for early retirement benefits while waiting for your disability claim to be approved or denied to have some Social Security income in the meantime.
It is also wise to consider working with a disability attorney for a complex case. A Social Security disability attorney is a specialist in working with Social Security benefits. A disability lawyer may help if your disability claim faces a denial and the decision needs an appeal.
What Are The Characteristics Of Medicare Beneficiaries Under Age 65 With Disabilities Compared To Beneficiaries Age 65 Or Older
Medicare beneficiaries under age 65 with disabilities differ from beneficiaries age 65 or older in several ways, including their demographic, socioeconomic, and health status profiles.
Income: In 2012, a much larger share of beneficiaries under age 65 with disabilities than older beneficiaries had low annual incomes . Nearly one quarter of younger beneficiaries with disabilities had incomes less than $10,000 per year and two-thirds had incomes less than $20,000 per year, compared to 13% and 39%, respectively, of older beneficiaries.7
Figure 1: Selected Characteristics of Medicare Beneficiaries Under Age 65 Compared to Those Age 65 or Older
Race/ethnicity and gender: A larger share of beneficiaries under age 65 than older beneficiaries are black and Hispanic , and a larger share are male .
Health status: Nearly two-thirds of all younger Medicare beneficiaries had a cognitive or mental impairment in 2012, compared to 29% of older beneficiaries . This includes memory loss that interferes with daily activity, difficulty making decisions, trouble concentrating, and loss of interest within the past year.8 Nearly 6 in 10 reported their health status as fair or poor and almost the same share reported having one or more limitations in their activities of daily living, compared to 20% and 34% of beneficiaries age 65 or older, respectively. But roughly the same share of both younger beneficiaries with disabilities and older beneficiaries report having five or more chronic conditions .
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Timely Application And Proofs
If you have Medicare, we need your application and proofs more than one month prior to your retirement effective date. If your last day of work is in June and you want your insurance coverage to start July 1, your retirement effective date, we need your required proofs before June 1. If we get the request and proofs after the first of the month, one month prior to your retirement, but before the end of the month, you will not be enrolled until a month later.
For example, if you submit your application and proofs on June 1, for a retirement effective date of July 1, your actual insurance effective date will be Aug. 1.
Why Do Doctors Not Like Medicare Advantage Plans
If they dont say under budget, they end up losing money. Meaning, you may not receive the full extent of care. Thus, many doctors will likely tell you they do not like Medicare Advantage plans because the private insurance companies make it difficult for them to get paid for the services they provide.
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How About Medicare At Age 65
When you reach 65, that is still the same year you qualify for Medicare. Be sure to apply for Medicare when you turn 65 to avoid paying the penalty to join later. Medicare Part A is free, and you have options to consider about paying an insurance premium to get Medicare Part B. You may want to consider paid supplemental insurance such as Medicare Advantage programs.