As it may happen to some seniors, retirees or other individuals with Medicare, the decision to get off of any health insurance plan is a personal risk. And then deciding to get back on becomes another decision/challenge. Here, a personal friend contacted me asking what it would take to do such a thing. How to re-enroll in Medicare Part B after dropping it because he was living outside the U.S. and the territories and has now returned back to Hawai‘i to live.

Answer:

Medicare (federal health insurance): Part B covers doctors visits, labs & x-rays etc. (the things people use the most). If individuals dropped their Medicare Part B (currently in 2013 the monthly premium is $104.90 and it comes directly out of the Social Security check) and they wanted to re-enroll, they would have to enroll during the General Enrollment Period from January 1– March 31 and coverage begins July 1st. They could face a penalty for the time that they were eligible and not covered. It is a 10% penalty for every 12 months that they were not covered and did not have an active Employer Group Health Plan.

Medicaid (state assistance): Assists those with limited income and assets. Individuals can apply for Medicaid at any time. For full state assistance/Medicaid, income has to be under 100% of the federal poverty level (a couple that is $17,850 per year combined income) and combined assets can not be more than $3,000. Theres a program that pays just for the Part B premiums —  that is $24,097 combined annual income (about $2,008 per month) with combined assets no more than $10,620.

Both programs will give help in paying for prescription drug coverage. BUT the important thing is if they qualify for either of the programs, then they can get Medicare Part B coverage through a special enrollment and the penalty may be waived.

The State has 45 days (by federal law) to review the application. The best way we at Sage PLUS have found is to fax the application to the MedQUEST office, as you have a receipt that they received it (proof for an appeal if the application is lost). Or, you can take it directly to the MedQUEST office with a copy and have the person who takes the application sign, date and time stamp your copy.

There is no on-line application, but the form is on the DHS website and can be filled out and printed . Otherwise, you can contact us and we can mail an application or assist individuals in completing the form and fax it to MedQUEST.

Do you have a Medicare question that you would like answered in this column?

Please send questions to help@hawaii-ship.org or call and leave your name and phone number on the SHIP/Sage PLUS Program hotline, leave the message “question for Generations Magazine column” and we will call you for more information.

Would you like to learn more about Medicare?

Did you know that April is National Volunteer Month and May is National Older Americans month? Become a volunteer for the Hawai‘i SHIP and become a Super Hero in your community by helping seniors and disabled individuals navigate Medicare. For volunteer information, please visit email at help@hawaiiship.org, www.hawaiiship.org or call 1-88-875-9229.

Sage PLUS - Generations Magazine - June-July 2013

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