Senior Living
/Health
Medicare rules worry HR manager
from August of 2023. It has been revised and updated.
Hello Toni:
I am a human resources manager for an oil service company and have a question about an employee. He is turning 65 and is still working full time. His situation is unusual because next month he will begin receiving chemotherapy for lung cancer. I am not sure how to advise him ...Read more
Medicare problem began with a notice from CMS
I delayed enrolling in Part B for 5 years, after I turned 70, and retired with a Jan. 1 effective date for my Medicare Supplement Plan G and Part D prescription drug plan.
Now my Medicare stress has started, because I have received a notice from CMS saying they do not have record of me having prescription drug coverage that “met Medicare’...Read more
What does Medicare Part B NOT cover during an emergency room visit?
Dear Toni,
I have been told that Medicare does not cover drugs when you are in an emergency room. My mother went in the hospital from the ER for 2 days and because it was considered “under observation,” we are now fighting the hospital because they say her drugs were not covered during her stay. She has a Part D plan, but the hospital ...Read more
Legal documents are important to Americans at any age
I am turning 65 and retiring from my current employer and will no longer have health insurance benefits, life insurance, and dental and vision benefits. My husband will still be employed with benefits from his current employer.
I have been told that if I do not have a Power of Attorney or other legal documents in effect for both of us, we ...Read more
Enrolling in Medicare with a blocked Social Security account
Note: Because Toni recently received more reader queries about creating a My Social Security account after the account is blocked, we are rerunning the following column from April of 2024.
Hi Toni:
I’m turning 65 in July and not receiving my Social Security check. Last week I tried to open a “My Social Security” account to enroll in...Read more
Does enrollment in COBRA protect you from Medicare penalties?
I retired from my employer of 20 years last June when I turned 66. I enrolled in COBRA, which began July 1, instead of enrolling in Medicare because I was told that COBRA protected me from the Medicare penalty for 18 months.
My sister informed me about Medicare’s Special Enrollment Period in the Medicare & You Handbook which explained ...Read more
Do I enroll in Medicare’s Part A or B during the turning-65 enrollment time?
Toni:
I am turning 65 on April 4, working part-time, and not eligible for my employer benefits, so I need Medicare. A friend gave me confusing information about enrolling, saying that the 7-month window is only for enrolling in Medicare Part A, and I have to prove that I qualify for Medicare Part B at the same time. If that is true, then how ...Read more
The difference between long- and short-term care plans
I am retiring in June when I turn 70 and my wife, Bonnie, will be 68. Our Medicare issue is that recently we applied for a long-term care plan and were both denied due to our simple health issues.
I had my prostate removed due to cancer about 5 years ago with no current issues and Bonnie has A-Fib which is under control. The agent who helped...Read more
How do I file a medical claim with Medicare?
This week, I went to see my primary care doctor, and his office manager informed me that they are no longer accepting Medicare. I recently enrolled in Medicare and will have to pay the complete bill upfront and be reimbursed by Medicare. His office is a small one, and he will be retiring soon, so I need to find a new doctor. Can you please tell...Read more
I need my citizenship paperwork to enroll in Medicare…?
Dear Toni:
I had no problem opening the “My Social Security” account to enroll in Medicare because I knew those answers. When it came to filling out the application for Medicare that was another story.
I had a problem with some of Medicare’s personal questions. I knew my name, address, date of birth, Social Security number, etc. When ...Read more
Contact your local Congressperson for help with Social Security/Medicare
Toni:
Last week’s Medicare Part D question was from Tonya regarding discovering that she and her husband are receiving an “extra” Part D premium, which she never knew about. You advised her to contact her local Congressional office to help appeal the Medicare issue.
I now must fight Social Security because they are under the ...Read more
Why am I paying more for my 2025 Part D premium?
Dear Toni:
In December 2016, you assisted me and my husband Gary in leaving my employer’s benefits. We enrolled into Medicare Part B with a Medicare Supplement and Part D prescription drug plan that began on January 1, 2017.
The 2024 Medicare AEP is the ONLY year that we have changed from the original Medicare Part D plan that we ...Read more
What’s the difference between home health care and in-home care?
Note: Due to the continued confusion on the issue, Toni is rerunning this column from May. It has been slightly updated.
Dear Toni,
I need your help regarding my parents who are in their late 80s. My mother has been disabled with Parkinson’s for the past 3 years and my father has been her caretaker, but due to his recent heart attack, he...Read more
What is Medicare’s General Enrollment Period?
I turned 65 in June, 2 years ago and did not enroll in Medicare because I do not have any health issues. A friend advised me to enroll in Medicare during Medicare’s Annual Enrollment Period. I received a letter stating that because I did not enroll in Medicare when I turned 65 that I have been denied Medicare.
The letter also stated that ...Read more
Enroll in Medicare the right way when leaving employer benefits
Dear Toni,
I am retiring in February when I turn 65 and will need to enroll in Medicare Parts A and B with a Medicare Supplement and a Part D prescription drug plan.
My husband, James, is 72 and has heart issues, so he enrolled in Medicare A and B when he turned 65 and remained on my company benefits to have his heart surgery. He is taking ...Read more
I picked the wrong Advantage plan … when can I return to original Medicare?
Toni:
I never should have listened to my brother who bragged about how his Medicare Advantage plan was a great way to save money and not have to spend so much on my Medicare supplement plan’s premium. I discovered that the eye doctor who was to perform surgery on my right eye in early January is not in this plan. I should have called his ...Read more
Making sense of Medicare’s inpatient ‘under observation’ hospital rule
Toni,
I have Original Medicare with a Supplement and in October, I was taken by ambulance to the emergency room for heart issues. I was surprised when I signed a hospital form stating that I was “under observation,” as the doctor decided whether to admit me as an inpatient or send me home. I was lucky that he sent me home.
During this ...Read more