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1 Social Security www.socialsecurity.gov Jeffrey C. Rodriguez Public Affairs Specialist Social Security & Medicare: 2015 CMS National Training Program.

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Presentation on theme: "1 Social Security www.socialsecurity.gov Jeffrey C. Rodriguez Public Affairs Specialist Social Security & Medicare: 2015 CMS National Training Program."— Presentation transcript:

1 1 Social Security www.socialsecurity.gov Jeffrey C. Rodriguez Public Affairs Specialist Social Security & Medicare: 2015 CMS National Training Program

2 2 www.socialsecurity.gov/myaccount my Social Security is an easy-to-access, easy-to-use portal to view and update some of your own Social Security information. my Social Security my

3 3 Social Security Home Page

4 4  1935 – Retirement Insurance  1939 – Survivors Insurance  1956 – Disability Insurance  1965 – Medicare Program History of SSA Programs

5 5 Other SSA Programs  1972 – Supplemental Security Income  2003 – Medicare Prescription Drug Coverage  2010 – Patient Protection and Affordable Care Act

6 6 65 Age to Apply for Medicare

7 7 65 & older -or- 24 months after entitlement to Social Security disability benefits -or- Amyotrophic Lateral Sclerosis -or- Permanent kidney failure and receive maintenance dialysis or a kidney transplant Who Can Get Medicare ?

8 8 How to Apply for Medicare

9 9 Note If you already have Medicare Part A and wish to sign up for Medicare Part B only, please complete form CMS 40-B, Application for Enrollment in Medicare - Part B (Medical Insurance), and take or mail it to your local Social Security officeCMS 40-B, Application for Enrollment in Medicare - Part B (Medical Insurance)local Social Security office

10 10 1.Call Social Security to schedule an appointment 1-800-772-1213 (TTY 1-800-325-0778); or 2.Apply at your local Social Security office. How To Apply for Benefits Based on a Spouse?

11 When Can I Sign Up for Medicare Part B?  Initial – at age 65  Special – if still working  General – January-March Medicare Enrollment Periods: 58

12 12 SEP Terms Group Health Plan (GHP)  GHP plan based on current employment status (beneficiary/spouse)  GHP any size, for disabled plan is any size below 100 employees  Types of GHP: self-insured, governmental entities, employee organizational plans, employee pay-all- plans, and national health plans in foreign countries.  Does not include plans unavailable to employess (S/E)  Employer or employee doesn’t have to be in the United States.

13 13 SEP Terms Health Savings Account (HAS)  HSAs are NOT group health plans  Individual must be covered under a high deductible health plan (HDHP) and not entitled to Medicare Part A.  To be eligible for SEP for working aged or working disabled, individual must have coverage under a HDHP based on current employment

14 14 SEP Terms Current Employment Status  An individual has “current employment status” if he or she is actively working as an employee, is the employer (including a self-employed individual), or is associated with the employer in a business relationship  Individual covered under a retirement GHP is rehired  Employment Status of Senior Judges  Clergy and members of religious orders  Individuals serving as volunteers  Directors of Corporations

15 15 Income Related Monthly Adjustment Amount (IRMAA) MAGI Thresholds for 2011-2019  IRS filing status: Married, filing jointly $170,00  20IRS filing status: All other filing statuses $85,00  Determined by Tax Year PY-2 Qualifying Circumstances  Death of spouse  Marriage  Divorce/Annulment  Work Reduction  Work Stoppage  Loss of income from income-producing property  Loss or reduction of certain pension income

16 16 Medicare Billing Four Methods  Payment by a State under a buy-in agreement  Deduction from a monthly Railroad Retirement (RR) or Social Security benefit or Federal Civil Service Retirement (CSR) annuity  Direct remittances on an individual basis, or on behalf of the enrollee  Direct remittances on a group basis by an employee, union, lodge or other organization, or by an entity of a State or local government.

17 17 Medicare Billing Cycles Quarterly for Insured – not receiving benefits  Cycles start for records selected on 27 th of preceding month  Example: bill mailed in July include premiums for August, September and October. The next bill will be mailed in October. Quarterly for Uninsured  Cycles A, B, or C  Cycle A starts in January  Cycle B starts in February  Cycle A starts in March

18 18 Social Security www.socialsecurity.gov 1-800-772-1213


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