Help Toni!

I have developed a rare form of cancer that requires the use of proton therapy at MD Anderson and my problem is that my employer health insurance plan does not cover proton therapy.  I will have to pay all of the costs from my 401K.

My oncologist’s office manager has advised me that because I am over 65, I may want to apply for Medicare Parts A and B.  She says that Medicare will pay and provide the care I need. 

I have seen articles that you write about people leaving their jobs and having to apply for Medicare. I am not leaving or retiring from my job, but I need to begin my Medicare benefits as quickly as possible.  

Please advise me what I need to do. 

David  Houston, Tx

 

David,

During Medicare consultations at the Toni Says office, we are hearing of various health procedures being excluded from various group health insurance plans and the patient was advised to go to Medicare.

A healthcare professional once told me that many of the newest healthcare and cancer procedures are not readily approved by insurance plans and that these procedures are generally approved with “Original or Traditional Medicare”.  He has to fight everyday to get his patients the care they desperately need.

The process to enroll in Medicare Part A and/or B past 65 is the same whether you or your spouse are leaving company benefits because of:

  • Health issues since Medicare will pay for the specific procedure that your company benefits will not cover.
  • You have been laid off as so many have in recent months.
  • You have decided to retire.

This procedure has to be followed correctly and the step by step process is listed below:

  1. The forms listed below must be signed by your HR or benefits manager for you and/or your spouse who are covered on company benefits since turning 65.
  2. There are two forms that Social Security provides from the Social Security website and they are:
  • Request for Employment Information: At the top of the form written in red letters is Special Enrollment Period to inform the Social Security agent that is processing the form that you are signing up at the right time and may keep you from receiving a Medicare Part B penalty. This information is needed to process your and/or your spouse’s Medicare enrollment application and inform Social Security that you have had company benefits from an employer or employers.  If you have had 2 or more jobs since turning 65, then each company you have worked for will have to sign a form.
  • Application for Enrollment in Medicare: is filled out by Social Security to say when Part B will begin.
  1. Take both forms to your local Social Security office for your Medicare to begin and be sure to make copies of all paperwork given to the Social Security office, just in case the paperwork is lost.

You can see David, there are options for those who wish to enroll in Medicare that many are not aware exist.

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