Life After 50 Expo

The first day of spring is Sunday, March 20! With warmer weather and more colorful seasonal foods also comes potential seasonal allergies. As plants release pollen, millions of people with allergies may experience runny nose, watery and itchy eyes, sneezing, and/or coughing (WebMD). If you believe you may have seasonal allergies, you can speak with your primary care doctor, who may refer you to an allergist for tests. In addition to prescription allergy treatments, you can also find over-the-counter medicines that ease the symptoms of allergies caused by spring’s trees, grasses, and weeds.

Does Medicare cover depression screenings? I’ve read about how depression is more common in older adults, and I want to be sure I am not missing signs and symptoms.

-Sara (Chapman, ME)


Dear Sara,

Yes, Medicare Part B covers an annual depression screening. The annual depression screening includes a questionnaire that you complete yourself or with the help of your doctor. This questionnaire is designed to indicate if you are at risk or have symptoms of depression. If your results show that you may be at risk of depression, your provider will perform a thorough assessment and will refer you for follow-up mental health care if appropriate.

Depression screenings should be conducted by your primary care provider (PCP) or another trusted doctor to ensure that you are correctly diagnosed and treated. In most cases, you should receive your depression screening when you have a scheduled doctor’s office visit, often during your annual wellness visit. However, you can also ask your provider to screen you during a separate visit.

You do not need to show signs or symptoms of depression to qualify for screening. However, the screening must take place in a primary care setting, like a doctor’s office. This means Medicare will not cover your screening if it takes place in an emergency room, skilled nursing facility (SNF), or hospital.

If you qualify, Original Medicare covers depression screenings at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance). Medicare Advantage Plans are required to cover depression screenings without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.

Finally, if you are having thoughts of suicide or are concerned that someone you know may be having those thoughts, in the United States you can call the National Suicide Prevention Lifeline at 800-273-8255 (TALK) or go to SpeakingOfSuicide.com/resources for a list of additional resources. Click here for a list of international resources.

Remember that depression screenings are a healthy and important part of everyone’s preventive care! You can learn more about Medicare’s coverage of behavioral health services here.

-Marci

Dear Marci,

I just realized I missed my Initial Enrollment Period to enroll in Medicare. What happens if I enroll in Medicare late?

-Dan (Herman, MN)

Dear Dan,

If you missed your Initial Enrollment Period (IEP) and need to enroll in Medicare, you will have to enroll during either a Special Enrollment Period (SEP) or the General Enrollment Period (GEP) to enroll in Part B or Premium Part A unless you have limited income and savings and are eligible for a Buy In. If you are eligible for Premium-Free Part A, you can enroll at any time.

Special Enrollment Period

If you are eligible for the Part B SEP, you can enroll in Medicare without penalty at any time while you have job-based insurance and for eight months after you lose your job-based insurance or you (or your spouse) stop working, whichever comes first.
If you are under 65, are Medicare-eligible due to disability, and have job-based insurance through a family member’s current work, you may also be entitled to the SEP if there are at least 100 employees at your family member’s place of work.

General Enrollment Period
The GEP takes place January 1 through March 31 of each year. During this period, you can enroll in Medicare Part B or Part A if you have to pay a premium for it.
Enrolling during the GEP in 2022 means your coverage will start on July 1, 2022. Until that time, you will not be covered by Part B, although your Part A may start sooner if you qualify for premium-free Part A.
You may have to pay a Part B premium penalty depending on the amount of time between your IEP and your enrollment.

Let’s talk about the Part B premium penalty. For each 12-month period you delay Medicare Part B enrollment, you will have to pay a 10% Part B premium penalty (unless you are eligible for a SEP through job-based insurance or are eligible for a Medicare Savings Program). In most cases, you will have to pay that penalty every month for as long as you have Medicare. If you are enrolled in Medicare because of a disability and currently pay premium penalties, once you turn 65 you will no longer have to pay that premium penalty.

If you have limited income and savings, you may be eligible for additional help. the Medicare Savings Program (MSP) or Buy-in Program. MSPs help pay your Medicare Part B premium costs and may also pay Medicare cost sharing and Part A premiums. Additional benefits of enrolling in an MSP include:
Allowing you to enroll in Medicare Part B outside of usual enrollment periods (like the GEP)
Eliminating your Part B late enrollment penalty if you have one
Allowing you to enroll in Premium Part A outside of usual enrollment periods in some circumstances

So, if you have missed your IEP, but have limited income and assets and qualify for an MSP, you will be able to enroll in Part B at any time without incurring a late enrollment penalty. I recommend contacting your State Health Insurance Assistance Program (SHIP) to check if you qualify for an MSP in your state.

I hope this helps you learn what to expect as you enroll in Medicare late. Best of luck!

-Marci

According to Harvard Health Publishing, social connections “not only give us pleasure, they also influence our long-term health in ways every bit as powerful as adequate sleep, a good diet, and not smoking. Dozens of studies have shown that people who have social support from family, friends, and their community are happier, have fewer health problems, and live longer.” Maintaining our ties and connections is not always easy, though, and often takes time and effort. Here are some actions you can take to care for your important relationships, whether you are near or far:

Send a card to someone letting them know you’re thinking of them
Call a loved one who has been having a tough time to check in
Mail a small gift to someone who recently accomplished something
Start a book or movie club with someone you want to spend time with
Text or email a favorite photo of you and a friend to reminisce about shared memories

Dear Marci,

My husband still works, and I am covered by his employer’s insurance. I am turning 65 in a few months and wondering if I should enroll in Medicare?

-Mariko (Sallisaw, OK)

Dear Mariko,

It is great that you are looking into this ahead of time and making a plan!

Job-based insurance allows you to delay Medicare enrollment in many cases. There are two questions to consider:

Will I have an opportunity to enroll in Medicare Part B later without a penalty and without waiting for a specific time of year?
Will my job-based insurance pay primary on my health care claims?
In other words, before you delay enrollment, you should determine whether you will have a Part B Special Enrollment Period (SEP) and whether your job-based insurance pays primary or secondary.

In most cases, you should only delay Part B if you will have an SEP and your job-based insurance is the primary payer (meaning it pays first for your medical bills) and Medicare is secondary.

Part B Special Enrollment Period
Because you will be eligible for Medicare due to age (meaning you will be 65+) and are covered by your spouse’s job-based insurance, you will have a Special Enrollment Period (SEP) to enroll in Part B while you have that coverage from current work up to eight months after the coverage or the work ends (whichever is first). This means that you can enroll in Part B after your Initial Enrollment Period (IEP) ends without facing a penalty and without having to wait for the General Enrollment Period (GEP).

Primary or secondary job-based insurance
Next, consider whether your job-based insurance will be the primary payer.
Job-based insurance is primary if it is from an employer with 20+ employees. Medicare is secondary in this case, and some people choose not to enroll in Part B because of the additional monthly premium.
Job-based insurance is secondary if it is from an employer with fewer than 20 employees. Medicare is primary in this case, and if you delay Medicare enrollment, your job-based insurance may provide little or no payment. You should enroll in Part B for coverage when you are first eligible.
Note: There are different rules about the SEP and which insurance is primary if you are Medicare-eligible due to disability or because you have ESRD.

To find out if your job-based insurance is primary or secondary, contact your or your spouse’s human resources department for information about your employer’s size. If you plan to delay enrollment into Part B and use the SEP later, keep records of your health insurance coverage. You will be required to submit proof of your enrollment in job-based insurance when using the SEP to enroll in Part B later. Proof of enrollment in job-based insurance includes:
Written notice from your employer or plan
Documents that show health insurance premiums paid, including W-2s, pay stubs, tax returns, and/or receipts
Health insurance cards with the appropriate effective date
Note: If you have insurance from an employer that is not because of current work, like COBRA or retiree insurance, there are different rules for the SEP and which insurance is primary.

In summary, you should find out if your husband’s insurance will be primary to Medicare. If it is primary, then you can delay Medicare enrollment if you’d like, since you would already have primary insurance from your husband’s current work.

I hope this helps you decide whether or not to enroll in Medicare during your Initial Enrollment Period!

-Marci