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 Question:

We recently discovered that we can’t find my father’s Social Security Card. How do we get a new one?

Answer:

Your Social Security (SS) Card is such an important piece of paper, and yet we don’t need it that often – once you are an adult you have other forms of ID that are used, like a driver’s license or work ID. Plus many individuals have memorized their SS Number, so they just say it without having to refer to the card itself.

However, there are situations where you need to have the actual card.

The process for getting a new SS Card is somewhat difficult and that is on purpose, to prevent identity theft. We don’t want someone who isn’t you getting a copy of your card and then acting like you and hijacking your life and potentially all you have.

There are a couple of ways to get a new SS Card. One of the easiest ways to get a new SS Card is by heading over to your local Social Security Administration (SSA) office. Be prepared to have ID with you, and you may need your birth certificate as well to prove your identity. Once they verify your identity, they can print out a piece of paper with your SS Number on it, and then you will receive the new card in the mail in about 7 to 14 business days. So be sure to watch your mail and OPEN everything that comes. You wouldn’t want to throw your new card away assuming it’s junk mail.

Another way to get a new SS Card is to use the SSA.gov website. To get a new SS Card online you must establish a username and password on this website. This may be something you have already done before. If you haven’t, it is quite a process, so be sure to record your user ID name and password, exactly as you typed them in. The SSA.gov website is not an easy website to join, but once established it is very useful and worth the work. In fact, you can tell your friends to establish a profile now, BEFORE they lose their SS cards, so it’s easier to get a new one if that ever happens.

If you order your new SS Card via the website, it will take the same 7 to 14 business days to actually get the card, but again you can write down the SS Number, if you need it right away.

I do want to offer a word of caution, because recently I had a family member use the SSA.gov website to order their SS Card. They thought they had completed the process and as they were finishing up a “pop-up” came on the screen. The pop-up was telling them they “had a couple more steps before their card was ordered.” They clicked on the pop-up and found it was a “PAID service” to help get a copy of the new SS Card. It asked them to enter their personal information and their credit card information, and they would be charged $47 to receive their new SS Card in the mail. Unfortunately, they entered their personal information and their credit card information and were charged the $47. They received a confirmation that their new SS Card has been ordered.

Shortly after, their bank called to say they had a suspicious charge on their credit card and the bank wanted to review the situation. They called the bank back and confirmed that they did in fact authorize this $47 to get their new card. The bank reinforced that you DON’T have to PAY to get a new SS Card. But the individual insisted that it was a legitimate charge and they wanted it paid. The bank agreed to let it go through.

Upon further investigation, we found that this is in fact a legitimate business which has an agreement with the SSA to “HELP” people order their SS Cards. BUT it is so easy to order a new card yourself, I don’t recommend using this service and paying that money unnecessarily to get your new SS Card.

I have to say that in the end my family member received TWO SS Cards: one they ordered successfully themselves, and one that the $47 service ordered for them. That was $47 they didn’t need to spend!

So, if the SSA office is a reasonable distance for you to drive, I believe going to the SSA office with your proof of identity makes the most sense for getting a new SS Card. That way you won’t be offered any unusual additional services at a fee, and you know exactly what you’re getting.

At Lawley Medicare Solutions, our Medicare and Individual Health Consultants are dedicated to helping you make the most informed decisions about your healthcare needs. We offer personalized service and expert advice tailored to your unique situation. Contact us today by phone or email to schedule a consultation and ensure you’re getting the best coverage for your needs.

Read all Inside Medicare articles HERE.

LAWLEY HAS A TEAM DEDICATED TO MEDICARE INSURANCE!

Our licensed Medicare & Individual Health Insurance team can help clients understand the details of Medicare insurance plans, assist with choosing the right benefits and coverage, and provide guidance when life events that affect health coverage occur. For questions, concerns, or to reach Lawley Medicare Solutions, call 716.849.8223.

 Question:  I signed up for Medicare, evaluated my options, and signed up for additional insurance. Now, I received paperwork telling me I have a late enrollment penalty and have to pay more money for my premiums. What should I do? Do I have to pay this?

Answer:

The steps for getting onto Medicare are different for everyone, and the timeline to join can be different too. Every individual has a different set of variables they bring to the table when discussing Medicare and when to join.

Most individuals become eligible for Medicare when they turn 65. If you are working and carry insurance from an employer group of more than 20 employees, you CAN stay on your employer health insurance and decline Medicare without any penalties or issues. Then when you are preparing to retire and drop the employer coverage, you’ll have a Special Enrollment Period (SEP) to sign up for Medicare. The process for signing up for Medicare after a delay like this has some unique steps, but you are allowed to use that SEP created upon leaving employer coverage to join Medicare AND pick any additional coverage.

Once you join Medicare and add your additional plan of choice, your new insurance company will usually send paperwork to complete. This paperwork will ask why you are enrolling at this time (instead of earlier when you turned 65) and what your coverage was before.

When signing up for Medicare deferring while on employer coverage, you should complete two forms: the 40B, which is your written request to get Medicare Part B, and the L564, which your employer completes to indicate that you did in fact have coverage through active employment and therefore qualify for the SEP to get your Medicare Part B started. You probably disclosed that information on the application for your insurance when you completed it, but these forms verify that you do in fact qualify for the SEP. If you didn’t complete and submit these forms, or based on these forms it looks like you had a gap in coverage, your new insurance company may assume you were without coverage, and therefore you might incur a Late Enrollment Penalty (LEP). This LEP will increase the cost of your coverage.

However, in your particular situation, there is another kind of LEP that applies, and it is based on your Prescription Drug Coverage. THAT information was NOT included in either the 40B or the L564 form. Prescription Drug coverage has a different standard entirely, called the Creditable Coverage standard. This standard asks if the Prescription Drug Coverage portion of your employer insurance meets the minimum standard that Medicare Part D requires. You’ll know if you met this standard based on a document given to all employees in group coverage every year, stating that the Prescription Drug Coverage portion of their insurance meets the minimum standard (or not), called the Creditable Coverage Letter. It is an actual letter that is created by your insurance carrier and employer. It’s usually two pages long and begins with “Important Notice from (Employer’s Name) About Your Prescription Drug Coverage and Medicare.” Most individuals are NOT familiar with this and don’t remember ever receiving it in the mail.

When your new insurance company tells you that you incurred an LEP, you can certainly work with the insurance company to eliminate the LEP, as long as you can prove proof that you had coverage from your employer plan and that is was deemed Creditable Coverage. Start by trying to find old Creditable Coverage Letters. If you don’t have one, then you can go back to your employer and ask for copies of the letter for the years that you were Medicare-eligible. Once you have those copies of the letter, you must present one for each year to your new insurance carrier. If you resolve the confusion about your prescription drug coverage, you will see your premium reduced to the usual amount.

More and more we see individuals working beyond 65 years of age with employer health benefits and therefore choosing to defer Medicare enrollment. We also see situations where one spouse turns 65 and the other spouse is still working and carries the insurance for them both, and they can also choose to defer Medicare. These are the situations where all of these factors I’ve discussed like Creditable Coverage and SEPs come into play.

It is important to understand the options available and rules that apply to you when eligible for Medicare at age 65. It is worth talking to professional Medicare experts to be sure you are making the correct enrollment decisions. You need to have accurate and useful information for your individual situation to be sure you are making the correct Medicare choices.

At Lawley Medicare Solutions, our Medicare and Individual Health Consultants are dedicated to helping you make the most informed decisions about your healthcare needs. We offer personalized service and expert advice tailored to your unique situation. Contact us today by phone or email to schedule a consultation and ensure you’re getting the best coverage for your needs.

Read all Inside Medicare articles HERE.

LAWLEY HAS A TEAM DEDICATED TO MEDICARE INSURANCE!

Our licensed Medicare & Individual Health Insurance team can help clients understand the details of Medicare insurance plans, assist with choosing the right benefits and coverage, and provide guidance when life events that affect health coverage occur. For questions, concerns, or to reach Lawley Medicare Solutions, call 716.849.8223.

This NEW State of Emergency Rule was rescinded by Centers For Medicare Services (CMS). There may be Special Enrollment Periods available for you to use, please reach out to our Medicare Solutions Team to help you with the alternatives available to you.

 Question:

I couldn’t change my insurance for 2025 due to a recent State of Emergency declaration, but I believe I should have made a change. Am I still able to make a change?

Answer:

There are many rules that apply to Original Medicare and the insurance products that go along with that coverage. One of the most important rules to understand is the time period when you are allowed to change your insurance coverage. That usually occurs during the Annual Open Enrollment Period, which is October 15 to December 7 each year. There is also a Medicare Advantage Open Enrollment Period which is open right now, from January 1 to March 31 each year.

There are also more than 20 different Special Enrollment Periods (SEP) available to allow coverage changes due to new situations and concerns.

One very broad SEP is “you experience an ‘exceptional circumstance.’” The most common of these “exceptional circumstances” is a State of Emergency declaration, often due to natural disasters, weather emergencies, or similar situations. This State of Emergency declaration created a situation where some individuals were unable to make the necessary adjustment to their insurance coverage when they could have made the change, and are therefore given extra time to make that decision. The State of Emergency declaration creates an additional Special Enrollment Period (SEP) that runs for a specific period of time. That period of time is defined in the State of Emergency declaration and applies to those individuals who were impacted by the situation.

In the past, individuals who wanted to make a change using the State of Emergency SEP could do so with any broker, insurance website, the medicare.gov website, or over the phone. However, beginning in 2025, now you can ONLY use this SEP by talking with the customer service department of Medicare, using the 1-800-MEDICARE phone number.

This change in how the State of Emergency SEP will be accessed was designed to protect individuals with Medicare and additional Medicare insurance products. Over the years, Centers for Medicare Services (CMS) has found that many seniors were receiving phone calls and mailings that prompted them to change their insurance in a way that may not have been in their best interest. A Medicare-eligible individual would receive a phone call, answer that phone call, and find that it was a salesperson talking to them about a different insurance product than what they were currently enrolled in. Later, the individual discovers that just by talking with this salesperson and answering some questions, they had been enrolled into a different insurance product. Sometimes the individual knew this was happening and sometimes they did not realize that is what happened until after they received the new cards in the mail, or it even took until they ran into problems with their insurance at the pharmacy or a doctor’s appointment.

To me, this new rule is a positive change for those of us that work with Medicare eligible individuals. This SEP protection allows those individuals to change their insurance when they qualify for the State of Emergency SEP, but protects them from = being misled by those salespeople who would try to use the SEP to change their coverage.

When using this State of Emergency SEP, you can still change your insurance, but you can only do so by working through the 1-800-MEDICARE helpline. Their customer service will help you to understand the products available to you, and determine if this SEP is appropriate for what you want to change.

As I mentioned, there are more than 20 SEP’s that are available all the time for those individuals who qualify for special situations. All of those other SEP’s can be handled as usual, with an insurance broker, a company website or the medicare.gov website.

So if you feel you have been impacted by a State of Emergency declaration in your area, or you have questions about your Medicare coverage, you can call 1-800-MEDICARE to find out more. You can continue to work with a broker or the websites as well. But if you determine you want to make a change using the State of Emergency SEP, instead of one of the other 20 available, you simply call 1-800-medicare, to make the change.

I am pleased with this added protection for those with Medicare. It is my hope that we will see fewer repeated phone calls trying to convince you to change your insurance. I hope we see fewer individuals who get changed, when they had no intention of changing their insurance, but simply answered their phone. I hope this new protection leads to a more stable insurance situation for those on Medicare.

At Lawley Medicare Solutions, our Medicare and Individual Health Consultants are dedicated to helping you make the most informed decisions about your healthcare needs. We offer personalized service and expert advice tailored to your unique situation. Contact us today by phone or email to schedule a consultation and ensure you’re getting the best coverage for your needs.

Read all Inside Medicare articles HERE.

LAWLEY HAS A TEAM DEDICATED TO MEDICARE INSURANCE!

Our licensed Medicare & Individual Health Insurance team can help clients understand the details of Medicare insurance plans, assist with choosing the right benefits and coverage, and provide guidance when life events that affect health coverage occur. For questions, concerns, or to reach Lawley Medicare Solutions, call 716.849.8223.

 Question: I’m getting ready to sign up for Medicare, but I don’t want to collect Social Security yet. How will I pay for the Medicare Part B premium?

Answer:

Social Security and Medicare have been around for a long time, and for many of those years, individuals filed for both benefits at the same time. Now, many individuals wait to collect their Social Security Benefits until after they sign up for Medicare Part A and B.

To understand this trend, I’ll lay out the timing: while you may start collecting Social Security as early as age 62, individuals born after 1960 don’t reach “full retirement age” (FRA) until their 67th birthday. So many newly eligible individuals opt to wait until FRA to collect Social Security. However, eligibility for Medicare insurance for most individuals starts when they turn 65. So, along the way to FRA, they’ll still need to make a Medicare insurance enrollment decision at age 65.

So, to address your situation, let’s start by contrasting it with individuals who DO collect Social Security before they become eligible for Medicare insurance: first of all, they’ll be automatically enrolled into Medicare Parts A & B, starting the month in which they turn 65. Second, before they even turn 65, they will be mailed a Medicare ID card noting their Medicare ID number and their Part A & B start date. Third, their Medicare Part B premium of $185/ month is automatically deducted from their Social Security Benefit.

You’ll notice that all of this happens automatically, so generally the process to sign up for Medicare insurance isn’t as complex if you are already collecting Social Security.

So back to your situation, if you are not collecting Social Security, but you are eligible for Medicare insurance, you will NOT be automatically enrolled in Medicare Part A or B, so you’ll need to take certain steps to actively enroll in the parts of Medicare insurance that best fit your needs. Once you add Part B, you will need to pay a premium to keep it active, and again it will NOT be an automatic deduction. You pay your Part B Premium using a quarterly bill that you’ll receive, known as the CMS-500.

The normal quarterly bill amount will be $555 – the normal $185 Part B Premium, times 3 months. Sometimes the bill that individuals receive is higher than $555. This can be for three reasons: first, your quarterly bill is determined by when your birthday month falls, so you may be billed for four months instead of three ($185 X 4= $740). This would only happen on your first bill, to get you on the normal quarterly billing schedule.

The second reason you might be billed more would be that your income is high according to the IRS. This higher Medicare Part B premium is called an IRMAA (Income Related Monthly Adjustment Amount) and is based on your income on your tax returns two years before adding Medicare – so the 2025 IRMAA is based on your 2023 tax returns. With an IRMAA, your Medicare Part B premium could be between $259 and $628.90 per month. And, because you’d have a higher monthly premium, your quarterly bill will be higher to reflect this. Keep in mind, if you feel your income has reduced enough that you’d no longer owe an IRMAA or it should be reduced, you can request an adjustment of your IRMAA from your local Social Security Administration office. This can be based on more recent tax returns or a Life Changing Event, i.e. retirement, death of a spouse, remarriage, etc.

The third reason your bill might be high is that you enrolled in Medicare Part B late, after you first became eligible, and you have a Late Enrollment Penalty (LEP). An LEP is based on the number of months you were late with your enrollment. It increases your monthly Part B premium by 10% for each full, consecutive 12-month period you were late to your enrollment.

Returning to how to pay your Part B Premium, you can always send a check each quarter. However, you can use the info provided with your Part B premium bill to set up an automatic payment, like an Electronic Funds Transfer (EFT) or auto-pay with a credit card. You can also use your secure MyMedicare.gov account to pay this bill via credit card or debit card.

Should you decide to start collecting Social Security, your Part B premium WILL automatically begin to get deducted from your monthly Benefit. At that point, you’ll stop getting a bill. Still, note that the premium will be taken out of your Social Security BEFORE it is deposited into your account.

I’ll stress that YOU SHOULD NOT PAY YOUR PART B PREMIUM BILL LATE. The amount is certainly high, but it covers a three-month period, so it is less frequent than normal monthly bills. Remember that you can find lots of information about this bill and other Medicare topics on the www.Medicare.gov website.

At Lawley Medicare Solutions, our Medicare and Individual Health Consultants are dedicated to helping you make the most informed decisions about your healthcare needs. We offer personalized service and expert advice tailored to your unique situation. Contact us today by phone or email to schedule a consultation and ensure you’re getting the best coverage for your needs.

Read all Inside Medicare articles HERE.

LAWLEY HAS A TEAM DEDICATED TO MEDICARE INSURANCE!

Our licensed Medicare & Individual Health Insurance team can help clients understand the details of Medicare insurance plans, assist with choosing the right benefits and coverage, and provide guidance when life events that affect health coverage occur. For questions, concerns, or to reach Lawley Medicare Solutions, call 716.849.8223.