Know who to call when: SSA and Medicare

Government agencies can help you best when you have specific questions

By Heather Drago, Ohio Public Employees Retirement System

April 23, 2019 – The Social Security Administration and Medicare are subject matter experts in their field, just like us. They also share a common link – the Centers for Medicare and Medicaid Services. Medicare is managed by CMS, and Social Security partners with CMS by enrolling people in Medicare.

To get the customer service you want, it’s important to call the right place to get the right information when you need it. Let’s explore.

Social Security

You can contact SSA to do any of the following:

  • Understand if you are eligible for Medicare.
  • Sign up for Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).
  • Apply for the Low-Income Subsidy “Extra Help” with Medicare Part D prescription drug costs.
  • Appeal an Income-Related Monthly Adjustment Amount decision — this is for those who pay a higher Medicare Part B and/or Medicare Part D premium if income is over a certain threshold.
  • Report a death.

Social Security also has an online portal for communicating if that’s more your cup of tea. If you haven’t signed up, go to SSA.gov and create a My Social Security online account. The online portal can be used to request a replacement Medicare card or report a change of address, name or phone number to name a few. Learn more about Medicare benefits through the Social Security Administration.

Medicare

If you’re looking ahead or have already reached Medicare eligibility, Medicare can help you understand what services are covered. The organization can also provide information on how to set up a trusted individual to speak on your behalf as well as connect you to resources such as forms for filing a Medicare appeal.

Retirees enrolled in both Medicare Parts A and B can enroll in supplemental insurance — a Medigap (Medicare supplement) or Medicare Advantage plan and Medicare D prescription drug plan — through Via Benefits. Via Benefits not only helps with enrollment but is your advocate throughout the year. They are available online at my.viabenefits.com/opers or by calling 844-287-9945 and can assist you with the following:

  • Resolving concerns with your current insurance provider
  • Answering questions about your medical or prescription drug plan
  • Accessing and understanding reimbursement requests, Explanation of Benefits statements, copays, coinsurance and more

Upon enrolling in a medical plan through Via Benefits, you’ll receive a monthly Health Reimbursement Arrangement allowance that can be used to seek reimbursements for eligible medical expenses as defined by IRS Publication 502. Such expenses may include Medicare premiums; medical, dental and vision premiums; copays, coinsurance and deductibles; and prescription medications. For additional information about Medicare, visit Medicare.gov.

Heather Drago

Heather Drago is a health care communications specialist with the Ohio Public Employees Retirement System. She breaks down health care topics into clear, concise, consumable messaging for our retirees. When she’s not blogging, Heather composes content for OPERS print publications, the OPERS website and internal employee communications.

Heather Drago

Health Care Communication Specialist

2 thoughts on “Know who to call when: SSA and Medicare

  • May 1, 2019 at 11:23 am
    Permalink

    Recently in the past few months,it was posted about a bill to alter the G.O.P.Which reduced the amount of social security we received from social security what ever happen to it?Was it passed or not?if passed when does it take effect? Thank You

    Reply
    • May 3, 2019 at 11:37 am
      Permalink

      Danny,

      OPERS believes the WEP and GPO negatively impact our retirees and should be addressed. We follow this process every year and stand ready to work with interested parties to develop a solution that works best for all of our members.

      Last year’s bill, which would have changed the way the WEP is calculated, did not advance before the last Congress ended. It has not been reintroduced. A full repeal bill has been introduced this session, but this type of proposal is introduced every session without success.

      –Ohio PERS

      Reply

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