How do I apply for Medicare death benefits?

Just the essentials...
  • Medicare death benefits not cover funeral expenses in full, but they might cover some of the costs
  • Medicare death benefits and social security benefits are not the same thing
  • Medicare death benefits apply to people who are over age 65
  • You can’t apply for Medicare death benefits online, so you’ll have to visit your local Medicare office

Loss of a family member might cripple the financial situation in the family especially if the deceased was the family’s breadwinner. Medicare death benefits pay a lump sum for the deceased who has paid Medicare taxes for more than ten years or has attained the age of 65 and above.

The SSA (Social Security Administration) pays the funds to the surviving spouses or the children who meet the eligibility criteria for the plan.

Medicare death benefits do not pay out for the entire funeral expenses, but they may pay a small amount of money to help in covering some funeral-related costs.

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Differences between Medicare Death Benefits and Social Security

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People tend to generalize Social Security and Medicare death benefits and take them as the same, but there are some differences between the two. However, most of the elderly in America receive the two simultaneously.

Retirees who have worked for 10 years and above and paid the Social Security taxes earn the Social Security benefits, while the Medicare benefits apply to the retirees who have acquired 65 years of age and above.

Social Security Administration (SSA) manages the functions of the two programs. This means that anyone enrolled into the Social Security Benefits gets an enrollment automatically into the Medicare program after attaining 65 years of age.

Eligibility for the Medicare Death Benefits

The insurance companies use the following criteria to determine the spouses and children eligible for the Medicare death benefits:

  • The remaining spouse should be over 60 years of age.
  • A disabled spouse who has reached 50 years.
  • Children who are under 18 years.
  • A surviving spouse caring for the deceased’s child who is disabled or under 16 years of age.
  • Any child with a disability as long as it began before 22 years.
  • Parents over 62 years who depended on the deceased support.

Documents Required During Application for the Medicare Death Benefits

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The Medicare death benefits only apply from the time of application and not when the worker dies. Therefore, it is important to make an application as soon as possible.

The application is not available online, and a survivor would require visiting the nearest Medicare office. One is bound to provide the following information during the application to prove their eligibility:

  • A certified evidence of death- this may be from a funeral home or a death certificate.
  • A proof of birth through the use birth certificate.
  • Proof of United States Citizenship or the lawful alien status for the immigrants.
  • W-2 forms or the tax returns for the previous year.
  • U.S military discharge papers (this applies to the ones who were in the army before 1968).

Completion of Paperwork

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Before the compensations, the company completes some information from the survivors that may include the name, gender, and the social security number of the deceased. They may also ask about the time and place of death, and the records of the Social Security benefits in case of any.

Other information includes the beneficiaries name and social security number, and details about the deceased spouse and children. They may also want to know about the deceased earnings during the time of death and the previous years and whether he was ever active in the military.

The beneficiary should also have the papers showing your account number or a credit union.

The Nature of the Medicare Death Benefits

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The insurance company stops the Medicare payments following the demise of a loved one. That marks the beginning of the Medicare death benefits. If the deceased leaves some unpaid medical bills, the Medicare sorts out 80 percent of the total bill as agreed in the insurance plan and the recipient’s estate pays the remaining amount.

If there are no compensations from the insurance company, the estate, child, or spouse who covered the cost may file a separate claim to receive the funds. The payment of the Medicare death benefits depends on whether there were unsettled bills or not.

Lump- Sum Cash Payment

All people enrolled in the Medicare Health plan qualify for the lump- sum cash payment. The amount received depends on the working record for beneficiaries of the Social Security and the Medicare program.

The eligible survivor (the deceased spouse or child) receives a one-time payment of $225. The beneficiaries who had the Social Security health care benefits before joining the Medicare health plan are eligible for the monthly payments of up to half the original insured amount. There is a two-year limit for the application of the lump sum death benefit.

The Benefits Earned

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What the beneficiaries get the basic benefit amount depends on the age of the surviving spouse. The spouse who has attained the full retirement age gets 100 percent of the funds designated as the worker’s benefits. The partner who is 60 years and older and at full retirement age gets between 72 and 90 percent.

The dependent parents at the age of 62 and above acquire 75 percent of the worker’s basic benefit amount for each parent and 83 percent for one parent. The disabled children under the age of 22 receive 75 percent, as well as a spouse taking care of a child under the age of 16.

Appealing for the Denial of Benefits

Sometimes, the Medicare plan may deny eligible person compensations due to one reason or another. He or she should write an appeal within 60 days of receiving the notification from the SSA.

Failure to appeal within the stipulated time leads to the closure of the beneficiaries claims. Appealing takes place on four levels that include:

  • Reconsideration by a social security worker
  • Hearing before a judge
  • Consideration by the Washington Dc’s Social Security Administration Appeal Council
  • Review by the Federal Court

Important Things to do After the Demise of a Loved One

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  • Notifying SSA team about the death of a beneficiary or make a visit to their offices.
  • Make a call to the bank or the financial institutions where the direct payments came from and request the return of funds to the SSA
  • Do not cash any check that was received a month before the demise and return it to SSA.

Medicare Death Benefits and Funeral Coverage

As stated earlier the Medicare medical coverage does not cater for the funeral costs and burial expenses. However, the insured may set up a Medicare Medical Savings Account that allows the channeling of unused funds to cover the funeral expenses.

The program covers for the healthcare plans, and the very advanced ones allow one to designate a beneficiary, who gets the funds after their demise.

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