Level 3, Course 4: Medicare Late Enrollment Penalties and ...



Online SHIP Counselor TrainingLevel 3, Course 4: Medicare Late Enrollment Penalties and IRMAASlide 1: Title slideHello and welcome to the final course in Level 3 of the Online SHIP Counselor Training core curriculum: Medicare Late Enrollment Penalties and Income-Related Monthly Adjustment Amounts (IRMAA). Remember, you can pause this course at any time and review any part of it at your convenience. Feel free to take the Course 4 quiz after this course to review what you learned. Each course also includes supplementary materials and a case study that you can use to augment and reinforce key concepts. Now, let’s begin. Slide 2: Learning objectives After taking this course, you will be able to:One: Explain Medicare late enrollment penaltiesTwo: Identify situations when a beneficiary would incur a late enrollment penaltyThree: Advise beneficiaries about strategies for avoiding and eliminating late enrollment penaltiesFour: Talk about income-related monthly adjustment amounts (IRMAA)Slide 3: Late enrollment penalties We will begin by discussing late enrollment penalties, which are the amount a beneficiary pays in addition to their monthly premium if they did not sign up for Medicare when they were first eligible and were not covered by certain types of current employer coverage. Late enrollment penalties can apply for Part A, Part B, and Part D. These penalties must be paid in addition to the monthly premium in order to maintain coverage. A beneficiary could have a late enrollment penalty if they did not sign up for Medicare during their Initial Enrollment Period or within eight months of losing certain types of employer coverage. A beneficiary could also have a late enrollment penalty if they were without creditable drug coverage for more than 63 days. If a beneficiary receives Social Security payments, late enrollment penalties may be deducted from their monthly payments in addition to any Medicare premiums that are also deducted. Beneficiaries can also be billed the penalty amount directly if they do not receive Social Security payments yet, or if they do receive Social Security payments, but the payments do not cover the combined cost of the premium and late enrollment penalty. Beneficiaries can also request to pay the penalty amount directly. Medicare sets certain enrollment periods for beneficiaries to sign up for Medicare for the first time. If a beneficiary misses one of these enrollment periods, they may face a late enrollment penalty. They may also face gaps in health and/or drug coverage, since individuals who have delayed Medicare enrollment often have to wait before their Medicare coverage takes effect.These first-time enrollment periods are different depending on if a beneficiary is signing up for Parts A and B or Part D for the first time.To avoid a Part A or B late enrollment penalty, a beneficiary usually must sign up during their Initial Enrollment Period (IEP), or within eight months of losing current employer coverage. This is the Part B Special Enrollment Period you learned about in Level 1, Course 4: Medicare Enrollment Periods. A beneficiary can also avoid a Part A or B late enrollment penalty by signing up for Medicare for the first time during the General Enrollment Period within 12 months of their 65th birthday. To avoid a Part D late enrollment penalty, a beneficiary must sign up for Part D during their Initial Enrollment Period, or within 63 days of losing creditable drug coverage. You will learn more about how current employer insurance and creditable drug coverage affect Medicare enrollment in Level 4: Other Insurance and Assistance Programs. For now, it is important to understand that in general, late enrollment penalties are assessed for beneficiaries who do not enroll in Medicare when they are first eligible to do so. Slide 4: Part A late enrollment penaltyLate enrollment penalties apply to each part of Medicare, meaning a beneficiary may have to pay a late enrollment penalty for delaying enrollment in Medicare Parts A, B, or D.First, let’s learn more about late enrollment penalties for Part A, which only apply to beneficiaries who do not have sufficient work history to qualify for premium-free Part A. Although most beneficiaries qualify for premium-free Part A, some beneficiaries may not qualify if they have not worked at least 10 years, or 40 quarters, in the United States. Individuals who do have to pay a premium to have Part A and delay Part A enrollment will be subject to the Part A late enrollment penalty. How is it calculated? The Part A penalty is 10% of the Part A premium after the first 12-month period that a beneficiary did not sign up for Part A or have certain types of current employer coverage. The Part A penalty is capped at 10%, meaning that regardless of how long an individual delayed Part A enrollment, their premium will only increase by ten percent. The 10% penalty is based on the yearly-determined Original Medicare Part A premium and is subject to change each year. How long does it last? If a Medicare-eligible individual delays Part A enrollment, they will have to pay the penalty for twice the number of years that they were eligible for Part A but did not sign up. For example, if a Medicare-eligible individual delays enrollment for two years, they will have to pay a Part A penalty in addition to the Part A premium for four years. After four years, the penalty goes away, and they only have to pay the Part A premium to have Part A coverage.Remember, most beneficiaries are entitled to premium-free Part A, and can sign up for Part A at any time without penalty. Additionally, individuals who already collect Social Security Retirement Benefits are automatically enrolled in premium-free Part A. If not automatically enrolled, many individuals sign up when they are first eligible for Medicare because they do not have to pay anything for the coverage. You can review the difference between active and passive Medicare enrollment in Level 1: Medicare Basics. Note that if an individual gets Part A after turning 65 years old and is entitled to premium-free Part A, then Part A coverage is retroactive for up to 6 months. Individuals who do not sign up for premium Part A during their Initial Enrollment Period can do so during the General Enrollment Period, which runs January 1 through March 31 of each year. Part A coverage will begin July 1 of that same year. For individuals with special circumstances relating to work and other factors, a Special Enrollment Period may apply instead of the General Enrollment Period. The Special Enrollment Periods chart in the supplementary materials section provides more information about these circumstances. Slide 5: Part B late enrollment penaltyNext let’s discuss Part B late enrollment penalties. Individuals may delay Part B enrollment for a number of reasons. Some people do not want to pay the monthly Part B premium, while those who are not automatically enrolled may not realize that they are supposed to sign up for Part B. In other cases, an individual may delay Part B enrollment because they misunderstand how their retiree or other insurance works with Medicare. You will learn more about the considerations for delaying enrollment in Level 4: Other Insurance and Assistance Programs. For now, it is important to understand that there are various reasons an individual may decide not to enroll in Part B. How is it calculated? The Part B penalty is 10% of the Part B premium for each 12-month period an individual did not sign up for Part B or have certain types of current employer coverage. Unlike the Part A premium penalty, the Part B premium penalty is not capped at 10%. An individual who delays Part B enrollment for five years will pay 50% of the Part B premium in addition to their monthly premium. The Part B penalty is based on the yearly-determined Original Medicare Part B premium and is subject to change each year.How long does it last? A key difference between the Part A and Part B late enrollment penalty is their length. Unlike Part A, Part B late enrollment penalties have different durations depending on whether an individual is eligible for Medicare because they have been receiving Social Security Disability Insurance (SSDI) for more than 24 months, or because they are 65 years or older.If an individual becomes eligible for Medicare due to disability and delays enrolling in Medicare Part B, they will have to pay the Part B premium penalty until they turn 65 and become eligible for Medicare due to age. When they turn 65, the penalty goes away, and they will only have to pay the Part B premium. On the other hand, if an individual becomes eligible for Medicare due to age and delays signing up for Part B, they will have to pay the Part B premium penalty for the rest of their life. Later in the course we will explore two ways that this lifetime penalty can be eliminated. Individuals who have not signed up for Part B can do so during the General Enrollment Period, which runs January 1 through March 31 of each year. Part B coverage will begin July 1 of that same year. For individuals with special circumstances relating to work and other factors, a Special Enrollment Period may apply instead of the General Enrollment Period. The Special Enrollment Periods chart in the supplementary materials section provides more information about these circumstances.Slide 6: Part D late enrollment penaltyLastly, let’s explore Part D enrollment penalties. How is it calculated? Individuals who delay signing up for Part D will have to pay 1% of the Part D premium for each month they did not have Part D coverage or creditable drug coverage. As with the Parts A and B premiums, the Part D penalty is based on the yearly-determined average Part D premium and is subject to change each year.How long does it last? Like Part B penalties, Part D late enrollment penalties have different durations depending on whether an individual qualifies for Medicare due to disability or age.If an individual becomes eligible for Medicare due to disability and does not have a Part D plan or creditable drug coverage, they will have to pay the Part D penalty on top of their Part D premium until they turn 65. When they turn 65 the penalty goes away, and they will only have to pay the Part D premium. On the other hand, if an individual is eligible for Medicare due to age, delays signing up for a Part D plan, and does not have creditable drug coverage, they will have to pay the Part D penalty on top of their Part D premium for the rest of their life. In this course, as with other courses, we mention creditable drug coverage. This is drug coverage that is as good as or better than the baseline coverage offered through Medicare Part D, based on an actuarial analysis. This doesn’t mean that the coverage is the same as that offered under any particular drug plan but that the expected coverage is equivalent. Beneficiaries could have creditable drug coverage through their current employer coverage, retiree plan, or other source. If a beneficiary has creditable drug coverage, they can delay Part D enrollment without penalty. Beneficiaries should receive written notice from their plan each year about whether it is creditable or continues to be creditable. They should keep this information for their records. If they do not receive notice, they should contact their plan or benefits administrator to find out. An individual cannot tell if a plan is creditable simply based on whether it covers certain drugs, or has larger or smaller deductible and cost-sharing amounts than a particular Part D plan—they must receive confirmation of creditability from the plan.Individuals are eligible to sign up for Part D once they have enrolled in either Part A or Part B. If an individual signs up for Medicare during their Initial Enrollment Period, they can sign up for Part D at that time. An individual can also sign up for Part D during the Fall Open Enrollment Period, which spans October 15 through December 7 of each year. Part D coverage will take effect January 1 of the following year.If an individual signs up for Part B during the General Enrollment Period because they delayed Part B enrollment, then they can sign up for Part D from April 1 through June 30, and their Part D coverage will take effect July 1 of that same year.Slide 7: Counseling strategy: Equitable reliefNow that we have introduced Part A, B, and D late enrollment penalties, let’s talk about two strategies that SHIP counselors can use to help beneficiaries possibly eliminate late enrollment penalties. First, counselors can help beneficiaries in certain circumstances request equitable relief from Social Security. Second, counselors can help lower-income beneficiaries enroll in an assistance program that helps pay Medicare costs, such as a Medicare Savings Program (MSP) or the Extra Help drug subsidy. We will learn more about these specific programs in Level 4: Other Insurance and Assistance Programs. Let’s learn about equitable relief.Equitable relief is an administrative process that allows people with Medicare to request the following from Social Security:Immediate or retroactive Medicare enrollment andElimination of the Part B premium penalty Beneficiaries must meet certain requirements in order to request equitable relief. They must have failed to enroll in Medicare owing to error, misrepresentation, or inaction of a federal employee. For example, if a beneficiary did not sign up for Medicare Part B when first eligible to do so because a Social Security or 1-800-MEDICARE representative said they did not need to sign up, they may have grounds for requesting equitable relief. For this reason, it is extremely important that beneficiaries take down the name of any representative they speak to, the date and time in which they speak to the representative, and the outcome of the conversation any time they speak to a Medicare or other government agency representative. Having these records can add validity to a case and act as evidence that the beneficiary was misinformed by a government employee. Remember, equitable relief does not apply if an individual was misinformed about their Medicare enrollment options by their employer, their insurance plan, or anyone other than a government employee.To request equitable relief, a beneficiary should write a letter to their local Social Security office explaining that they received misinformation that caused them to delay enrollment. They should be as specific as possible in their letter, including the name of the representative, the date and time of the call, and the outcome of the conversation. The beneficiary also needs to indicate whether they just want coverage going forward or if they would like retroactive coverage. If a beneficiary requests retroactive coverage, they will have to pay premiums back to the time that the retroactive coverage begins. In either of these cases, the beneficiary must also note in their request that they wish for their late enrollment penalty to be eliminated. As we previously noted, beneficiaries should always keep copies of the documents they send to Social Security, as well as any documents they receive, and take good notes when speaking to various representatives.Social Security is not required to respond to the request for equitable relief within any set timeframe. They are also not obligated to send beneficiaries a formal decision letter in response to the request. As such, beneficiaries should follow up with their local Social Security office one month after submitting their request. Beneficiaries may also want to contact a federal representative, such as a representative or senator, and ask them to follow up on the case for them. If beneficiaries are denied equitable relief, there is no formal appeals process for higher levels of review, but they can resubmit the request with more or different information as many times as they wish. Take a look at the equitable relief flier in the supplementary materials section for a sample letter a beneficiary or their counselor could use to draft an equitable relief request to Social Security. Slide 8: Counseling strategy: Assistance programsAnother way that an individual can eliminate Medicare late enrollment penalties is to enroll in an assistance program that helps pay Medicare costs. The assistance programs on this slide can help waive these penalties. We will describe these programs in more detail in Level 4: Other Insurance and Assistance Programs. For now, just know that if a beneficiary qualifies for one of the following assistance programs, they will no longer have a late enrollment penalty. The first type of assistance program is called the Medicare Savings Program, or MSP. There are three different types of MSP, and they are administered by the state Medicaid program. In addition to helping pay Medicare health costs, such as Medicare premiums, MSPs can eliminate Part A and Part B penalties. Keep in mind, however, that these programs vary by state. Only one, the Qualified Medicare Beneficiary (QMB) program, will help individuals enroll in premium Part A outside of an enrollment period and eliminate the Part A penalty. However, all three MSPs will eliminate the Part B late enrollment penalty, and allow the beneficiary to enroll in Part B outside of enrollment periods. A second Medicare cost-assistance benefit is Extra Help, the federal program that helps pay Medicare prescription drug costs. In addition to paying Medicare drug costs, such as deductibles and copays, Extra Help can eliminate the Part D late enrollment penalty. Since Extra Help is a federal program administered by Social Security, the eligibility rules and guidelines are the same throughout the U.S. In addition, Extra Help allows individuals to enroll in a Part D plan outside the Fall Open Enrollment period. This means that those who qualify for Extra Help do not have to wait until a specific enrollment period to enroll in and get Medicare prescription drug coverage. Remember, MSP and Extra Help eligibility is based on income and in some cases assets. We will learn more about MSP and Extra Help eligibility guidelines, enrollment and benefits in Level 4: Other Insurance and Assistance Programs. For now, know that enrollment in an MSP can eliminate Part A and B penalties, and enrollment in Extra Help can eliminate Part D penalties. Slide 9: Case example: Late enrollment penaltyBefore moving on to the second half of this course, let’s review a case example to illustrate what we just learned.Hiroshi first signed up for Original Medicare Parts A and B, as well as a Part D plan, when he turned 65 years old a few years ago. He disenrolled from his Part D plan a few months later because he did not want to pay for a Part D plan when he was not taking any drugs. Last month, Hiroshi’s doctor prescribed him a blood pressure medication. Now Hiroshi realizes that he needs drug coverage, since he does not have Part D or any other drug insurance.The question is: Can Hiroshi sign up for a stand-alone Part D plan at any time?The answer is no. Hiroshi will have to wait until Fall Open Enrollment to sign up for a stand-alone Part D plan. Fall Open Enrollment, which spans October 15 through December 7 of each year, is when anyone eligible can sign up for a Part D plan. Hiroshi’s Part D coverage will begin January 1 of the following year. In addition, Hiroshi will have a Part D late enrollment penalty for each month he was eligible for Part D but did not have either Part D coverage or creditable drug coverage. He will have to pay the Part D Late Enrollment Penalty, in addition to his monthly Part D premium, when his drug coverage takes effect. Hiroshi should apply for Extra Help, the federal assistance program that helps pay Medicare prescription drug costs. If Hiroshi is eligible for and enrolled in Extra Help, he will be entitled to sign up for a Part D plan immediately. Extra Help will also eliminate Hiroshi’s Part D late enrollment penalty, and would pay for some of his prescription drug costs. You will learn more about Extra Help in Level 4: Other Insurance and Assistance ProgramsSlide 10: IRMAAIn the second part of this course, we will learn more about the Medicare Income-Related Monthly Adjustment Amount, or IRMAA. IRMAA is an amount that beneficiaries pay in addition to their Medicare Part B and/or Part D premiums if their income is above a certain level. It affects less than 5% of beneficiaries. For most beneficiaries, the government pays for 75% of the total cost of Part B, and the beneficiary’s Part B premium is the remaining 25 percent. Beneficiaries who pay an IRMAA pay a higher percentage of the total cost of Part B, depending on their income. Social Security sets four income brackets that determine an individual’s or couple’s IRMAA. The supplementary materials section contains information about these income brackets and corresponding IRMAA. Beneficiaries only have to start paying IRMAA once they have signed up for Medicare Part B and/or Part D and their coverage takes effect. For example, let’s say a beneficiary signs up for Medicare Part B during their Initial Enrollment Period. They have creditable retiree drug coverage and therefore know that they can delay enrollment into a Part D plan without penalty. If Social Security finds that their income is high enough and determines that they have to pay IRMAA, they will tell the beneficiary that as soon as their Part B coverage takes effect, they will have to pay IRMAA for Part B, in addition to their monthly Part B premiums. The beneficiary should not have to pay Part D IRMAA, since they did not sign up for a Part D plan.Social Security determines if an individual owes an IRMAA based on the income that they reported on their IRS tax return two years prior, meaning two years before the year that the beneficiary starts paying IRMAA. For example, Social Security would use tax returns from 2014 to determine the IRMAA for 2016. Social Security looks at beneficiaries’ Modified Adjusted Gross Income, or MAGI, which is adjusted gross income as defined by the Internal Revenue Code, in addition to tax-exempt interest income. The amount of MAGI that triggers IRMAA depends on a person’s tax filing status. Tax filing status can be single, married filing jointly, or married filing separately. The takeaway point is that Social Security uses income reported on the tax return from two years ago to determine whether beneficiaries have to pay IRMAA for Parts B and/or D, and what the amount of the IRMAA will be.If Social Security determines that a beneficiary should pay IRMAA, they will mail the beneficiary a notice called an “initial determination.” We will talk more about this notice in a few minutes.IRMAA may be deducted from a beneficiary’s Social Security check if they receive Social Security checks. Beneficiaries may also be billed this amount if the IRMAA amount is more than their Social Security check.There are a few things to keep in mind about IRMAA.First, there are consequences if beneficiaries do not pay IRMAA when they are expected to do so:Beneficiaries may be involuntarily disenrolled from Medicare Part B if they do not pay their Part B IRMAA, and disenrolled from their Part D plan if they do not pay their Part D IRMAA. Once disenrolled, beneficiaries may also have to wait to re-enroll into Medicare Part B and/or Part D during a specific enrollment period and experience gaps in coverage and possible premium penalties as a resultHowever, beneficiaries can request a recalculation of Social Security’s IRMAA determination if they experience what’s called a life-changing event or if they do not agree with Social Security’s decision and want to appeal it.Slide 11: Counseling strategy: Request a new initial determinationThere are a few strategies that SHIP counselors can use to eliminate or decrease a beneficiary’s Part B or Part D IRMAA. Depending on the situation, a beneficiary can either request a new initial determination, or appeal Social Security’s decision. First we will talk about requesting a new initial determination. As noted earlier, if Social Security determines that a beneficiary should pay IRMAA, they will mail the beneficiary a notice called an “initial determination.” This notice should indicate the IRMAA the beneficiary has to pay, the income used to make the determination, and the day the beneficiary is expected to start paying. The notice should also provide information about how to request a new initial determination. How to request a new initial determination:A new initial determination is a revised decision that Social Security makes regarding IRMAA. Beneficiaries can request a new initial determination if they have experienced what Social Security considers to be a life-changing event that causes an income decrease, or if they feel that the income information Social Security used to determine the IRMAA was incorrect or outdated. Requesting a new initial determination is not considered appealing Social Security’s initial IRMAA decision. Requesting a new initial determination and appealing the IRMAA decision are two different processes. Requesting a new initial determination only applies under the circumstances we just mentioned. The first circumstance for requesting a new initial determination is a life-changing event. Social Security considers any of the following situations to be life-changing events:The death of a spouseMarriageDivorce or annulment The beneficiary or spouse stops working or reduces the hours they work Involuntary loss of income-producing property due to a natural disaster, disease, fraud, or other circumstancesLoss of pensionReceipt of settlement payment from a current or former employer due to the employer’s closure or bankruptcySocial Security will only consider an experience to be a life-changing event if it decreases a beneficiary’s income compared to the amount on the tax return from two years prior. Social Security will not consider events that affect expenses, such as higher living expenses or higher medical expenses. If a beneficiary has experienced a life-changing event, they can submit an IRMAA Life-Changing Event Form to Social Security, or schedule an interview with their local Social Security office. You or a beneficiary can find this form and related instructions online at online or request that a copy of the form be mailed by calling Social Security at 800-772-1213. Beneficiaries should be prepared to include with their IRMAA Life-Changing Event Form documentation that serves as evidence of the life-changing event, such as a letter from their employer if they have lost their job.A second way beneficiaries can request a new initial determination from Social Security is if they find that the IRS made an error in the tax year that was used to determine IRMAA, or if they would like Social Security use a more recent year’s tax return information to make the IRMAA determination. In cases like these, beneficiaries should first contact the Social Security Administration, and a representative will provide them with information about how to request the correct income information from the IRS and what specific documentation is needed to process the redetermination. Then the beneficiary should obtain the correct information from the IRS and share this information with Social Security. Note that Social Security considers it the beneficiary’s responsibility to obtain the correct income information from the IRS. Remember, requesting a new initial determination from Social Security is different from appealing the initial IRMAA decision, which we will talk about on the next slide. Slide 12: Counseling strategy: Appealing an IRMAA decisionIf a beneficiary does not qualify to request a new initial determination, but still disagrees with Social Security’s IRMAA decision, they have the right to appeal. Note that if a beneficiary requests a reconsideration solely because they experience a life-changing event or if they believe the IRS information that SSA used was incorrect, SSA will most likely dismiss the appeal. Instead, SSA will notify the beneficiary of their right to request a new initial determination. A beneficiary can only start an appeal if their circumstances do not allow them to request a new initial determination.Requesting a reconsideration from Social Security is typically the first step in the Social Security appeal process, after the beneficiary has received the IRMAA initial determination notice. To request a reconsideration, the beneficiary should follow directions on their initial determination notice. The notice should tell beneficiaries that they can request a reconsideration by completing and submitting a Request for Reconsideration Form to Social Security. You or a beneficiary can find the form online at online or request a copy by calling the national Social Security hotline at 800-772-1213. Alternatively, a beneficiary can also contact their local Social Security office to request a reconsideration and start an appeal.Beneficiaries need to submit their Request for Reconsideration Form within the timeframe specified on the initial determination notice they receive. A beneficiary can send a late request to Social Security as long there is good cause. Similar to the good cause extension we discussed in the appeal courses, good cause may exist if the beneficiary was seriously ill, if there was a death or serious illness in the immediate family, if the beneficiary did not receive their initial determination notice, or if they were unable to find the necessary evidence to support their request in time. These are just some examples of circumstances when good cause may exist. Beneficiaries should keep copies of any documents they send to and receive from Social Security and take notes during any conversations with government representatives. Slide 13: Case example: Higher premium costsNow that we have learned about IRMAA, let’s review a case example.Yvette and her husband received a notice in the mail saying that they need to pay an IRMAA for Medicare Part B and Part D. Yvette’s husband lost his job a few months ago, and they are unable to pay their Part B and Part D IRMAAs.The question is: What can Yvette and her husband do?Yvette and her husband can fill out a Medicare IRMAA Life-Changing Event form in order to receive a new initial determination from Social Security that takes into account their new income. Yvette and her husband must fill out their own separate IRMAA Life-Changing Event forms. They can call Social Security to get this form or download it online at . Alternatively, they can schedule an interview with their local Social Security office to inform a local representative of their life-changing event and resultant change in income. Regardless of whether they submit the form to Social Security or speak to their local Social Security office, they should show documentation related to their life-changing event. In this case, it would be helpful for Yvette and her husband to present information such as a letter from the husband’s former employer indicating termination of his job. Slide 14: What you have learnedThis concludes Course 4: Late Enrollment Penalties and IRMAA in Level 3 of the Online SHIP Counselor Training core curriculum.In this course, we reviewed Medicare late enrollment penalties.These penalties are costs beneficiaries pay on top of their monthly premium in order to maintain Medicare coverage. Beneficiaries pay these late enrollment penalties if they did not enroll in Medicare Parts A, B, and/or D when they were first eligible to do so. Beneficiaries may be able to eliminate these penalties by requesting equitable relief from Social Security or by enrolling into assistance programs that help pay Medicare costs.In addition to late enrollment penalties, we introduced the Income-Related Monthly Adjustment Amount or IRMAA.This is a cost that certain beneficiaries pay on top of their monthly premium in order to maintain Medicare coverage. Beneficiaries must pay IRMAA if they meet higher incomes standardsIf beneficiaries disagree with Social Security’s IRMAA decision, they can either request a new initial determination based on a life-changing event that causes an income decrease or the belief that the IRS made a mistake, or they can appeal the decision. The important thing to remember is that there are strategies SHIP counselors can employ to help beneficiaries eliminate late enrollment penalties and IRMAA. Slide 15: End slide Thank you for your attention throughout this course. Remember that you can always go back to review course information at any time. Please feel free to take a look at the supplementary materials section for helpful handouts and fliers that will enrich your Medicare learning. You can also take the short quiz for this course to help you review and practice the Medicare information you just learned. ................
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