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Who Qualifies for Medicare Premium Refund and How To Get It?

After a Medicare policyholder dies, family members or a personal representative may be eligible to receive a Medicare premium refund on their behalf. This usually occurs when the policyholder paid an excess amount of Medicare premium or if payments are still being made after they’ve passed.

Key takeaways:

What is a Medicare Premium refund?

Generally speaking, a Medicare premium refund is when a Medicare beneficiary dies and their family members continue to pay their premium costs, or they had overpaid their premium costs prior to dying. This results in an overpayment. Surviving family members or personal representatives can make a request to receive a refund for this money.

An overpayment could also occur if the Medicare beneficiary received any Social Security benefits while alive. Oftentimes payment for Medicare coverage is taken out of your Social Security benefits in advance. This means if the policyholder passed away in July, the Social Security benefit they received that same month already includes the deducted Medicare premium cost from their benefit that applies to the month of August.

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Who qualifies for a Medicare Premium refund?

There are two main parties that typically qualify to receive a Medicare premium refund—a family member or a legal representative. In the event that you, as a spouse or family member, were making payments toward any medical benefits through the deceased’s Medicare plan, you may be able to submit a request and receive a refund of the premium costs that you continued to pay after the policyholder died.

You may also receive a refund for costs the policyholder had made prior to their death. Medicare beneficiaries may also have assigned a personal or legal representative to work on their behalf, and they too may also be eligible for receiving a premium refund.

Note
Refunds can be made as a Social Security payment and/or a Medicare premium refund, depending on the specific circumstances. Each method of refund may be paid out differently, usually in this order.

Social Security payment refund order:

  1. The surviving spouse who lived with the deceased or was entitled to a monthly benefit during the month of the death.
  2. Children who were entitled to a monthly benefit during the month of the death.
  3. Parents who were entitled to a monthly benefit during the month of the death.
  4. A surviving spouse who does not meet the requirements of 1.
  5. Children who do not meet the requirements of 2.
  6. Parents who do not meet the requirements of 3.
  7. A legal representative of the deceased beneficiary’s estate.

Medicare premium refund order:

  1. A legal representative of the deceased beneficiary’s estate.
  2. The surviving spouse who lived with the deceased or was entitled to a monthly benefit during the month of the death.
  3. Children who were entitled to a monthly benefit during the month of the death.
  4. Parents who were entitled to a monthly benefit during the month of the death.
  5. A surviving spouse who does not meet the requirements of 2.
  6. Children who do not meet the requirements of 3.
  7. Parents who do not meet the requirements of 4.

When should I file for a Medicare refund?

If you find that your recently deceased Medicare beneficiary is due a refund, be sure to submit your claim within 12 months after the date of their passing. If you fail to file your claim in this 12-month window, you may lose out on receiving your Medicare premium overpayment refund. This applies to both loved ones and family members as well as personal or legal representatives acting on the deceased beneficiary’s behalf.

How do I receive a Medicare Premium refund?

Medicare beneficiaries who need to request a Medicare premium refund can do so by reaching out to the Social Security Administration directly. A representative will be able to assist in gathering the necessary information required to submit a claim. You can also fill out the SSA Form 1724, which is the official Claims For Amounts Due in the Case of A Deceased Beneficiary form that will need to be submitted to the Social Security department to process.

Medicare Premium Refund Policy

Although family members of the deceased beneficiary or a legal representative can submit the SSA Form 1724 to initiate the request for a refund, a formal claim is not required. You may be able to request a Medicare premium refund without submitting documentation as you would when filing a traditional insurance claim. It should also be noted that there isn’t any kind of tolerance for the amount of the refund. This means that a refund for the excess amount of the premium can be issued, regardless of the amount.

If you ever have any questions regarding submitting a Medicare premium refund request or other concerns, it’s best to reach out to your insurance company. Since insurance companies may have different policies or processes in place for claim submission, a representative will be able to assist you with your specific questions. You can also speak directly with the Social Security Administration or with Medicare for more information.

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