The following 20 questions and answers are the most frequently asked questions by callers to the Medicare+ Choice toll free line.
You will need to call the Social Security Administration at 1-800-772-1213 or contact your local Social Security Office to get a replacement Medicare card. Make sure you have your Medicare number ready when you call. You should receive your new card in about four weeks.
You must call the Social Security Administration at 1-800-772-1213 or contact your local Social Security Office to verify your Medicare Part A and Part B coverage. This information can also be found on your red, white, and blue Medicare card.
If your income is limited, your State may help pay your Medicare costs such as your premiums and deductibles. Check the Helpful Contacts section of this web site for the phone number of your State Medical Assistance Program. They can help you determine if you are qualified.
If you have Medicare Part A, your income is limited, and your financial resources such as bank accounts, stocks, and bonds are not more than $4,000 for an individual, or $6000 for a couple, you may qualify for assistance as a Qualified Medicare Beneficiary or Specified Low Income Medicare Beneficiary.
The Qualified Medicare Beneficiary Program (also known as QMB) pays the Medicare monthly Part B premium, deductibles and coinsurance. In most states, the 2006 monthly income limits are $798 for an individual and $1,070 for a couple.
The Specified Low Income Medicare Beneficiary Program (also known as SLMB) helps pay the Medicare monthly Part B premium for qualified Medicare beneficiaries. In most states, the 2006 Monthly Income Limits are $957 for an individual and $1,283 for a couple.
If you are receiving Social Security or Railroad Retirement or disability benefits, you will be automatically enrolled in Medicare Part A and Part B. About 3 months prior to your 65th birthday or 24th month of disability, you will be sent an Initial Enrollment Package that will contain information about Medicare, a questionnaire and your red, white and blue Medicare card. If you want both Medicare Part A (hospital insurance) and Part B (medical insurance), you should sign your Medicare card and keep it in your wallet. If you don't want Part B coverage, you must put an X in the refusal box on the back of the Medicare card form; sign the form and return it with the card to Social Security at the address shown. You will then be sent a new Medicare card showing that you only have Part A.
Some people are not automatically enrolled in Medicare. You need to file an application if you are:
You can call the Social Security Administration to set up an appointment or go to your local Social Security Office. The phone number for the Social Security office in your area can be found in the Helpful Contacts section of this site. Social Security will take your application, determine if you are eligible for Medicare and send you a Medicare card.
If you are in Original Medicare, your doctor or other health care provider will file your claim with Medicare. You'll receive a statement showing how much you'll need to pay. If you do not receive a Medicare statement (Medicare Summary Notice or Explanation of Medicare Benefits), you'll need to contact your local carrier to have them send you a copy. Check the Helpful Contacts section of this web site for the phone number of your carrier. If you have supplemental insurance or Medigap, they may pay part of your costs. Check with your supplemental insurance company to find out what they will pay.
Medicare is a Federal health insurance program for people 65 years or older, certain people with disabilities, and people with permanent kidney failure treated with dialysis or a transplant. Medicare has two parts - Part A which is hospital insurance, and Part B which is medical insurance.
You are eligible for Medicare Part A (hospital insurance) if you are under 65 and have been getting Social Security or Railroad Retirement Disability checks for 24 months. You may also enroll in Part B (medical insurance) for a month premium of $88.50.
Medicare+ Choice is a term used to describe the various health plan options available to Medicare beneficiaries.
You can leave a plan in one of 3 ways. You can:
In most cases, you are disenrolled the month after your request is made as long as your request was filed before the 10th day of the month. If your request was made after the 10th of the month, you will be disenrolled the first day of the second calendar month after your request was made. You do not need to fill out a disenrollment form if you decide to join another managed care plan. You will be automatically disenrolled from your old plan when your new plan enrollment becomes effective.
Medicare Part B helps pay for durable medical equipment such as oxygen equipment, wheelchairs, and other medically necessary equipment that your doctor prescribes to use in your home. Other items covered by Medicare include:
Medicare pays for different kinds of durable medical equipment in different ways. Some equipment must be rented, other equipment must be purchased. Your Durable Medical Equipment Regional Carrier can provide more specific information.
Generally, Original Medicare does not cover prescription drugs. However, Medicare does cover some drugs in certain cases such as immunosuppressive drugs (for transplant patients) and oral anti-cancer drugs. You should call your Durable Medical Equipment Regional Carrier for more information.
There are some Medicare Health Plans that cover prescription drugs. You can also check into getting a Medigap or supplemental insurance policy for prescription drug coverage. Medicaid may also help pay for prescription drugs for people who are eligible.
You qualify to enroll in Medicare during a Special Enrollment Period if you delayed enrolling in Part B because you were working and had group health insurance through your employer or your spouse's employer. If you sign up during the Special Enrollment Period, you do not have to pay the Part B premium surcharge. Signing up for Medicare Part B will begin your 6 month open enrollment period for buying a Medigap policy. You can enroll in Part B: any month in which you are still covered under your current enrollment; or the 8-month period beginning with either the date your employment ends or the date your group health plan ends, whichever comes first.
You should contact the Social Security Administration at 1-800-772-1213 to file an application.
You will need to contact your local Medical Assistance Office to file an application for Medicaid. They will determine if you qualify for help in paying your medical and hospital bills. They may also help pay your Medicare premiums, deductibles, and co-insurance. For more information contact your local SRS office.
Supplemental insurance policies are sometimes called Medigap plans. Medigap plans are private health insurance policies that cover some of the costs the Original Medicare Plan does not cover. Some Medigap policies will cover services not covered by Medicare such as prescription drugs. Medigap has 10 standard plans called Plan "A" through Plan "J". Each plan has a different set of benefits. The states of Minnesota, Wisconsin and Massachusetts have choices other than Plan "A" through Plan "J". Your State Insurance Department can answer questions about the Medigap policies sold in your area.
Medicare covers the same supplies for both insulin and non-insulin dependent diabetics. They include:
Some frequency limitations may apply. Medicare does not cover insulin and syringes. Contact your Durable Medical Equipment Regional Carrier for more information.
Medicare Part B helps pay for doctors' services, outpatient hospital care, blood, medical equipment and some home health services. It also pays for other medical services such as lab tests and physical and occupational therapy. Some preventive services such as mammograms and flu shots are also covered.
Medicare Part B does NOT cover routine physical exams; eye glasses; custodial care; dental care; dentures; routine foot care; hearing aids; orthopedic shoes; or cosmetic surgery. It also does not cover most prescription drugs or health care you get while traveling outside the United States (except under limited circumstances).
Medicare does not cover routine dental care or most dental procedures such as cleanings, fillings or tooth extractions or dentures. There are rare cases in which Medicare Part B will pay for certain dental services. In addition, there are some situations in which Medicare Part A will pay for certain dental services delivered on an inpatient basis. You should contact your local Carrier for more information.
If you have worked at least 10 years in Medicare covered employment you will qualify for premium free Medicare Part A (Hospital Insurance). To qualify, you must be:
You should contact the Social Security Administration at 1-800-772-1213 to file an application.
Medicare managed care plans are another way for you to receive Medicare benefits. All plans must provide all of the services that you would receive under Original Medicare with some added benefits.
You usually must use the doctors, hospitals and providers in the plan's network. You may have to pay a monthly premium to your health plan. However, you would not need a supplemental Medigap policy if you join a managed care plan.