Medicare Contact Information
For general information about Medicare, call 1-800-MEDICARE (633-4227) or go to www.medicare.gov. TTY users should call 1-877-486-2048.
For information about eligibility or to apply for Medicare, call the Social Security Administration at (800) 772-1213, visit their website or visit your local Social Security office. TTY users should call 1-800-325-0778. If you are newly eligible for Social Security benefits and you want to apply for both Social Security and Medicare you can do it online.
Prevent Medicare Fraud: 10 Do’s and Don’ts
From the U.S. Department of Health and Human Services 1. Don’t let anyone borrow or pay to use your Medicare ID card. 2. Don’t respond to telemarketers
Disability Facts and Resource Guide
Most Americans know someone with a disability, but few are aware that disability could affect them at any point in their lives. Though some disabilities
Medicare and Caregiving for your Child
What is Medicare?
Medicare is a federal government program that provides health insurance to people age 65 and over. Younger people who have received Social Security Disability Insurance (SSDI) benefits for 24 months also qualify. To be eligible, you must be a U.S. Citizens or permanent legal resident with at least five years of continuous residence. Additionally, people with End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS) are eligible for Medicare benefits as soon as they are eligible for SSDI without having to wait 24 months. 55 million people currently have Medicare coverage.
Part A covers inpatient hospital care, skilled nursing facilities and some home health care. Most people do not have to pay a monthly premium for Part A coverage. Part A does have a deductible and additional co-payment. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period.
Part B, the Supplementary Medical Insurance (SMI) program, covers doctor visits (but not routine exams), medically necessary supplies and equipment, physical and occupational therapy, outpatient mental health services and other outpatient hospital services. Part B coverage also includes certain preventive benefits like mammograms and cardiovascular screenings. While Part B is an optional program, most people enroll when first eligible as there are higher premium costs for those enrolling later.
Part B has a monthly premium that is deducted from Social Security, Civil Service, Railroad Retirement benefits or is paid directly each quarter for those eligible for Medicare who are not receiving Social Security benefits. Your premium is based on income.
Part C allows Medicare beneficiaries to enroll in private plan, such as a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO). You must be entitled to Part A and enrolled in Part B. In addition to the Part B premium, you usually pay one monthly premium for the service included in a Part C plan. Part C plans receive payments from Medicare to provide all Medicare covered benefits including hospital and physician services and, in most cases, prescription drug benefits.
Part D is an optional program, requiring a separate enrollment if you want to receive coverage for prescription drugs. Part D is offered through private insurance plans that contract with Medicare. Part D plans also have a monthly premium and an annual deductible before the plan will pick up the cost of your prescriptions.
After you meet your deductible, your plan will help pay for your covered prescription drugs. Your plan will pay some of the cost, and you will pay a co-payment or coinsurance.
Medigap is Medicare Supplement Insurance offered by private companies to fill the “gap” in original Medicare. A Medigap policy can pay some of the cost remaining after Medicare insurance coverage.
However, federal law does not require insurance companies to offer Medigap policies to individuals younger than 65. Some states still do require insurance companies to sell Medigap policies even to people younger than 65. If your child is under 65, you may not be able to find a Medigap policy for them or it may be more expensive. Read Medicare’s page on buying Medigap to learn more.
Resources about Medicare Eligibility and Applications
Low-income individuals enrolled in a Medicare Part D plan may also be eligible for Extra Help with Medicare Part Prescription Drug Plan Costs. The Social Security Administration (SSA) administers the Extra Help Program. Applications may be made online or by calling Social Security toll –free at 1-800-772-1213 (TTY 1-800-325-0778).
Free consumer counseling is available in every state through state programs that are funded by the federal government. These programs, called SHIP programs (Senior Health Insurance Assistance Program) give neutral advice to Medicare beneficiaries and their families about Medicare, Medicaid, private Medigap insurance and Medicare Advantage plans. SHIP counselors may also assist with applying for Medicare Savings Programs and for filing the Extra Help application with SSA. A listing of SHIP programs by state is available online.
Medicare Rights Center, a non-profit organization that operates a national telephone helpline to help callers understand Medicare benefits, find the right coverage, and understand how any existing coverage works with Medicare. Callers living on low or fixed incomes are also screened for additional programs that they may be eligible for that can help pay costs of Medicare. Helpline: 1-800-333-4114.
My Medicare Matters is a resource of the National Council on Aging (NCOA) in partnership with Aon Retiree Health Exchange™. This educational service is designed to make it easier for people with Medicare (and those turning 65) to make informed and confident choices about their health coverage and to make the most of that coverage. The service offers: Education and unique decision-support tools provided by NCOA to help people make good decisions and save money; and for those who choose it, one-on-one assistance – at no cost – in selecting and enrolling in healthcare coverage that best fits that individual from a licensed Benefits Advisor at Aon Retiree Health Exchange.
Frequently Asked Questions
Medicare does not cover most long-term care and covers only limited home health care and nursing home costs, usually following a hospital stay. It also does not cover routine dental, eye care or hearing aids.
If you are not 65 yet, but are already receiving Social Security retirement or disability benefits, you will be automatically enrolled in Part A and will have the opportunity to enroll in Part B in the month you turn 65 or after 24 months of receiving disability benefits. You will receive a Medicare Initial Enrollment Period package three months before your 65th birthday.
If you are approaching age 65 and not receiving Social Security benefits, you must contact Social Security to apply for Medicare benefits. You will not get Medicare information sent to you automatically.
The open period to apply for Medicare is 3 months prior to your 65th birthday, the month of your 65th birthday and 3 months after your 65th birthday. For example if your birthday is on June 1, you will have from March 1-September 1 to apply. Social Security recommends applying 3 months before you turn 65.
There is a penalty for delaying enrollment in Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you were eligible and could have enrolled in Part B but didn’t. However, the penalty does not apply if you delayed enrollment because you were actively employed and covered in a workplace plan or covered by an employed spouse’s workplace plan. If you are working past age 65 and have health coverage from an employer, you should consult with your employers’ benefit administrator about your health coverage options.
Medicare Savings Programs (MSPs), also called Medicare buy-in programs, provide financial assistance to Medicare eligible individuals with limited finances to help pay for premiums, co-payments, or deductibles. The three main programs are: the Qualified Medicare Beneficiary (QMB), the Specified Low-income Medicare Beneficiary (SLMB), and the Qualifying Individual (QI) Program.
Contact your state agency that administers Medicaid for specific information on each program. States may use different rules to count income and assets when determining eligibility.