Medicare

Medicare is a federal health insurance program for people age 65 or older. People younger than age 65 with certain disabilities, permanent kidney failure, or amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease), may also be eligible for Medicare. The program helps with the cost of health care, but it doesn’t cover all medical expenses or the cost of most long-term care. You have choices for how you get Medicare coverage. If you choose to have Original Medicare (Part A and Part B) coverage, you can buy a Medicare Supplement Insurance “Medigap” policy from a private insurance company, “Medigap” covers some of the costs that Medicare does not, such as copayments, coinsurance, and deductibles. If you choose Medicare Advantage, you can buy a Medicare-approved plan from a private company that bundles your Part A, Part B, and usually Part D (prescription drug coverage) into one plan. Although the Centers for Medicare & Medicaid Services (CMS) is the agency in charge of the Medicare program, Social Security processes your application for Original Medicare (Part A and Part B). The Medicare recipient must notify timely of address changes, name changes, and deaths.

Parts of Medicare

The Social Security Administration https://www.ssa.gov enrolls you in Original Medicare (Part A and Part B).

• Medicare Part A (hospital insurance) helps cover inpatient care in hospitals (including critical access hospitals) and skilled nursing facilities (not custodial or long-term care). Part A also pays for some home health care and hospice care and inpatient care in a religious non-medical health care institution.
• Medicare Part B (medical insurance) helps cover medically necessary doctors’ services, outpatient care, home health services, durable medical equipment, mental health services, and other medical services. Part B also covers many preventative services. Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.
• Supplemental “Medigap” policies help pay Medicare out-of-pocket copayments, coinsurance, and deductible expenses.
• Medicare Advantage Plan (previously known as Part C) includes all benefits and services covered under Part A and Part B, plus prescription drugs and additional benefits such as vision, hearing, and dental, bundled together in one plan.
• Medicare Part D (Medicare prescription drug coverage) helps cover the cost of prescription drugs.

You can sign up for Original Medicare (Part A and Part B) through Social Security’s online Medicare application https://secure.ssa.gov/iClaim/rib

Please visit Medicare’s website https://www.medicare.gov/ to get more information about Original Medicare, Medicare Advantage, or Part D coverage. You can download a copy of the publication Medicare & You (Publication No. CMS-10050). You can also call the Medicare toll-free number at 1-800-633-4227; TTY users can call 1-877-486-2048.