How can I get a Replacement Medicare card?
If you lose your card, you can obtain a replacement card by phone at 1-800-772-1213,
or online at the Social Security Administration web site. Make sure you
have your Medicare number ready when you call. You should receive your
new card in about four weeks.
How can I find out if I have Medicare coverage?
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.
I can't afford my Medicare premiums. What can I do?
If your income is limited, your State may help pay your Medicare costs
such as your premiums and deductibles. Check the Important Phone Numbers
page 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. The Specified
Low Income Medicare Beneficiary Program (also known as SLMB) helps pay
the Medicare monthly Part B premium for qualified Medicare beneficiaries.
Will I automatically be enrolled in Medicare when I turn 65?
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.
Does Medicare pay for dental services?
Medicare does not cover routine dental care or most dental procedures such
as cleanings, fillings, tooth extraction 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. Check the Important Phone Numbers
of this web site for the phone number.
Who submits my bills to Medicare? How much do I have to pay?
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 Important Phone Numbers page 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.
What is Medicare?
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.
Who do I contact to change my name and address for Medicare purposes?
If you have had a recent name or address change, it will need to be reported
to the Social Security Administration. Social Security will notify Medicare
of the change when they change their records. Their phone number can be
found in the Important Phone Numbers page of this web site. If you are
in the Original Medicare Plan, you should also notify the Part B carrier
of your new name or address change. The carrier processes your claims
for doctor bills and other medical expenses. Check the Important Phone
Numbers section of this web site for the phone number of your carrier.
If you are in a Medicare managed care plan, you should contact your plan
of any name or address changes.
What is Medicare + Choice?
Medicare + Choice is a term used to describe the various health plan options
available to Medicare beneficiaries.
How can I leave a Medicare Health Plan?
You can leave a plan in one of 3 ways.You can:
- Call the plan you wish to leave and ask for a disenrollment form; or
-
Call
1-800-MEDICARE (1-800-633-4227) to request that your disenrollment be processed over the phone; or
- Call the Social Security Administration or visit your Social Security Office
to file your disenrollment request.
The phone number for the Social Security office in your area can be found
in the Important Phone Numbers section of this site. 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.
What medical supplies and equipment does Medicare Part B cover?
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:
- Arm, leg, back and neck braces
- Medical supplies such as ostomy pouches, surgical dressings, splints and casts
- Breast prostheses following a mastectomy
- One pair of eyeglasses with an intraocular lens after cataract surgery
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. Check the Important Phone Numbers section of this web site
for the phone number for your Durable Medical Equipment Regional Carrier.
Does Medicare pay for prescription drugs?
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.
Check the Important Phone Numbers section of this web site for the phone
number. 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.
I didn't enroll in Medicare Part B when I turned 65 because I was still
working. Can I enroll now?
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 to file an application.
The phone number for the Social Security office in your area can be found
in the Important Phone Numbers section of this site.
I originally refused Medicare Part B when I turned 65. Can I enroll now?
Anyone who has refused, terminated, or withdrawn from Medicare Part B or
Premium Free Part A coverage can enroll again. You can enroll during January,
February, or March of each year. This is referred to as the General Enrollment
Period. Your Medicare coverage will not begin until July 1st. You may
or may not have to pay a premium surcharge. Call the Social Security Administration at
1-800-772-1213 for an appointment or visit your local Social Security Office to file
an application. They will also tell you the amount of any premium surcharge
you may have to pay.
What is a Medigap policy?
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. Check the Important Phone Numbers section of this web site for the
phone number of your State Insurance Department.
Who is eligible for Medicare Part A (hospital insurance)?
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:
- 65 or older; or
- Disabled and receiving disability benefits from Social Security or the
Railroad Retirement Board for 24 months; or
- Have permanent kidney failure treated with dialysis or a transplant
You should contact the Social Security Administration to file an application.
Check the Important Phone Numbers section of this web site for the phone
number of the Social Security Office in your area.
What types of services are covered under Medicare Part B?
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).
What diabetic supplies does Original Medicare cover?
Medicare covers the same supplies for both insulin and non-insulin dependent
diabetics. They include: Glucose testing monitor, Blood glucose test strips,
Lancets, Spring powered devices for lancets, and Glucose control solutions.
Some frequency limitations may apply. Medicare does not cover insulin
and syringes. Contact your Durable Medical Equipment Regional Carrier
for more information. Check the Important Phone Numbers section of this
web site for the phone number.
What is a Medicare deductible?
A deductible is the amount you must pay each year before Medicare begins
paying its portion of your medical bill. There are deductibles for both
the Part A (Hospital Insurance) and Part B (doctor services) portions
of Medicare. Your deductible is taken out of your claims when Medicare
receives them. Medicare will not start paying on your claims until you
have met your annual deductible. If you have any questions on the status
of your deductible please contact your Medicare carrier.
How do Medicare managed care plans work?
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.