Medicare is the nation’s health insurance program for people 65 and older, and younger people who are disabled or who have end stage renal disease. Medicare consists of four parts–Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage Insurance Plans) and MedicarePart D (Medicare Prescription Drug Plans). Almost all persons over age 65 are automatically entitled to Medicare Part A if they or their spouse are eligible for Social Security or Railroad Retirement.
Part A covers inpatient hospital care, skilled nursing facility, home health and hospice care. Part B is optional insurance that complements Part A coverage. Part B covers physician services, outpatient hospital services, home health, durable medical equipment, laboratory and x-rays, ambulance and other services.
Apply for Medicare at Social Security three months before turning age 65.
For Medicare information, call 1-800-MEDICARE (1-800-633-4227),or go to web site www.medicare.gov. Beneficiaries can also create a personal health care profile on the Medicare web site.
Go to the Medicare web site and click on “My Health. My Medicare.”
To report Medicare fraud, waste or abuse, call Rhode Island SMP at 462-0560.
Quality Partners of Rhode Island, 235 Promenade Street, Suite 500, Providence, RI 02908 investigates complaints of improper or inadequate care and works to improve the quality of care for Medicare beneficiaries. Call 1-800-662-5028 or 528-3200.
The Qualified Medicare Beneficiary (QMB), Specified Low-income Medicare Beneficiary (SLMB), and Qualifying Individuals (QI-1) programs pay the monthly Medicare Part B premium for eligible Medicare beneficiaries who meet the following guidelines:
Monthly Income |
Individual |
Couple |
| QMB | $850.83 |
$1,140.83 |
| SLMB | $1021 |
$1.369 |
| QI-1 | $1,148.63 |
$1,540.13 |
| Resources | $4,000 |
$6,000 |
Income limits change are adjusted each year in accordance with the Federal Poverty Level.
QMB pays the Medicare Part A premium, if necessary, the Part B premium, plus the Medicare deductibles and coinsurances. SLMB and QI-1, which pay the Part B premiums only, can be retroactive up to 3 months prior to the month of application.
Qualifying for any of these programs increases your Social Security benefit. This can affect eligibility for Medical Assistance (Medicaid) and other programs.
To apply, contact the nearest DHS office:
| Office | Phone |
|---|---|
| Cranston & Vicinity | 462-6500 |
| East Providence & Pawtucket | 729-5400 |
| Johnston & Vicinity | 222-5666 |
| Newport / Aquidneck Island | 849-6000 also 1-800-675-9397 |
| Providence | 222-7000 |
| South County | 267-1030 also 1-800-862-0222 |
| Warwick / Kent County | 736-6511 |
| Woonsocket & Vicinity | 235-6300 also 10800-510-6988 |
Or call 462-5300 (Voice) or 462-3363 (TTY).
