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Should I sign up for Medicare Part A and B if I am still working?
- Even if you keep working after you turn 65, you should sign up for Medicare Part A. If you have health coverage through ... (more)
- Even if you keep working after you turn 65, you should sign up for Medicare Part A. If you have health coverage through your employer or union, Part A may still help pay some of the costs not covered by your group health plan. Call the Social Security Administration at 1-800-772-1213 to sign up. However, you may want to wait to sign up for Medicare Part B if you or your spouse are working and have group health coverage through you or your spouse's employer or union. (See note below if you work for a small company.) You would have to pay the monthly Medicare Part B premium, and the Medicare Part B benefits may be of limited value to you as long as the group health plan is the primary payer of your medical bills. In addition, you would start your 6-month Medigap open enrollment period during a time when it will not be of most use to you. For more information on your Medigap open enrollment period, see the publication Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare.
Note: If you are age 65 or older and working for a small company (less than 20 employees), you should talk to your employee health benefits administrator before making any decision not to take Medicare Part B. If your employer has less than 20 employees, Medicare is the primary payer and your group health insurance would be the secondary payer. You may also wish to read our publication: Medicare and Other Health Benefits: Your Guide to Who Pays First If you are disabled and working (or you have coverage from a working family member), the Special Enrollment Period rules also apply. Call the Social Security Administration at 1-800-772-1213 or visit their web site for more information. See also our FAQ on
.
Keywords: enrollment, sign up, working after age 65, delayed enrollment, medicare enrollment, CSREMAIL (FAQ3975)
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Who is eligible for Medicare?
- Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage ... (more)
- Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has two parts, Part A (Hospital Insurance) and Part B (Medical Insurance). You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:
You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
You or your spouse had Medicare-covered government employment.
If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:
You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. (Note: If you have Lou Gehrig's disease, your Medicare benefits begin the first month you get disability benefits.)
You are a kidney dialysis or kidney transplant patient.
While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.
If you have questions about your eligibility for Medicare Part A or Part B, or if you want to apply for Medicare, call the Social Security Administration or visit their web site . The toll-free telephone number is: 1-800-772-1213. The TTY-TDD number for the hearing impaired is 1-800-325-0778. You can also get information about buying Part A as well as Part B if you do not qualify for premium-free Part A. See also our FAQ on .
Keywords: eligibility, Eligibility, ELIGIBILITY, ELIGIBLE, Eligible, eligible, qualify, Qualify, QUALIFY (FAQ3967)
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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 ... (more)
- 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. The Medicare Part A deductible for 2009 is $1,068.00 per benefit period. The Medicare Part B deductible for 2009 is $135.00. If you have any questions on the status of your deductible please contact 1-800-MEDICARE (1-800-633-4227).
Keywords: deductible (FAQ3959)
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How do I apply for Medicare?
- You can ... (more)
- You can file for Medicare online when you file for retirement or disability. You also can file for just Medicare if you do not wish to start receiving your retirement benefits.
If you do not wish to apply online you can make an appointment by calling 1-800-772-1213. People who are deaf or hard of hearing may call our "TTY" number, 1-800-325-0778, between 7 a.m. and 7 p.m. on business days.
If you are already receiving Social Security benefits, you will automatically be enrolled in Medicare Parts A and B. However, because you must pay a premium for Part B coverage, you have the option of turning it down. You will be contacted by mail a few months before you become eligible and given all the information you need. (Note: Residents of Puerto Rico or foreign countries will not receive Part B automatically. They must elect this benefit.)
For additional information please see:
Medicare information for eligibility requirements
Medicare benefits for general information.
Keywords: CSREMAIL (FAQ5839)
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Can I delay Medicare Part B enrollment without paying higher premiums?
- Yes. In certain cases, you can delay your Medicare Part B enrollment without having to pay higher premiums. If you didn’... (more)
- Yes. In certain cases, you can delay your Medicare Part B enrollment without having to pay higher premiums. If you didn’t take Medicare Part B when you were first eligible because you or your spouse were working and had group health plan coverage through your or your spouse’s employer or union, you can sign up for Medicare Part B during a Special Enrollment Period. You can sign up:
Anytime you are still covered by the employer or union group health plan through your or your spouse’s current or active employment, orDuring the 8 months following the month the employer or union group health plan coverage ends, or when the employment ends (whichever is first). If you are disabled and working (or you have coverage from a working family member), the Special Enrollment Period rules also apply.
Effective date if you sign up during a Special Enrollment Period
If you enroll in Medicare Part B while covered by the group health plan or during the first full month after coverage ends, your Medicare Part B coverage starts on the first day of the month you enroll. You also can delay the start date for Medicare Part B coverage until the first day of any of the following 3 months.
If you enroll during any of the 7 remaining months of the Special Enrollment Period, your Medicare Part B coverage begins the month after you enroll.
Remember: If you do not enroll in Medicare Part B during your Special Enrollment Period, you'll have to wait until the next General Enrollment Period, which is January 1 through March 31 of each year. You may then have to pay a higher Medicare Part B premium because you could have had Medicare Part B and did not take it. Call the Social Security Administration at 1-800-772-1213 for more information or to enroll in Medicare. You can visit the Social Security web site .
Keywords: delayed medicare enrollment, delay medicare, enrollment, delayed part b enrollment, delay medicare part b enrollment (FAQ3979)
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I have more than one insurance. How do I know who pays first?
- If any of the following situations apply to you, your other insurance may be primary to Medicare, meaning the other ... (more)
If any of the following situations apply to you, your other insurance may be primary to Medicare, meaning the other insurance pays first: You have Medicare; are still working; and are covered by your employer’s health insurance plan;You have Medicare, are retired, but your spouse is working and has a health plan that also covers you; orYou are injured on the job, in an automobile accident, or slip and fall at a shopping center (worker’s compensation, auto insurance or liability insurance may cover the cost of medical care related to the accident). You can contact the Coordination of Benefits Contractor at 1-800-999-1118 for questions about, or to report changes in, your primary insurance. Medicare has a dedicated “Coordination of Benefits Contractor” that keeps track of when Medicare is primary or when another insurer is primary. If you have other insurance and it pays after Medicare, it is called your supplemental insurance. Supplemental insurance often covers the deductible and/or co-payments required by Medicare. Examples include: Retiree insurance from your former employer or union;Medigap insurance;Tricare for Life (for military retirees); andMedicaid. If you change your supplemental insurance, or are experiencing problems with supplemental insurance payments, you need to call your old and new supplemental insurance companies. If you have questions about how your supplemental insurance works with Medicare, contact the supplemental insurer. If you need Medicare to start or stop sending claims information to a supplemental insurance company, again, this is something the supplemental insurer must resolve. The Medicare publication, Medicare and Other Health Benefits: Your Guide to Who Pays First contains additional information on this topic that you may find useful.
Keywords: secondary, Secondary, SECONDARY, COORDINATION, Coordination, coordination, benefits, Benefits, BENEFITS, CHANGE, Change, change, insurance, Insurance, INSURANCE, MEDIGAP, coordination of benefits, coordination of benefits contractor, COB Contractor, COB, Medigap, medigap (FAQ4003)
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Will my Medicare Part B premium increase in 2011?
- Most Medicare beneficiaries will continue to pay the same $96.40 or $110.50 Part B premium amount in 2011. Beneficiaries... (more)
- Most Medicare beneficiaries will continue to pay the same $96.40 or $110.50 Part B premium amount in 2011. Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium for 2011.
For all others, the standard Medicare Part B monthly premium will be $115.40 in 2011, which is a 4.4% increase over the 2010 premium. The Medicare Part B premium is increasing in 2011 due to possible increases in Part B costs. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $115.40 per month. For additional details, see our FAQ titled: . In 2011:
New Part B beneficiaries will pay $115.40 (because they did not have the premium withheld from their Social Security benefit in the previous year).
Beneficiaries who do not currently have the Part B premium withheld from their Social Security benefit will pay $115.40.
pay $115.40 plus an additional amount, based on the income-related monthly adjustment amount (IRMAA). (FAQ5917)
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Should I sign up for Medicare Part B?
- Most people sign up for and buy Medicare Part B. If you want to join a Medicare managed care plan or a Medicare Private ... (more)
- Most people sign up for and buy Medicare Part B. If you want to join a Medicare managed care plan or a Medicare Private Fee-for-Service plan, you will need to have both Medicare Parts A and B. If you are still working, read our FAQ,
Call the Social Security Administration at 1-800-772-1213 or visit their web site for more information or to enroll. See also our FAQ on
.
(FAQ3973)
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What is a Medicare Advantage plan?
- A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. ... (more)
- A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.
If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).
Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare. However, each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan for non?emergency or non-urgent care). These rules can change each year.
Different Types of Medicare Advantage Plans
Health Maintenance Organization (HMO) Plans
Preferred Provider Organization (PPO) Plans
Private Fee-for-Service (PFFS) Plans
Special Needs Plans (SNP)
There are other less common types of Medicare Advantage Plans that may be available:
HMO Point of Service (HMOPOS) Plans— An HMO plan that may allow you to get some services out-of-network for a higher cost.
Medical Savings Account (MSA) Plans—A plan that combines a high deductible health plan with a bank account. Medicare deposits money into the account (usually less than the deductible). You can use the money to pay for your health care services during the year.
Keywords: medicare + choice, Medicare + Choice, M+C, managed care plan, HMO, Medicare Health Plans (FAQ4027)
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What if I'm over 65 and didn't enroll in Part B during my Initial Enrollment Period?
- Your Initial Enrollment Period starts 3 months before you turn age 65 and lasts for 7 months. Except in certain cases, i... (more)
- Your Initial Enrollment Period starts 3 months before you turn age 65 and lasts for 7 months. Except in certain cases, if you do not enroll in Medicare Part B during your Initial Enrollment Period, you will have wait until the next General Enrollment Period to enroll. General Enrollment Periods are between January 1 and March 31 each year. When March 31 falls on a non-business day, the General Enrollment Period is extended to the next business day. If you sign up for Medicare Part B during a General Enrollment Period, your coverage starts on July 1 of that year. Your Medicare Part B premium may go up 10 percent for each 12 month period that you could have had Medicare Part B, but did not take it. For example, in 2009, the Medicare Part B premium is $96.40 per month*. If you delayed enrolling in Medicare Part B for 24 months from the time you first could have had Medicare Part B, your premium in 2009 would be $115.68 per month.
Example: You delayed enrolling in Medicare Part B for 24 months
$96.40 base premium in 2009
+ $9.64 (10% of $96.40) for the first 12 month delay
+ $9.64 (10% of $96.40) for the second 12 month delay
= $115.68 will be your Medicare Part B premium for 2009
To enroll in Part B, call the Social Security Administration at 1-800-772-1213. For more information, call the Social Security Administration at 1-800-772-1213 or visit their web site. See question
for more information about exceptions to paying higher premiums. See question on
for more information on enrolling in Medicare.
*Note: If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $96.40 per month. For additional details, see our FAQ: Medicare Part B monthly premiums in 2009.
Keywords: PART B, part b, Part B, delayed enrollment, delaying Part B, Medicare Part B, medicare part b, MEDICARE PART B (FAQ3977)
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Does Medicare cover dental services?
- Medicare does not cover routine dental care or most dental procedures such as cleanings, fillings, tooth extractions or ... (more)
- Medicare does not cover routine dental care or most dental procedures such as cleanings, fillings, tooth extractions or dentures. In rare cases, Medicare Part B will pay for certain dental services. In addition, Medicare Part A will pay for certain dental services that you get when you are in the hospital. Call your local Medicare Carrier for more information. You can find their phone number in the Helpful Contacts section on our Website. Some Medicare health plans may offer additional dental coverage.
Some Medicare Advantage plans may include dental benefits. You should check with your Medicare Advantage plan directly to see what dental services are covered. (FAQ4045)
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Should I sign up for Medicare Part B if I am (or my spouse is) still working?
- You may want to wait to sign up for Medicare Part B if you or your spouse are working and have health coverage through y... (more)
- You may want to wait to sign up for Medicare Part B if you or your spouse are working and have health coverage through you or your spouse's employer or union. (See note below if you work for a small company.) You would have to pay the monthly Medicare Part B premium, and the Medicare Part B benefits may be of limited value to you as long as the group health plan is the primary payer of your medical bills.
Note: If you are working for a small company (less than 20 employees), you should talk to your employee health benefits administrator before making any decision not to take Medicare Part B. If your employer has less than 20 employees, Medicare is the primary payer and your group health insurance would be the secondary payer.
You may also wish to read our publication: Medicare and Other Health Benefits: Your Guide to Who Pays First.
If you don’t take Medicare Part B when you are first eligible because you or your spouse are working and have group health plan coverage through your or your spouse’s employer or union, you can sign up for Medicare Part B during a Special Enrollment Period.
If you are disabled and working (or you have group health coverage from a working family member), the Special Enrollment Period rules also apply.
You can sign up: Anytime you are still covered by the employer or union group health plan through your or your spouse’s (or if you are disabled, a family member's) current or active employment, orDuring 8 months following the month the employer or union group health plan coverage ends, or when the employment ends (whichever is first). Most people who sign up for Medicare Part B during a Special Enrollment Period do not pay higher premiums. The Social Security Administration handles Medicare enrollments. If you have more questions about enrolling in Medicare Part B, you should call the Social Security Administration at 1-800-772-1213. You can visit their Web site .
Keywords: part B, Part B, PART B, SIGN UP, sign up, Sign up, enroll, Enroll, ENROLL, OTHER HEALTH INSURANCE, Other Health Insurance, other health insurance, employer coverage, Employer Coverage, EMPLOYER COVERAGE (FAQ4121)
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Do I have to pay for Medicare Part A (Hospital Insurance)?
- You will not have to pay for Medicare Part A if you (or your spouse) worked and paid Medicare taxes for at least 10 year... (more)
- You will not have to pay for Medicare Part A if you (or your spouse) worked and paid Medicare taxes for at least 10 years. If you (or your spouse) did not pay Medicare taxes while you worked and you are age 65 or older, you may be able to buy Part A. Call the Social Security Administration at 1-800-772-1213 for more information about buying Medicare Part A.
(FAQ3969)
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What is Medicaid and who does it cover?
- Medicaid is a joint Federal and State program that helps pay medical costs for some people with limited incomes and reso... (more)
- Medicaid is a joint Federal and State program that helps pay medical costs for some people with limited incomes and resources. Most of your health care costs are covered if you have Medicare and Medicaid. Medicaid programs vary from state to state. People with Medicaid may get coverage for services such as nursing home and home health care, that aren’t fully covered by Medicare.
For more information about Medicaid, call your State medical assistance office or visit the Medicaid Section of www.cms.hhs.gov.
You may also be interested in the Medicare Savings Programs. States have programs for people with limited income and resources that pay Medicare premiums and, in some cases, may also pay Medicare deductibles and coinsurance. These programs help millions of people with Medicare save money each year. It's very important to call your State medical assistance office if you think you qualify for the Medicare Savings Programs, even if you aren't sure.
You can find the phone number for your State medical assistance office in the Helpful Contacts section on our Website, or by calling 1-800-MEDICARE (1-800-633-4227).
Keywords: medicaid (FAQ4063)
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How can I hire and pay for a home health aide?
- If you are eligible for home health care, the Original Medicare Plan will cover home health aide services on a part... (more)
- If you are eligible for home health care, the Original Medicare Plan will cover home health aide services on a part-time or intermittent basis, if you are also getting skilled care such a nursing care or other therapy from the home health agency. A home health aide doesn't have a nursing license. The aide provides support services for skilled nursing care. These services include help with personal care such as bathing, using the toilet, or dressing. For Medicare to pay, the home health aide services must be part of the care for your illness or injury. For more information, please see the publication, "Medicare and Home Health Care".
You can find Home Health Agencies (including those agencies who have home health aides) in the Home Health Compare section of this web site. (FAQ5443)
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Does Medicare pay for prescription drugs?
- Generally, Original Medicare does not cover prescription drugs. However, Medicare does cover some drugs in certain cases... (more)
- 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 some oral anti-cancer drugs. Medicare also covers certain prescription drugs used in nebulizers and external infusion pumps.
If you get Medicare covered prescription drugs, make sure your pharmacy or supplier is enrolled in the Medicare Program. If you go to a pharmacy that is not enrolled, Medicare will not pay. You will be responsible for paying the entire bill. Under current law, all Medicare enrolled pharmacies must accept assignment for Medicare covered drugs and biologicals. If you purchase these items from a Medicare-enrolled pharmacy or supplier, you should only pay your 20% co-pay (and any remaining Medicare Part B deductible) when you get your prescription or supplies. Medicare will pay the remaining 80% directly to the pharmacy or supplier after they submit the claim.
Many Medicare Advantage plans cover prescription drugs, up to certain dollar limits (sometimes for an extra cost). Some Medigap policies and states also cover prescription drugs.
The Prescription Drug Assistance Programs Database on www.medicare.gov provides information on programs that offer discounts or free medication to individuals in need including the Medicare-approved prescription drug discount card, State prescription drug assistance programs, programs sponsored by pharmaceutical companies, and disease-specific programs. The Prescription Drug Assistance Database also provides information on prescription drug benefits offered through Medicare managed care plans and Medigap policies.
Starting January 1, 2006, Medicare-approved drug discount cards will begin to phase out, and the new Medicare prescription drug plans will begin.
Medicare will contract with private companies to offer this drug coverage. These companies will most likely offer a variety of options, with different covered prescriptions, and different costs. Medicare prescription drug plans are voluntary. If you want to participate, you must choose a plan offering the coverage that best meets your needs and then enroll. In most cases, there is no automatic enrollment to get a Medicare prescription drug plan.
To enroll, you must have Medicare Part A or Part B. You can first enroll from November 15, 2005 through May 15, 2006. This is called the “initial open enrollment period.”
Keywords: PRESCRIPTION, DRUGS, prescription, drugs, Prescription, Drugs (FAQ4023)
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Why doesn’t Medicare pay for dental care, hearing aids, and eyeglasses?
- Unfortunately, the Medicare program does not cover routine dental care, hearing aids or eyeglasses for they are statutor... (more)
- Unfortunately, the Medicare program does not cover routine dental care, hearing aids or eyeglasses for they are statutorily excluded from coverage. It would take an act of Congress to change the national coverage decision to not cover dental care, hearing aids, and eyeglasses.
There are a few exceptions to the statutory exclusion for dental care:
1) A non-covered dental service MAY be covered if it is:
- The result of a covered dental service,
- A necessary part of the same covered dental service, and
- Performed by the same Medicare approved dentist.
2) Extraction of teeth to prepare the jaw for radiation treatment secondary to cancer; and
3) Dental examination prior to kidney transplantation.
(FAQ4245)
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I have employer group health insurance. Can I drop Part B and add it later?
- If you are working and covered by your employer group health insurance, your Part B benefits may be of limited value to ... (more)
- If you are working and covered by your employer group health insurance, your Part B benefits may be of limited value to you as long as your group health insurance is the primary payer of your medical bills. (See note below.)
If you have Medicare Part B and decide to drop it while you are working and covered by your employer group health insurance, you can sign up for Medicare Part B again during your Special Enrollment Period. As long as you enroll in Part B during your Special Enrollment Period, you will not have to pay a higher Part B premium. See our FAQ:
Note: If you are working for a small company (less than 20 employees), you should talk to your employee health benefits administrator before making any decision not to take Medicare Part B. If your employer has less than 20 employees, Medicare is the primary payer and your group health insurance would be the secondary payer. You may also wish to read our publication: Medicare and Other Health Benefits: Your Guide to Who Pays First
The Social Security Administration handles Medicare enrollments. If you want to drop your Part B or have more questions about enrolling in or dropping Medicare Part B, you should call the Social Security Administration at 1-800-772-1213, or visit their web site . For more information about when you can add Medicare Part B, see our FAQ:
Keywords: part b, Part B, part B, PART B, ADD PART B, Add Part B, add part b, add part B, adding part b, adding part B, Adding Part B, ADDING PART B, enroll part b, enroll part B, Enroll Part B, ENROLL PART B (FAQ4153)
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Why is Social Security still taking money each month for Part B when I joined a Medicare Advantage plan?
- Medicare Advantage plans provide care under contract to Medicare. You must continue to pay the monthly Medicare Pa... (more)
- Medicare Advantage plans provide care under contract to Medicare. You must continue to pay the monthly Medicare Part B premium when you join a Medicare Advantage plan. You may also have to pay an additional monthly premium to the plan. For the plan premium, the plan may provide benefits like coordination of care or reduce out-of-pocket expenses. If you join a Medicare Advantage plan you are still in the Medicare program and are still entitled to get all your regular Medicare-covered services and have Medicare rights and protections.
Keywords: Part B, premium, premiums, HMO, managed care, Medicare Managed Care, Medicare HMO, M+C, Medicare + Choice, Medicare Plus Choice (FAQ3985)
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What is a Medigap policy?
- A Medigap policy is a health insurance policy sold by private companies to fill gaps in the Original Medicare Plan cover... (more)
- A Medigap policy is a health insurance policy sold by private companies to fill gaps in the Original Medicare Plan coverage. Medigap policies must follow federal and state laws. These laws protect you. The front of a Medigap policy must clearly identify it as "Medicare Supplemental Insurance". You need both Medicare Parts A & B to buy a Medigap Policy. In all States, except Massachusetts, Minnesota, and Wisconsin, a Medigap policy must be one of twelve standardized policies so you can compare them easily. Each policy has a different set of benefits. Two of the standardized policies may have a high deductible option. For a list of Medigap policies in your area and more information about policy benefits, you can visit the Medicare Health Plans section on this Website, or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
Keywords: Medigap, ten standarized policies (FAQ4103)
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Where can I find a list of all physicians that participate in Medicare?
- A list of participating physicians in your area can be found in the ... (more)
- A list of participating physicians in your area can be found in the Find a Doctor or Other Healthcare Professional section of this Website. Or, your local Medicare Carrier or A/B MAC can assist you with this question. You can find their phone number in the Helpful Contacts section on our Website.
(FAQ3965)
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Medicare Initial Enrollment Period
- Generally, Medicare is available for people age 65 or older, some younger people with disabilities, and people with End-... (more)
- Generally, Medicare is available for people age 65 or older, some younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).
If you already get benefits from the Social Security Administration or the Railroad Retirement Board, you are automatically entitled to Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) starting the first day of the month that you turn 65. You do not need to do anything to enroll. Your Medicare card will be mailed to you about 3 months before your 65th birthday. If you wait until you are 65, or sign up during the last three months of your initial enrollment period, your Medicare Part B start date will be delayed.
**EXAMPLE: If your 65th birthday is August 20, your Medicare effective date would be August 1. If your birthday is on the 1st day of any month, Medicare Part A and Part B will be effective the 1st day of the prior month. For example, if your 65th birthday is August 1, your Medicare effective date would be July 1.**
If you are not receiving Social Security, Railroad or disability benefits, you can enroll in Medicare and a Medicare drug plan up to 3 months before your 65th birthday and no later than 3 months after the month of your birthday. This is called the initial enrollment period. You will need to submit an application to the Social Security Administration. You can also sign up for Part B at your local Social Security office. They will determine if you are eligible, and then send you a Medicare card. Some government employees who have not paid into Social Security may also have to file an application. Social Security can answer any questions about your application.
If you want both Medicare Part A and Medicare Part B, 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. You should then sign the form and return it in the enclosed envelope to the address shown (below where you sign the Medicare card). In about 4 weeks, you will receive a new card showing you only have Medicare Part A coverage.
Please be aware that if you decide to pick up Part B coverage at a later date, the cost of Part B may go up 10% for each 12-month period that you could have had Part B but did not sign up for it. Also, if you decline or cancel your Part B coverage, you will not be eligible to receive Medicare covered preventive services.
If you live in Puerto Rico and are receiving Social Security or Railroad Retirement benefits, you will be automatically enrolled in Medicare Part A only. If you would like to enroll in Medicare Part B, you'll need to contact the Social Security Administration to fill out an application. If you do not enroll in Medicare Part B, you will be sent a Medicare card showing Part A only.
Note: A Special Enrollment Period is available if you waited to enroll in Medicare Part B because you or your spouse was working AND had group health coverage through a current employer or union. If this applies, you can sign up for Medicare Part B:
While you are still covered by an employer or union group health plan, through your or your spouse's employment, or
During the 8 months following the month when the employer or union group health plan coverage ends or when the employment ends (whichever comes first). (FAQ5705)
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What is Medicare?
- Medicare is health insurance for people 65 years or older, under age 65 with certain disabilities, and an... (more)
- Medicare is health insurance for people 65 years or older, under age 65 with certain disabilities, and any age with end-stage renal disease (ESRD) or Lou Gehrig's disease. Medicare has four parts -- Part A, which is hospital insurance, Part B, which is medical insurance, Part C, which is Medicare Advantage Plans, and Part D, which is Prescription Drug Coverage.
Keywords: CSREMAIL (FAQ3951)
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Medicare premiums and coinsurance rates for 2009
- The following is a listing of the Medicare premium, deductible, and coinsurance rates that will be in effect in 2009:... (more)
- The following is a listing of the Medicare premium, deductible, and coinsurance rates that will be in effect in 2009:
Medicare Premiums for 2009:
Part A: (Hospital Insurance) Premium
Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
The Part A premium is $244.00 per month for people having 30-39 quarters of Medicare-covered employment.
The Part A premium is $443.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.
Part B: (Medical Insurance) Premium
$96.40 per month*
Medicare Deductible and Coinsurance Amounts for 2009:
Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2009 = $1,068) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.
For each benefit period you pay:
A total of $1,068 for a hospital stay of 1-60 days.
$267 per day for days 61-90 of a hospital stay.
$534 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
All costs for each day beyond 150 days
Skilled Nursing Facility Coinsurance
$133.50 per day for days 21 through 100 each benefit period.
Part B: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)
$135.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $135.00 deductible.)
Additional information about the Medicare premiums, deductibles, and coinsurance rates for 2009 is available in the September 19, 2008 Fact Sheet titled, "CMS Announces Medicare Premiums, Deductibles for 2009" on the www.cms.gov website.
*Note: If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $96.40 per month. For additional details, see our FAQ titled: "
" (FAQ5537)
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I disagree with Medicare not paying for the ambulance. What should I do?
- Medicare covers ambulance transportation when the condition of the patient at the time of transport is such that all oth... (more)
- Medicare covers ambulance transportation when the condition of the patient at the time of transport is such that all other means of transportation would be inadvisable. Ambulance transport is allowed to the nearest facility unless necessary services are not available locally. In cases where services are not available locally, transportation to the nearest facility furnishing those services is covered.
In some cases, Medicare may pay for limited non-emergency transportation if you have orders from your doctor. Medicare will only cover services to the nearest appropriate medical facility that is able to give you the care you need. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
You have the right to appeal any decision about your Medicare services. Your appeal rights are on the back of the Medicare Summary Notice. If you need help filing an appeal, call the State Health Insurance Assistance Program (SHIP) in your state. Their number can be found in the Helpful Contacts section of this website. Additional information about the appeal process and downloadable appeal forms can be found in the Medicare Appeals section of www.medicare.gov.
Keywords: appeals, appeal, Medicare Appeals, Medicare Appeal, claims, payment, denial (FAQ4035)
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Please explain how the Medicare Part B deductible is applied?
- The Part B deductible is applied based on the date the claim is processed by Medicare, not the actual date you got the s... (more)
- The Part B deductible is applied based on the date the claim is processed by Medicare, not the actual date you got the service. However, certain services won’t be applied toward your deductible. The Medicare Part B deductible is $135 per calendar year. A provider may ask you to pay a portion of your deductible at the time you get the service, or bill you after getting the notice from Medicare concerning the amount Medicare approves for the service(s). However, a provider can’t ask you to pay more than the amount Medicare approves for the service(s) you received that day. In addition, the provider should show the amount you already paid on the claim he or she submits to Medicare.
Keywords: part b, part b deductible, annual deductible, deductible (FAQ3989)
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Information for individuals who are the caregiver for aging family members or friends.
- In the course of their caregiving responsibilities, approximately 25 million Americans will participate in health care d... (more)
- In the course of their caregiving responsibilities, approximately 25 million Americans will participate in health care decisions that involve Medicare. Unfortunately, these decision points often occur during crises, leaving caregivers little time to digest options and fully understand the Medicare program. The Centers for Medicare & Medicaid Services (CMS) has produced a new online publication to help caregivers in this position, Medicare Basics: A Guide for Caregivers .
Medicare Basics: A Guide for Caregivers provides caregivers a guide through eight critical decision points in the health care process. Caregivers will benefit from practical information such as: how to read a Medicare card; the differences between various Medicare options; how to contact and utilize national and local resources; when to seek second opinions; how to read a Medicare Summary Notice, and how to begin looking into long-term care facilities.
Keywords: caregiver, caregivers, employee, employees, family member (FAQ4421)
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How can Medicaid help people with low incomes?
- Medicaid is a joint Federal and State program that helps with medical costs for some people with low incomes and limited... (more)
- Medicaid is a joint Federal and State program that helps with medical costs for some people with low incomes and limited resources. To qualify for Medicaid, you must have a low income and few savings or other assets. Medicaid coverage differs from state to state. In all states, Medicaid pays for basic home health care and medical equipment. Medicaid may pay for homemaker, personal care, and other services that are not paid for by Medicare. Medicaid has programs that pay some or all of Medicare’s premiums and may also pay Medicare deductibles and coinsurance for certain people who are entitled to Medicare and have a low income.
For more information about what Medicaid covers for home health care in your state, call your State medical assistance office. Please, go to the Helpful Contacts section of our Web site to find the phone number for the State Medical Assistance Office in your State.
Keywords: medicaid (FAQ4431)
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Are all people with Medicare eligible to get the “Welcome to Medicare” physical exam?
- No. In order to be eligible to get the “Welcome to Medicare” physical exam, your Medicare Part B covera... (more)
- No. In order to be eligible to get the “Welcome to Medicare” physical exam, your Medicare Part B coverage must have been effective on or after January 1, 2005. Also, you must get the “Welcome to Medicare” physical exam within the first six months you have Part B coverage.
Additional information can be found in our publication titled, Guide to Medicare’s Preventive Services. (FAQ4701)
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Will my secondary insurance cover my deductible and/or 20% coinsurance?
- It depends on the type of secondary insurance that you have purchased. Some plans may cover the Medicare deductible and... (more)
- It depends on the type of secondary insurance that you have purchased. Some plans may cover the Medicare deductible and coinsurance amount while others may not. You should contact your supplemental insurer to confirm if your plan helps pay for these expenses.
(FAQ4001)
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How long can I get home health services?
- Medicare will pay for home health services for as long as you are eligible and your doctor says you need these services.... (more)
- Medicare will pay for home health services for as long as you are eligible and your doctor says you need these services. However, skilled nursing care and home health aide services are paid for only on a part-time or "intermittent" basis. This means there are limits on the number of hours per day and days per week that you can get skilled nursing or home health aide services.
Medicare will only pay for intermittent care, defined as services given on fewer than 7 days each week, or less than 8 hours each day over a period of 21 days (or less).
Example: Jane's doctor says that she needs a nurse to visit her every day for the next 15 days to care for a wound. The nurse will be at Jane's house for less than an hour each day, and Jane only needs the nurse to come for 15 days. Jane's need for home health care meets the Medicare definition of "intermittent."
Hour and day limits can be increased by your doctor in special cases the number of hours per when the need for more care is limited and can be planned ahead.
Once you are getting home health care, Medicare uses the following definition of part-time or intermittent to make decisions about your coverage:
Skilled nursing or home health aide services combined must total less than 8 hours per day, and 28 or fewer hours each week.
Example: Fred has been getting home health care for 3 weeks. Fred's condition is improved, but his doctor would like Fred to continue to get home health care. Fred's doctor says that he needs a nurse to come in 3 days a week for 2 hours each day (a total of 6 hours) and a home health aide to come in 5 days a week for 3 hours each day (a total of 15 hours). This means that Fred is getting a total of 21 hours of home care per week, which meets Medicare's definition of "part-time or intermittent" home health care.
Medicare pays your home health agency a set amount of money for each 60 days you need care. (This 60-day period is called an "episode of care.") The payment is based on the kind of health care an average person in your situation would need. Medicare has paid hospitals this way for many years.
Keywords: home healthcare, home health care, home health, home care, home health services, home health coverage (FAQ4429)
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Enrollment Periods for Medicare Advantage and Prescription Drug Plans
- You can join, switch, or drop a Medicare Advantage or Prescription Drug Plan at these times:
Initial Enr... (more)
- You can join, switch, or drop a Medicare Advantage or Prescription Drug Plan at these times:
Initial Enrollment Period: When you first become eligible for Medicare (the seven-month period that begins three months before the month you turn age 65, includes the month you turn age 65, and ends three months after the month you turn age 65).
Annual Enrollment Period: Between October 15 through December 7. Your coverage will begin on January 1 of the following year, as long as the plan gets your enrollment request by December 31.
Open Enrollment Period: Between January 1 through March 31 of each year. Your coverage will begin the first day of the month after the plan gets your enrollment form. During this period, you can't do the following:
Join or switch to a plan with prescription drug coverage unless you already have Medicare prescription drug coverage (Part D).
Drop a plan with prescription drug coverage.
Join, switch, or drop a Medicare Medical Savings Account Plan.
Special Enrollment Periods: In most cases, you must stay enrolled for that calendar year starting the date your coverage begins. However, in certain situations, you may be able to join, switch, or drop a Medicare Advantage or Prescription Drug Plan at other times. Some of these situations include the following:
If you move out of your plan's service area.
If you have both Medicare and Medicaid.
If you qualify for Extra Help to pay for your prescription drug costs.
If you live in an institution (like a nursing home).
If you get Medicare due to a disability, you can join during the three months before to three months after your 25th month of disability. You will have another chance to join three months before the month you turn age 65 to three months after the month you turn age 65.
Keywords: csrpilot, csrscripts (FAQ5827)
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What medical supplies and equipment does Medicare Part B cover?
- Medicare Part B helps pay for durable medical equipment such as oxygen equipment, wheelchairs, walkers, and other medica... (more)
- Medicare Part B helps pay for durable medical equipment such as oxygen equipment, wheelchairs, walkers, 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 bags, 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. 1-800-Medicare can provide more specific information. You should also visit the Your Medicare Coverage section of our website for expanded information regarding your current coverage under the Original Medicare Plan.
Keywords: supplies, Supplies, SUPPLIES, Medical Equipment, MEDICAL EQUIPMENT, medical equipment, medical supplies, Medical Supplies, MEDICAL SUPPLIES (FAQ4033)
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How do I submit a Medicare claim (bill)?
- If you are in the Original Medicare Plan, providers (eg: hospitals, skilled nursing facilities, home health agencies, ph... (more)
- If you are in the Original Medicare Plan, providers (eg: hospitals, skilled nursing facilities, home health agencies, physicians, pharmacies, and suppliers) that are enrolled in the Medicare program are required by law to file Medicare claims for covered services or supplies you receive from a provider that is enrolled in the Medicare program. You should not need to file any Medicare claims.
Important: Ask the pharmacy or supplier if it is enrolled in the Medicare Program. If you go to a pharmacy or supplier that is not enrolled, Medicare will not pay. You will be responsible for paying the entire bill for any drugs or supplies. Medicare claims must be filed within one full calendar year following the year in which the services were provided. For example, if you see your physician on March 22, 2009, the Medicare claim for that visit must be filed by December 31, 2010. Note: This information on filing a Medicare claim only applies if you are in the Original Medicare Plan. If you get your Medicare health care through a managed care plan (like an HMO) or a Private Fee-for-Service Plan, Medicare claims are not filed. Medicare pays these private insurance companies a set amount every month. Therefore, they do not need to file Medicare claims. Information about when and how to file a Medicare claim.
Keywords: claim, Claim, CLAIM, Submit, submit, SUBMIT, bill, Bill, BILL (FAQ4019)
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Does the Original Medicare Plan pay for care in a nursing home?
- Usually, no. Most nursing home care is custodial care (help with bathing, dressing, using a bathroom, and eating.) Thi... (more)
- Usually, no. Most nursing home care is custodial care (help with bathing, dressing, using a bathroom, and eating.) This care is not covered by Medicare. Medicare Part A only covers skilled care given in a certified skilled nursing facility. You must meet certain conditions and coverage is limited. For more information about Medicare skilled nursing care, look at our publication Medicare Coverage of Skilled Nursing Facility Care.
If you have limited income and resources, Medicaid may help cover nursing home costs. For more information about Medicaid, call your State medical assistance office. You can find their phone number in the Helpful Contacts section on our Website.
(FAQ4011)
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Medicare Advantage plans can offer a Part B Premium reduction benefit. How does this benefit work?
- Medicare Advantage plans may offer an additional benefit by reducing the amount you pay for your Medicare Part B premium... (more)
- Medicare Advantage plans may offer an additional benefit by reducing the amount you pay for your Medicare Part B premium. If you join a plan that offers this benefit, it may save you money. You should read the plan materials carefully before joining to see if the Medicare Advantage plan you are interested in will offer this benefit. If the Medicare Advantage plan chooses to offer this benefit, it must offer it to every person with Medicare who joins the plan. The Medicare Advantage plan decides each year if they are going to reduce part or all of your Medicare Part B premium.
Important: Even though your Medicare Part B premium would be reduced, you would still get all Medicare Part A and Part B covered services. Reducing your Medicare Part B premium costs would not affect the services and care you get from the Medicare Advantage plan.
Keywords: Part B Premium, M+C, Medicare + Choice Plans, premium reduction benefit, reduce Medicare Part B premium, managed care plans, medicare managed care plans (FAQ4347)
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How do I leave a Medicare Advantage plan?
- Generally, if you join a Medicare Advantage Plan or Medicare Prescription Drug Plan, you can only change plans from Nove... (more)
- Generally, if you join a Medicare Advantage Plan or Medicare Prescription Drug Plan, you can only change plans from November 15 through December 31 of every year. This change will be effective January 1 of the following year. If you are also eligible for Medicaid, you can switch plans at anytime.
If you are eligible for a Medicare Advantage Plan, you can also join or switch Medicare Advantage Plans from January 1 to March 31 of any year, but you can’t join or drop Medicare prescription drug coverage during this time. For instance, if you are in a Medicare Advantage Plan with prescription drug coverage, you could return to the Original Medicare Plan, but you’d have to also join a Medicare Prescription Drug Plan at the same time. If you have questions about whether or not you can join or switch Medicare plans, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
You can switch your plan in one of three ways: Join another plan.Write or call the plan you want to join.Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If you want to switch from a Medicare Advantage Plan to the Original Medicare Plan, you need to contact your current plan or call 1-800-MEDICARE (1-800-633-4227). If you want to buy a Medigap policy, simply signing up for the Medigap policy won’t end your Medicare Advantage Plan coverage. You must disenroll. In some cases, you may have certain Medigap protections that give you the right to buy a Medigap policy, but in other cases, you may not be able to buy any Medigap policy. Your rights to buy a Medigap policy can vary by state. If you want to talk to someone who can help you decide what to do, call your State Health Insurance Assistance Program. Their number can be found in the Helpful Contacts section of this web site. (FAQ4029)
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When do the Medicare premiums and coinsurance rates change?
- New Medicare premium and coinsurance rates come out each fall and become effective in January. If you get Social Securit... (more)
- New Medicare premium and coinsurance rates come out each fall and become effective in January. If you get Social Security premiums or Railroad Retirement benefits, new rates are sent to you each year with your December cost of living adjustment notice. You can get new Medicare rates each fall on this website or by calling 1-800-MEDICARE (1-800-633-4227).
(FAQ3983)
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How do I get a new Medicare card if my card is lost, stolen, or damaged?
- If your Medicare card is lost, stolen or damaged, you can ask for a new one via the ... (more)
- If your Medicare card is lost, stolen or damaged, you can ask for a new one via the Social Security Administration website. Your red, white and blue card will be mailed within 30 days to the address SSA has on file for you. If you need proof that you have Medicare sooner than 30 days, you also can request a letter which you will receive in about 10 days. If you need proof immediately for your doctor or for a prescription, visit your nearest Social Security office.
If you have moved and have not reported this information to SSA, you will need to report the address change before they can process your request for a replacement card. If you have moved and have reported this information to SSA, you will need to contact them before they can process your request.
If you prefer, or if you are unable to use the online request to obtain a replacement Medicare card, call Social Security's toll-free number, 1-800-772-1213. Their representatives there will be glad to help you. You can also visit your local Social Security office. For the office closest to you try their Field Office Locator.
Keywords: card, medicare card, replacement, lost, stolen, damaged, replacement card, new card, (FAQ3955)
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I paid my doctor more than I owe, how do I get my money back?
- If you paid your doctor more than the amount indicated on your Medicare Summary Notice as your responsibility, you shoul... (more)
- If you paid your doctor more than the amount indicated on your Medicare Summary Notice as your responsibility, you should contact your doctor’s office to discuss a refund.
(FAQ3997)
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Is the Medicare Part B deductible something new?
- No. The Medicare Part B program has had an annual deductible since 1966. The 2008 Medicare Part B deductible is equal to... (more)
- No. The Medicare Part B program has had an annual deductible since 1966. The 2008 Medicare Part B deductible is equal to $135 per calendar year.
(FAQ3991)
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What if I do not have Medicare Part A -- should I sign up for Medicare Part B?
- If you are not eligible for free Medicare Part A hospital insurance, you can buy Medicare Part B, without having to buy ... (more)
- If you are not eligible for free Medicare Part A hospital insurance, you can buy Medicare Part B, without having to buy Part A, if you are: age 65 or older,a resident of the U.S., anda U.S. citizen or lawfully admitted alien* who has lived in the U.S. continuously for the five year period immediately preceding the month of enrollment.
The Medicare Part B premiums are much less costly than the Medicare Part A hospital insurance premiums. Call the Social Security Administration at 1-800-772-1213 for more information or to sign-up for Medicare. You can visit the Social Security web site . *A lawfully admitted alien is a permanent resident of the U.S. that has an I-155 card (sometimes called a "green card").
Keywords: enrollment, eligibility, purchasing Medicare coverage, buying part b coverage, buy medicare part b coverage (FAQ3981)
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How do I find out if I have Medicare Part A and B?
- You must call the Social Security Administration at 1-800-772-1213 or contact your local Social Security Office to verif... (more)
- 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. If you have a red, white, and blue Medicare card, look at the lower left corner of your card. It will show whether you have Hospital (Part A), Medical (Part B), or both.
Keywords: medicare coverage, verify, coverage verification, verify coverage (FAQ4031)
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Will my Medicare Part B premium increase in 2010?
- Most Medicare beneficiaries will continue to pay the same $96.40 Part B premium amount in 2010. Beneficiaries who curren... (more)
- Most Medicare beneficiaries will continue to pay the same $96.40 Part B premium amount in 2010. Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium for 2010.
For all others, the standard Medicare Part B monthly premium will be $110.50 in 2010, which is a 15% increase over the 2009 premium. The Medicare Part B premium is increasing in 2010 due to possible increases in Part B costs. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $110.50 per month. For additional details, see our FAQ titled: 2010 Part B Premium Amounts for Persons with Higher Income Levels. In 2010:
New Part B beneficiaries will pay $110.50 (because they did not have the premium withheld from their Social Security benefit in the previous year).
Beneficiaries who do not currently have the Part B premium withheld from their Social Security benefit will pay $110.50.
Higher-income beneficiaries pay $110.50 plus an additional amount, based on the income-related monthly adjustment amount (IRMAA).
Medicare Premiums and Coinsurance Rates for 2010 (FAQ5835)
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Does the Original Medicare Plan cover mental health care?
- Medicare Part A covers inpatient mental health care, including room, meals, nursing, and other related services and supp... (more)
- Medicare Part A covers inpatient mental health care, including room, meals, nursing, and other related services and supplies. Medicare Part B covers mental health services generally given outside a hospital, including visits with a doctor, clinical psychologist, clinical social worker, and lab tests. For more information about Medicare coverage for mental health care, look at Medicare and Your Mental Health Benefits.
Please visit the Your Medicare Coverage section of our website for expanded information regarding current Mental Health coverage under the Original Medicare Plan.
Keywords: Mental Health, mental health, MENTAL HEALTH, coverage, COVERAGE, Coverage, Psychiatric, PSYCHIATRIC, psychiatric, psychological, Psychological, PSYCHOLOGICAL (FAQ4043)
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What were the Medicare premiums and coinsurance rates in 2002?
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Part A: (Hospital Insurance) Premium
Most people do not pay a monthly Part A premium because they or a spo... (more)
Part A: (Hospital Insurance) Premium
Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare covered employment.
$319.00 per month (Note: This premium is paid only by individuals who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare covered employment).
The Part A premium is $175.00 for those individuals having 30-39 quarters of Medicare covered employment.
Part B: (Medical Insurance) Premium
$54.00 per month.
Deductible and Coinsurance Amounts
Part A: (Hospital Insurance) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2002 = $812) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.
For each benefit period you pay:
A total of $812 for a hospital stay of 1-60 days.
$203 per day for days 61-90 of a hospital stay.
$406 per day for days 91-150 of a hospital stay (Reserve Days).
All costs for each day beyond 150 days.
Part B: (Medical Insurance)
Deductible
$100.00 per year. (Note: You pay 20% of the Medicare approved amount for services after you meet the $100.00 deductible.)
Keywords: coinsurance, premium, 2002, 2002 rates (FAQ4255)
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I am a U.S. citizen living outside the country. How do I apply for Medicare?
- You should contact the Foreign Service Post which is normally located at the American Embassy to enroll in Medicare.... (more)
- You should contact the Foreign Service Post which is normally located at the American Embassy to enroll in Medicare.
Keywords: enroll in medicare, foreign enrollment, medicare enrollment, living outside of the US (FAQ3971)
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When can I get Medicare if I am under age 65 and have Lou Gehrig's disease?
- If you are under age 65 and have Lou Gehrig’s disease (ALS), you get your Medicare benefits the first month you ge... (more)
- If you are under age 65 and have Lou Gehrig’s disease (ALS), you get your Medicare benefits the first month you get disability benefits from Social Security or the Railroad Retirement Board. For more information about disability benefits, look at the Social Security Administration on the web, or call 1-800-772-1213.
(FAQ3953)
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Patient Survival: expected patient survival?
- The expected patient survival is the average length of life of patients on dialysis given the patients' age, size, race,... (more)
- The expected patient survival is the average length of life of patients on dialysis given the patients' age, size, race, sex, ethnicity, whether or not they have diabetes, how long they have had kidney failure, and whether they had other health problems when they started dialysis. For example, facilities with more older patients or more very ill patients would have a lower expected patient survival rate.
Keywords: survival, Survival, SURVIVAL, Dialysis, dialysis, DIALYSIS (FAQ4351)
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Should my doctor submit claims to Medicare if it is my secondary insurance?
- Yes, Medicare providers must submit claims (bills) to Medicare for you, whether Medicare is your primary or secondary in... (more)
- Yes, Medicare providers must submit claims (bills) to Medicare for you, whether Medicare is your primary or secondary insurer. For Medicare to process a claim as a secondary payer, the provider must give your primary insurance information to Medicare.
(FAQ4021)
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