Medicare is a health insurance plan for people who are age 65 or older. People who are disabled or have permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig’s disease) can get Medicare at any age. Medicare has four parts:
Hospital insurance (Part A) helps pay for inpatient hospital care and certain follow-up services.
Medical insurance (Part B) helps pay for doctors’ services, outpatient hospital care and other medical services.
Medicare Advantage plans (Part C) are available in many areas. People with Medicare Parts A and B can choose to receive all of their health care services through a provider organization under Part C.
Prescription drug coverage (Part D) helps pay for medications doctors prescribe for medical treatment.
Who is eligible for hospital insurance (Part A)?
Most people get hospital insurance when they turn 65. You qualify for it automatically if you are eligible for Social Security or Railroad Retirement benefits. Or you may qualify based on a spouse’s (including divorced spouse’s) work. Others qualify because they are government employees not covered by Social Security who paid the Medicare tax.
If you get Social Security disability benefits for 24 months, you will qualify for hospital insurance.
If you get disability benefits because you have amyotrophic lateral sclerosis (Lou Gehrig’s disease), you do not have to wait 24 months to qualify. Also, people who have permanent kidney failure that requires maintenance dialysis or a kidney replacement qualify for hospital insurance if they have worked long enough or if they are the spouse or child of a person who has worked long enough.
Who can get medical insurance (Part B)?
Almost anyone who is eligible for hospital insurance can sign up for medical insurance. Part B is an optional program. It is not free. In 2008, the standard monthly premium is $96.40. Some people with higher incomes will pay higher premiums.
Who can get Medicare Advantage plans (Part C)?
Anyone who has Medicare hospital insurance (Part A) and medical insurance (Part B) can join a Medicare Advantage plan. Medicare Advantage plans include: Medicare managed care plans;
Medicare preferred provider organization (PPO) plans; Medicare private fee-for-service plans; and Medicare specialty plans. You might have to pay a monthly premium because of the extra benefits the Medicare Advantage plan offers.
Who can get Medicare prescription drug coverage (Part D)?
Anyone who has Medicare hospital insurance (Part A) or medical insurance (Part B) or a Medicare Advantage plan (Part C) is eligible for prescription drug coverage (Part D). Prescription insurance is optional, and you pay an additional monthly premium for the coverage.
For more information, contact SSA and ask for Medicare (Publication No. 05-10043). Help with Medicare expenses for people with low income. If you have a low income and few resources, your state may pay your Medicare premiums and, in some cases, other “out-of-pocket” medical expenses, such as deductibles and coinsurance. Only your state can decide whether you qualify for help under this program. If you think you qualify, contact your state or local medical assistance (Medicaid) agency, social services or welfare office. You can get more information about this program from the publication, If you need help paying Medicare costs, there are programs that can help you save money (Publication CMS-10126). To get a copy, call the Medicare toll-free number, 1-800-MEDICARE (1-800-633-4227). If you are deaf or hard of hearing, you may call TTY 1-877-486-2048.
“Extra help” with Medicare prescription costs : If you have limited income and resources, you may qualify for extra help to pay for your prescription drugs under Medicare Part D. Social Security’s role is to help you understand how you may qualify and to process your application for extra help. To see if you qualify or to apply, call Social Security’s toll-free number or visit our website.