Medicare

From Life Done Right SeniorWiki

Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). Medicare covers certain medical services and items in hospitals and other settings. Some are covered under Medicare Part A, and some are covered under Medicare Part B.

Contents 1 Original Medicare Plan 2 Medicare Part A: Hospital Insurance 3 Medicare Part B: Medical Insurance 4 Medicare Part C: Medicare Advantage plans 5 Medicare Part D: Prescription Drug plans 6 Medicare Contact Information 7 External links 7.1 Governmental links - current 7.2 Governmental links - historical 7.3 Non-governmental links 8 Medicare Books 9 Related Advertisers

Original Medicare Plan

The Original Medicare Plan is a fee-for-service plan managed by the Federal Government. In general, with the Original Medicare Plan:

• You use your red, white, and blue Medicare card when you get health care.
• You can go to any doctor or supplier that accepts Medicare and is accepting new Medicare patients, or to any hospital or other facility.
• You pay a set amount for your health care (a deductible) before Medicare pays its part. Then, Medicare pays its share, and you pay your share (your coinsurance or copayment) for covered services and supplies (unless you have a Medigap policy or other supplemental insurance that may pay for these costs.)
• You may have a Medigap policy or other supplemental coverage that may pay deductibles, coinsurance, or other costs that aren’t covered by the Original Medicare Plan.

Medicare Part A: Hospital Insurance

Medicare Part A helps cover your inpatient care in hospitals. This includes critical access hospitals and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and home health care. You must meet certain conditions to get these benefits.

If you aren’t sure if you have Part A, look on your red, white, and blue Medicare card (see sample card below). If you have Part A, “HOSPITAL (PART A)” is printed on your card.

Medicare Part B: Medical Insurance

Medicare Part B helps cover medical services like doctors’ services, outpatient care, and other medical services that Part A doesn’t cover. Part B is optional. Part B helps pay for covered medical services and items when they are medically necessary). Part B also covers some preventive services.

Medicare Part C: Medicare Advantage plans

Medicare Advantage plans are health plan options that are approved by Medicare but run by private companies. They are part of the Medicare Program.

With Medicare Advantage Plans:

• You generally get all your Medicare-covered health care through that plan.
• Coverage can include prescription drug coverage.
• You may get extra benefits, such as coverage for vision, hearing, dental, and/or health and wellness programs.
• You may have lower out-of-pocket costs than the Original Medicare Plan.
• You may have to use the plan's doctors and hospitals to get services

Medicare Part D: Prescription Drug plans

Medicare Prescription Drug Plans add coverage to the Original Medicare Plan, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare.

When you join a Medicare Prescription Drug Plan, you use the plan member card that you get from the plan when you go to the pharmacy. When you use the card, you will get a discount on your prescriptions.

Your costs will vary depending on your financial situation and which Medicare Prescription Drug Plan you choose. If you have limited income and resources, you may get extra help to cover prescription drugs for little or no cost.

Medicare Contact Information

Call 1-800-MEDICARE (1-800-633-4227). Say “Agent” to speak to a customer service representative. TTY users should call 1-877-486-2048.

External links

Governmental links - current

• CMS official web site at cms.hhs.gov
  • Medicare at cms.hhs.gov
• Medicare.gov — the official website for people with Medicare
  • Official Medicare publications at Medicare.gov — includes official publications about current Medicare benefits
    • Medicare & You handbook for 2007 at Medicare.gov — includes information about current Medicare benefits
  • Information about the 1-800-MEDICARE helpline from Medicare.gov — a 24X7 toll-free number to call with questions about Medicare
  • Medicare Modernization Act at Medicare.gov
  • Medicare Plan Choices at Medicare.gov — basic information about plan choices for Medicare beneficiaries, including MA Plans
    • Medicare Personal Plan Finder at Medicare.gov — more detailed information about MA Plans; can do tailored searches
  • Prescription Drug Coverage homepage at Medicare.gov — a central location for Medicare's web-based information about the Part D benefit
    • Enroll in a Medicare Prescription Drug Plan at Medicare.gov — the web-based tool for enrolling online in a Part D plan
    • Landscape of plans — state-by-state breakdown of all plans available in an area, both stand-alone PDPs, as well as MA-PD plans
• MyMedicare.gov — Medicare's secure online service where beneficiaries can access their own personal Medicare information

Governmental links - historical

• Medicare Is Signed Into Law page from ssa.gov — material about the bill-signing ceremony
• Historical Background and Development of Social Security from ssa.gov — includes information about Medicare
• Detailed Chronology of SSA from ssa.gov — includes information about Medicare
• Early Medicare poster from ssa.gov

Non-governmental links

• Congressional Research Service (CRS) Reports related to Medicare from the University of Texas Libraries
• Center for Medicare Advocacy — National education & advocacy organization.
• Medicare Rights Center — Education and advocacy organization.
• Medicare.org — Medicare information site including descriptions of Part A through D
• Kaiser Family Foundation — Wide range of free information, including a drug benefit calculator, about the Medicare program and other U.S. health issues.
  • State Health Facts — Data on health care spending and utilization, including Medicare; provided by the Kaiser Family Foundation.
• HealthDecisions.org — Medicare information from America’s Health Insurance Plans (a national association of American health insurers).
• Social Security and Disability News Resource Center
• Issue Guide on Medicare — Policy alternatives and public opinion analysis on Medicare from Public Agenda Online
• How Stuff Works - Medicare

Medicare Books

• Complete Idiot's Guide to Social Security and Medicare, 2ndEdition by Lita Epstein
• Medicare Explained, 2007 Edition by CCH Health Law Editorial
• Medicare For The Clueless: The Complete Guide to This Federal Program by Joan H. Conklin
• Medicare Prospective Payment and the Shaping of U.S. Health Care by Rick Mayes
• Social Security, Medicare & Government Pensions: Get the Most of Your Retirement and Medical Benefits by Joseph L. Matthews
• The Political Life of Medicare by Jonathan Oberlander
• The Medicare Part D Drug Program: Making the Most of the Benefit by Jack E. Fincham

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