Medicare

Medicare is health insurance for people age 65 or older, under 65 with certain disabilities and any age with End-Stage Renal Disease (ESRD). ESRD is permanent kidney failure requiring dialysis or a kidney transplant. The different parts of Medicare help cover specific services if you meet certain conditions.

Visit this US Government internet site for comprehensive information and content at Medicare.gov

Due to a 2015 change in federal law, Medigap, also known as supplement, plans that cover Medicare’s Part B deductible will no longer be permitted in new plans sold to individuals eligible for Medicare starting January 1, 2020. As a result, the two existing Medigap plans that pay the annual Part B deductible, plans C and F, will not be available for future 65-year-olds. Existing policies will be grandfathered in.

Medicare has the following parts:

Medicare Part A

(Hospital Insurance)

Helps cover inpatient care in hospitals (includes critical access hospitals, inpatient rehabilitation facilities and long-term care hospitals).
Helps cover skilled nursing facilities (not custodial or long-term care), hospice, and home health care services.

Medicare Part B

(Medical Insurance)

Helps cover doctor services and outpatient care.
Helps cover some preventive services to help maintain a person’s health and to keep certain illnesses from getting worse.
Generally pays 80% of the Medicare-approved amount for covered services.

Medicare Part C

(Medicare Advantage)

A way to get Medicare benefits through private insurance companies approved by and under contract with Medicare.
Includes Part A, Part B and usually other benefits Medicare doesn’t cover. Most plans also provide prescription drug coverage.

Medicare Part D

(Prescription Drug Coverage)

Run by private insurance companies approved by Medicare, which can either be Medicare Advantage Plans or separate Medicare Prescription Drug Plans.
Helps cover the cost of prescription drugs.
Each plan can vary in cost and drugs covered.

Medicare FAQs:

How do I order a replacement Medicare Card?

MyMedicare.gov allows you to order a replacement Medicare card. To do so, select the Order Card button located on the Replacement Medicare Card tab from the My Account page. Replacement Medicare cards can only be sent to the address of record on file with the Social Security Administration. Please make sure that your address on the Replacement Medicare Card tab is your current address before ordering a replacement Medicare card. It may take up to 4 weeks for you to receive your new Medicare card. If you choose to receive an entitlement letter by checking the check box located on the Replacement Medicare Card tab from the My Account page, you will receive an entitlement letter within 14 days of your successful replacement Medicare card request. For your protection, you will not be able to order a replacement Medicare card, if one has been ordered in the last 30 days.

What is an Authorized Representative?

An Authorized Representative is a person you choose to assist you with Medicare-related matters, such as:

Choosing a plan to participate in;
Gathering more information about your insurance plan/policies for research and decision making purposes;
Handling claims and/or payments;
Receiving a notice in connection with an appeal on your behalf, and review/submit personal medical information when working with associated appeals.

What information should I have before completing my Initial Enrollment Questionnaire (IEQ)?

Before completing your IEQ, you should have the following information available:

Your insurance card, for insurance company and prescription drug information; Your employer’s name and address (if you receive group health plan coverage through your employer);
Your spouse’s Social Security number, employer’s name and address, and the group health plan information (if you receive group health plan coverage through your spouse’s employer);
Your family member’s Social Security number, employer’s name and address, and the group health plan information (if you receive group health plan coverage through your family member’s employer) The associated insurance carrier information, employer name and attorney information, if you are receiving benefits or treatment for one of the following conditions:
- Black Lung benefits
- Workers’ Compensation benefits
- Injury or illness for which another person could be held responsible
- Injury or illness covered under no fault, automobile or liability insurance

Where can I find answers to my Medicare questions?

Medicare.gov was redesigned to make it faster and easier for you to answer your Medicare questions. To get more information about a certain topic, click on a link below:

I understand that there are new benefits available to Uniformed Services retirees and their dependents. What are these benefits? Who is eligible?

The Department of Defense implemented TRICARE for Life (TFL) on October 1, 2001. TRICARE for Life provides expanded medical coverage for: Medicare-eligible uniformed services retirees, including retired National Guard members and reservists; Medicare-eligible family members and widows/widowers; and certain former spouses if they were eligible for TRICARE before age 65. You must be 65 or over and have Medicare Part A and Part B to be eligible for TFL. If eligible, you get all Medicare-covered benefits under the Original Medicare Plan, plus all TFL-covered benefits. If you use a Medicare provider, Medicare will be the first payer for all Medicare-covered services, and TFL will be the second payer. TFL will pay all Medicare co-payments and deductibles and cover most of the costs of certain care not covered by Medicare. When only Medicare covers a benefit (for example, chiropractic care), you will generally be responsible for any remaining costs after Medicare has paid the provider. When only TRICARE covers a benefit (for example, prescription drugs), you will generally be responsible for all TRICARE co-payments and deductibles. The amounts Medicare and TRICARE will pay are based on your use of a Medicare provider. To get more information about TRICARE for Life, call 1-888-DOD-LIFE (1-888-363-5433) or look at theTRICARE web site. Call 1-800-538-9552 for other military retiree eligibility and benefit questions.

Will I pay more for my Medicare Part B premium if I earn a lot of money each year?

If your income is above a certain amount, then you may have to pay a higher Medicare Part B premium. If your modified adjusted gross income (MAGI) as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay more for your monthly Part B premium:

Can I delay my Medicare Part B enrollment without paying higher premiums?

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 to 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.

How do I pay my Medicare premium?

The premium is deducted from your Social Security deposit or, if you’ve yet to activate Social Security, you are billed quarterly.

Do I need to activate my Social Security income in order to obtain Medicare?

No. Enrollment in Social Security is not required to be eligible for Medicare.