What is Medicare
Medicare is a federally funded health plan for seniors 65 and older and those who are under 65 and considered disabled or have end stage kidney failure.
Medicare is divided into four parts: A, B, C and D
This part of Medicare covers:
· Inpatient care (hospitals) includes Long Term Acute Care (LTAC) stays
· Blood after first 3 units*
· Hospice Care
· Home Health
· Skilled Nursing facilities (non-custodial)
*the member normally is financially responsible for the first three units of blood if the hospital paid for the blood. If not, the member will not have to pay.
This Part of Medicare covers:
· Outpatient Care
· Medical Equipment (DME)
* Home Health (if not covered by Part A)
Does not cover:
Private Duty Nursing
Care received outside the US
This Part of Medicare (Drug coverage)
· Combines benefits of parts A and B and in some cases part D
· Obtained through private health plans
· Must be paying part B premiums
Eligibility and Enrollment
You can be automatically enrolled in Part A and B if you:
· Already receiving social security benefits
· Under 65 and are disabled
· Have ALS (Lou Gehrig’s disease)
For those who are not automatically enrolled:
· For those approaching 65 years of age and are not receiving social security can enroll for Part A and Part B three months prior or three months after their birthday.
· Enrolling into Part B later will cost you a penalty.
· There is a Premium for Part B
You can enroll in Part A and B during a 7-month period that begins 3 months before your birthday and 3 months after. If you do not enroll at that time there is the general enrollment time which begins January 1st until March 31st of each year.
NOTE: If you choose the second option you might pay more for Part A/B premiums.
Social Security: 800-772-1213
Department of Defense (Tricare) 866-773-0404
Department of Health and Human Services (Office for Civil Rights) 800-368-1019
Department of Veterans Affairs: 800-827-1000
Railroad Retirement Board: 877-772-5772
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