Medicare
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
Part A
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.
Part B
This Part of Medicare covers:
· Outpatient Care
· Medical Equipment (DME)
* Home Health (if not covered by Part A)
Does not cover:
Vision Care
Dental Care
Hearing Care
Private Duty Nursing
Cosmetic Surgery
Care received outside the US
Part D
This Part of Medicare (Drug coverage)
Part C
· 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
Enrollment Period
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.
More Information
Medicare: 800-633-4227
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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