What is Medicare?
Medicare is a federal health insurance program created in 1965 to help pay medical costs incurred by people over the age of 65, people with certain disabilities, and people with end-stage renal disease. Under the original Medicare plan (sometimes called fee-for-service), coverage consisted of two parts:
What is it?
Medicare Part A is the portion of Medicare that is available premium free to all eligible individuals. Medicare Part A provides services associated with hospital, hospice, skilled nursing care, and home health care.
What is it?
Medicare Part B is the medical insurance portion of Medicare, which covers physician services, outpatient hospital care, and many other services typically covered under health insurance plans. Part B is financed through monthly premiums paid by enrollees and by contributions from the federal government.
What is Medicare Part C (Medicare Advantage)?
The Medicare program, which is a federal program that helps senior citizens and certain other individuals pay for health care, is divided into parts; Part A, Part B, Part C, and Part D. Part C is an alternative to Parts A and B.
What is Medicare Part D prescription drug coverage?
The Medicare program, which is a federal program that helps senior citizens and certain other individuals pay for health care, is divided into four parts. Part A covers hospital and inpatient services and Part B covers doctor visits and other outpatient services.
What is Medigap?
Because original Medicare coverage has limitations, many people purchase supplemental insurance policies that are specifically designed to cover some of the gaps. These supplemental insurance policies, called "Medigap" policies, are sold by private health insurance companies, not the federal government.
What is it?
Under certain conditions, disabled individuals are eligible to enroll in Medicare, the federal health insurance program that currently consists of premium-free hospital insurance (Part A) protection, premium-paid medical insurance (Part B) protection, Part C, which allows private companies to offer Medicare benefits as well as benefits not offered by Medicare, and Part D, which covers the costs of prescription drugs.
What is a Qualified Medicare Beneficiary (QMB) program?
If you are entitled to Medicare Part A coverage, are elderly or disabled, and have limited income, you may be eligible for the QMB program. If you are eligible, your state's Medicaid program may pay for your Medicare Part B premium, Part A and Part B deductibles, and coinsurance requirements.
What is the Medicare open enrollment period?
The Medicare open enrollment period is the time during which people with Medicare can make new choices and pick plans that work best for them. Each year Medicare plans typically change what they cost and cover. In addition, your health-care needs may have changed over the past year. The open enrollment period is your opportunity to switch Medicare health and prescription drug plans to better suit your needs.
The Medicare open enrollment period begins on October 15 and runs through December 7. Any changes made during open enrollment are effective as of January 1, 2014.
During the open enrollment period you can:
- Join a Medicare Prescription Drug Plan
- Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan
- Drop your Medicare prescription drug coverage altogether
- Switch from Original Medicare to a Medicare Advantage Plan
- Switch from a Medicare Advantage Plan to Original Medicare
- Change from one Medicare Advantage Plan to a different Medicare Advantage Plan
- Change from a Medicare Advantage Plan that offers prescription drug coverage to a Medicare Advantage Plan that doesn't offer prescription drug coverage
- Switch from a Medicare Advantage Plan that doesn't offer prescription drug coverage to a Medicare Advantage Plan that does offer prescription drug coverage
Now is a good time to review your current Medicare plan. There are some factors you may want to consider as part of that evaluation. For instance, are you satisfied with the coverage and level of care you're getting with your current plan? Are your premium costs or out-of-pocket expenses too high?
Has your health changed, or do you anticipate needing medical care or treatment? Now is the time to determine if your current plan will cover your treatment and what your potential out-of-pocket costs may be. If your current plan doesn't meet your health-care needs or fit within your budget, you can switch to a plan that may work better for you.
Most Medicare Prescription Drug Plans have a temporary limit on what a particular plan will cover for prescription drugs. In 2014, this gap in coverage (also called the "donut hole") begins after you and your drug plan have spent $2,850. It ends after you have spent $4,550 out-of-pocket, after which catastrophic coverage begins. However, part of the Affordable Care Act (ACA) gradually closes this gap by reducing your out-of-pocket costs for prescriptions purchased within the coverage gap. In 2014, you'll pay 47.5% of the cost for brand-name drugs in the coverage gap and 72% of the cost for generic drugs in the coverage gap. Each succeeding year, out-of-pocket prescription drug costs within the coverage gap continue to decrease until 2020, when you'll pay 25% for covered brand-name and generic drugs within the gap.
Health Exchanges, or Marketplaces, which are part of the ACA, are available for people to shop for health insurance coverage. The Exchanges are scheduled to open October 1, 2013. The ACA also includes an insurance mandate, which requires most individuals to have health insurance or face a penalty. However, if you have Medicare, neither provision applies to you. As a Medicare recipient, you won't face penalties for being uninsured. Also, Exchanges do not provide information on Medicare plans, and you can't purchase Medicare coverage through an Exchange.
Determining what coverage you have now and comparing it to other Medicare plans can be confusing and complicated. Pay attention to notices you receive from Medicare and from your plan, and take advantage of help available by calling 1-800-MEDICARE or by visiting the Medicare website, www.medicare.gov. Your financial professional can also help you find the information you need to make decisions about Medicare.
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Medicare enrollment using our online application
It’s convenient, quick and easy. There’s no need to drive to a local Social Security office or wait for an appointment with a Social Security representative.
Use our online application to sign up for Medicare. It takes less than 10 minutes. In most cases, once your application is submitted electronically, you’re done. There are no forms to sign and usually no documentation is required. Social Security will process your application and contact you if we need more information. Otherwise you’ll receive your Medicare card in the mail.
Medicare is managed by the Centers for Medicare and Medicaid Services (CMS). Social Security works with CMS by enrolling people in Medicare.
For more information about applying for Medicare only and delaying retirement benefits, visit Applying for Medicare Only – Before You Decide.
Apply for Medicare Only Use the “Benefit Application” to apply for just Medicare
Return to a Saved Application Finish an application you already started.
Check Application Status Check the status of an application you submitted.
You can also apply:
- By phone - Call us at 1-800-772-1213 from 7 a.m. to 7 p.m. Monday through Friday. If you are deaf or hard of hearing, you can call us at TTY 1-800-325-0778.
- In person - Visit your local Social Security office. (Call first to make an appointment.)
If you do not live in the U.S. or one of its territories you can also contact the nearest U.S. Social Security office, U.S. Embassy or consulate.
"Medicare & You 2014 Guide"