Medicare Overview
Who runs the Medicare Program?
The Centers for Medicare & Medicaid Services (CMS) is the Federal agency that runs Medicare. CMS is part of the U.S. Department of Health and Human Services.
What is Medicare?
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 kidney transplant).
Medicare has…
• Part A (Hospital)
• Part B (Medical)
• Part C (Medicare Advantage Plans, like HMOs and PPOs)
• Part D (Medicare Prescription Drug Coverage)
What is Medicare Part A?
Medicare Part A helps cover your inpatient care in hospitals, critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and
some home health care. You must meet certain conditions to get these benefits.
Cost: Most people don’t have to pay a monthly payment, called a premium, for Part A. This is because they or a spouse paid Medicare taxes while they were working. If you (or your spouse) didn’t pay Medicare taxes while you worked and you are age 65 or older, you may be able to buy Part A. If you aren’t sure if you have Part A, look on your red, white, and blue Medicare card (see sample card on page 4). If you have Part A, “Hospital (Part A)” is printed on your card. You can call Social Security at 1-800-772-1213, or visit your local Social Security office for more information about buying Part A. If you get benefits from the Railroad Retirement Board (RRB), call your local RRB office or 1-800-808-0772.
What is Medicare Part B?
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 like exams, lab tests,
and screening shots to help prevent, find, or manage a medical problem.
Cost: Most people will pay the standard monthly Part B premium of $96.40 for 2008. However, starting January 1, 2007, some people will pay a higher premium based on their modified adjusted gross income. If you file an individual tax return and your annual income is more than $80,000 (or if you are married (file a joint tax return) and your annual income is more than $160,000), your monthly Medicare Part B premium may be higher than the standard 2008 monthly premium of $96.40. These amounts change each year. In some cases, your monthly premium amount may be higher if you didn’t sign up for Part B when you first became eligible. The cost of Part B may go up 10% for each 12-month period that you could have had Part B but didn’t sign up for it. You will have to pay this extra amount as long as you have Part B, except in special cases.
More Information
Supplement
Medicare Advantage
Part D
Long-Term Care
Life
Links
Important Contacts
Medicare is here for you 24 hours a day, every day.
• www.medicare.gov
• 1-800-MEDICARE (1-800-633-4227)
• TTY users should call 1-877-486-2048.
Below are telephone numbers for organizations that provide nationwide services. These numbers were correct at the time of printing. Sometimes these numbers change.
Social Security
1-800-772-1213
TTY 1-800-325-0778
Coordination of Benefits Contractor
1-800-999-1118
1-800-318-8782
Department of Defense
TRICARE
1-888-363-5433
TRICARE for Life
1-866-773-0404
Department of Health and Human Services
Office of the Inspector General
1-800-447-8477
TTY 1-800-377-4950
Office for Civil Rights
1-800-368-1019
TTY 1-800-537-7697
Department of Veterans Affairs
1-800-827-1000
TTY 1-800-829-4833
Railroad Retirement Board (RRB)
(RRB beneficiaries only)
Local RRB office or 1-800-808-0772