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What is Medicare and how can I find out if I am eligible?

How can I join a Medicare prescription drug coverage plan?

How do I apply for Medicare?

How can I find out what is covered under Medicare?

What are the differences between Medicare Parts A, B, C and D?

How can I find a participating physician that fits my needs?

How can I find out more about my Medicare prescription coverage options?

Will every type of drug be covered under the Medicare prescription drug benefit?

What is Medicaid and who does it cover?

What is Medicare and how can I find out if I am eligible?

Medicare is a Health Insurance Program for people 65 years of age and older, some disabled people under 65 years of age, and people with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant). To find out if you are eligible for Medicare, click here.

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How can I join a Medicare prescription drug coverage plan?

• Mail in Application: Contact the company offering the drug plan you choose and ask for an application. Once you fill out the form, mail or fax it back to the company.
• On the Drug Plan’s Website: Visit the drug plan company’s website. You may be able to join online.
• On Medicare’s Website: You will also be able to join a drug plan by using Medicare’s online enrollment center.
• By Calling Medicare: You can join a drug plan by calling 1-800-MEDICARE (1-800-633-4227) and talking to a Medicare customer service representative. TTY users should call 1-877-486-2048.

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How do I apply for Medicare?

Most people qualify for Medicare when they turn 65. You qualify for it if you're eligible for Social Security or Railroad Retirement benefits. Or you may qualify on a spouse's (including divorced spouse's) record. Others qualify because they are government employees not covered by Social Security who paid the Medicare part of the Social Security tax. In addition, if you've been getting Social Security disability benefits for 24 months or get Social Security disability benefits and have amyotrophic lateral sclerosis (Lou Gehrig's disease), you'll qualify for Medicare. You may also qualify if you have permanent kidney failure and you receive maintenance dialysis or a kidney transplant.

If you are already getting Social Security benefits, you'll automatically be enrolled in Medicare Parts A and B. However, because you must pay a premium for Part B coverage, you have the option of turning it down. You will be contacted by mail a few months before you become eligible and given all the information you need.

If you are not already getting benefits when you turn 65, you should call or visit a Social Security office 3 months prior to your birthday so they can help you decide if you should sign up for Medicare. You should do this even if you plan to continue working or do not think you have enough work credit under Social Security, because Medicare enrollment period rules are very strict. If you would like to file for Medicare only, you can apply by calling 1-800-772-1213. Representatives there can make an appointment for you at any convenient Social Security office. When you apply for Medicare, often an application for monthly benefits will also be taken. If you want to apply, SSA suggests that you apply for retirement benefits online.

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How can I find out what is covered under Medicare?

Click here:

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What are the differences between Medicare Parts A, B, C and D?

There are four parts to Medicare: Medicare Part A, Hospital Insurance; Medicare Part B, Medical Insurance; Medicare Part C (Medicare Advantage), which was formerly known as "Medicare + Choice" and the new Medicare Part D, prescription drug coverage. Generally, people who are over age 65 and getting Social Security automatically qualify for Medicare Parts A and B. So do people who have been getting disability benefits for two years, people who have amyotrophic lateral sclerosis (Lou Gehrig's disease) and receive disability benefits, and people who have permanent kidney failure and receive maintenance dialysis or a kidney transplant.

Part A is paid for by a portion of Social Security tax. It helps pay for inpatient hospital care, skilled nursing care, hospice care and other services.

Part B is paid for by the monthly premiums of people enrolled and by general funds from the U.S. Treasury. It helps pay for doctors' fees, outpatient hospital visits, and other medical services and supplies that are not covered by Part A.

Part C (Medicare Advantage) plans allow you to choose to receive all of your health care services through a provider organization. These plans may help lower your costs of receiving medical services, or you may get extra benefits for an additional monthly fee. You must have both Parts A and B to enroll in Part C.

Part D (prescription drug coverage) is voluntary and the costs are paid for by the monthly premiums of enrollees and Medicare. Unlike Part B in which you are automatically enrolled and must opt out if you do not want it, with Part D you have to opt in by filling out a form and enrolling in an approved plan.

More information may be found in our publication called Medicare, publication number 05-10043. Many of our other publications are available on the Internet.

More information about all four parts of Medicare can be found at the Centers for Medicare and Medicaid Services website.

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How can I find a participating physician that fits my needs?

Click here to see a participating physician directory.

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How can I find out more about my Medicare prescription coverage options?

Click here

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Will every type of drug be covered under the Medicare prescription drug benefit?

No. Certain drugs such as benzodiazepines, barbiturates, drugs for weight loss or gain, and drugs for relief of colds will not be covered. However, a plan can choose to cover excluded drugs if the plan offers more than standard coverage.

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What is Medicaid and who does it cover?

Medicaid is a joint Federal and State program that helps pay medical costs for some people with limited incomes and resources. Most of your health care costs are covered if you have Medicare and Medicaid. Medicaid programs vary from state to state. People with Medicaid may get coverage for services such as nursing home and home health care, that aren’t fully covered by Medicare.

For more information about Medicaid, call your State medical assistance office or visit the Medicaid Section of www.cms.hhs.gov.

You may also be interested in the Medicare Savings Programs. States have programs for people with limited income and resources that pay Medicare premiums and, in some cases, may also pay Medicare deductibles and coinsurance. These programs help millions of people with Medicare save money each year. It's very important to call your State medical assistance office if you think you qualify for the Medicare Savings Programs, even if you aren't sure.

You can find the phone number for your State medical assistance office in the Helpful Contacts section on the Medicare Website, or by calling 1-800-MEDICARE (1-800-633-4227).

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