Medicare is a federally funded health insurance program administered by the U.S. Dept. of Health and Human Services, Centers for Medicare and Medicaid Services (CMS). Medicare has different parts – Part A, Part B, Part C, and Part D – that help cover specific services.
Medicare Part A (hospital insurance) helps cover inpatient hospital care, skilled nursing facility care, hospice care and home health care. Medicare A is free to anyone ages 65+, or under age 65 with a disability, if they have earned enough work credits to qualify. People over 65 and people with disabilities who have not earned enough work credits can obtain Medicare A, but they must pay for it. Medicare A has deductibles and co-pays.
Medicare Part B (medical insurance) helps cover doctors’ services, outpatient care, home health care, and some preventive services. There is a monthly premium for Medicare B; however, low income eligible individuals can have premiums paid by a Medicare Savings Program. In addition to the premium, Medicare B has deductibles and co-pays, which may also be paid for with a Medicare Savings Program.
Medicare Part C (Medicare Advantage Plans) is a health coverage option offered by private insurance companies that are approved by and under contract with Medicare. To join a Part C plan, a person must be enrolled in Parts A and B and pay the Part B premium to Medicare. An additional premium paid to the plan may also be required. Part C plans require enrollees to get their medical care through the plan’s network of providers.
Medicare Part D (Medicare Prescription Drug Coverage) helps cover prescription drugs. Part D plans are offered by private insurance companies approved by and under contract with Medicare. People with Medicare A or B must enroll in one of the plans to be covered. Part D has premiums, deductibles and co-pays. Low income individuals can apply for Extra Help, also known as Part D low income subsidy (LIS), to help pay these costs. To apply for the low income subsidy, call a Social Security office or go to the Social Security website (http://www.socialsecurity.gov/pgm/medicare.htm) or call Medicare (800-MEDICARE) or go to the Medicare website.
MEDIGAP (SUPPLEMENTAL INSURANCE) is health insurance sold by private insurance companies to fill the gaps in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover. For people with Original Medicare and a Medigap policy, Medicare and Medigap will both pay their shares of covered health care costs. Insurance companies can only sell a standardized Medigap policy. These Medigap policies must all have specific benefits madated by Medicare. In Connecticut, people can choose among different standardized Medigap plans. Medigap policies must follow Federal and State laws. A Medigap policy must be clearly identified on the cover as “Medicare Supplement Insurance.” Each plan has a different set of basic and extra benefits.
It’s important to compare Medigap policies because costs can vary. The benefits in any Medigap Plan are the same for any insurance company. Each insurance company decides which Medigap policies it wants to sell.
Generally, people who buy a Medigap policy must have Medicare Part A and Part B and pay the monthly Part B premium. In addition, they will have to pay a premium to the Medigap insurance company.
MEDICARE NUMBER: 1-800-MEDICARE
**Medicare has started sending new cards with new Medicare numbers to people with Medicare, starting in the Spring of 2018. The new Medicare card will include a new number unique number, instead of the current Social Security-based number. This will help to protect against fraud.
Starting this month, people who are enrolling in Medicare for the first time will be among the first in the country to get the new cards. If individuals have Medicare already, you’ll get your new card over the coming months. Medicare will mail cards on a rolling basis, sending a new card with a new number at no cost to everyone with Medicare over the next year. To update your official mailing address, visit https://www.ssa.gov/myaccount/ or call 1-800-772-1213. Cards for Connecticut residents currently on Medicare will be mailed sometime after June 2018.
Please Note: Scammers are using the rollout of new Medicare cards as an opportunity to get beneficiaries protected information. Please be aware that multiple scams have surfaced across the country. Scammers call beneficiaries claiming to be from Medicare. The scammer will say they have to update information so the person can get their card. This is not legitimate. Medicare is not calling people, they are mailing out new cards. If a beneficiaries address has changed it’s up to the beneficiary to update their address with Social Security online or by phone at 1-800-772-1213, TTY users can call 1-800-325-0778. Please read below Medicare Blog for updates on what’s happening right now with the new card roll-out.
MEDICARE WEBSITE http://www.medicare.gov offers Medicare information, including a section on Medicare costs, what Medicare covers, drug coverage (Part D), how to sign up and change plans, how to find doctors, providers, hospitals, and much more. A copy of the Medicare and You book, which is mailed to all Medicare beneficiaries in the fall, can be downloaded from the Medicare website.
THE CENTER FOR MEDICARE ADVOCACY http://www.medicareadvocacy.org offers information on Medicare and advocates for individuals who have Medicare related issues.
TO FIND PROVIDERS IN CONNECTICUT’S COMMUNITY RESOURCES DATABASE:
Search by service names:
Medicare Part D Low Income Subsidy Applications
Medicare Savings Programs
SOURCE: U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services: Medicare website
PREPARED BY: 211/rj
CONTENT LAST REVIEWED: June2019