Benefits Guide
Medicare
Medicare is a health insurance program administered by the federal government for people age 65 and over, people under 65 who have received Social Security disability benefits for two or more years, people with ALS and certain people with kidney failure. Medicare helps with the cost of health care, but it does not cover all medical expenses or long–term care costs. There are four parts to Medicare:
- Part A is hospital insurance. It helps pay for an inpatient stay at a hospital or skilled nursing facility for rehabilitation, as well as some home health care and hospice care. Most people do not pay a monthly premium for Medicare Part A, but there is a deductible and coinsurance charges depending on the number of days hospitalized.
- Part B is medical insurance. It helps pay medical services and supplies not covered by hospital insurance. Most people pay a monthly premium of $96.40 or $115.40 for Part B coverage. Part B premiums may be higher based on income. There are various copays and coinsurance amounts that people who have Medicare Part B are responsible for. Some people may be eligible to receive help paying for their Medicare Part B premiums through a Medicare Savings Program.
- Part C is private insurance that covers beneficiaries who sign their Medicare benefits over to companies called Medicare Advantage plans. Part C plans are available in many areas to people with Parts A and B so they can receive all of their health care services through one insurance provider. There is a monthly premium for the plan because of all the benefits it offers.
- Part D is prescription drug coverage. It helps pay for medication. Part D costs vary based on which plan you choose and which medications you take. Social Security administers a low–income subsidy program called "Extra Help" that may help reduce out–of–pocket drug costs.
Eligibility
In order to be eligible for Medicare, a person must be 65 years of age or older, have ALS or certain types of kidney failure, or have received Social Security Disability Insurance for 24 months.
If you decide not to enroll in Medicare Part B during your initial period of eligibility, you may have to pay a fee for late enrollment if you decide to enroll later. You may be eligible to receive help in paying for your Medicare Part B premiums by applying for a Medicare Savings Program through the county you live in.
If you have Medicare Parts A and B, you can enroll in Medicare Advantage (Part C). You can enroll in the program during your initial enrollment period. If you choose to enroll in Medicare Advantage after this period, you can only do so during certain times of the year.
Anyone who has Parts A, B, or C is eligible for prescription drug coverage (Part D). You should enroll in the Medicare prescription drug plan during your initial enrollment period if you don't have comparable prescription coverage under another plan. Otherwise, you will have to pay a penalty if you wait to join later. Typically, you are only able to enroll in a Part D plan or change your existing plan during open enrollment (October 15 – December 7, 2011) each year.
How to Apply
There are certain periods when a person may enroll in Medicare (see above).
More Information
For more information about Medicare, visit www.medicare.gov or call 800–MEDICARE.
To access more information about Medicare options for Minnesotans, you can download the Health Care Choices for Minnesotans on Medicare guide, published by the Minnesota Board on Aging. You can also call the Senior Linkage Line at 800–333–2433.
