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Medicare is a Health Insurance Program for:
- People 65 years of age and older.
- Some people with disabilities under age 65.
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).
Medicare has Two Parts:
- Part A (Hospital Insurance) - Most people don't have to pay for Part A.
- Part B (Medical Insurance) - Most people pay monthly for Part B.
You can choose different ways to get the services covered by Medicare. Depending on where you live, you may have different choices. In most cases, when you first get Medicare, you are in the Original Medicare Plan. You may want to consider a Medicare Prescription Drug Plan to add drug coverage. Or, you may want to consider a Medicare Advantage Plan (like an HMO or PPO) that provides all your Part A, Part B, and often Part D coverage. You make a choice when you are first eligible for Medicare. Each year you can review your health and prescription needs and switch to a different plan in the fall.
As long as you have both Part A and Part B, items covered by Part A and Part B are covered whether you have the Original Medicare Plan, or you belong to a Medicare Advantage Plan (like an HMO or PPO). For more information see the Your Medicare Coverage database.
Part A (Hospital Insurance)
Helps Pay For:
Care in hospitals as an inpatient, critical access hospitals (small facilities that give limited outpatient and inpatient services to people in rural areas), skilled nursing facilities (not custodial or long-term care), hospice care, and some home health care. Information about your coverage under Medicare Part A can be found in the Your Medicare Coverage database.
If you aren't sure if you have Part A, look on your red, white, and blue Medicare card. If you have Part A, "HOSPITAL (PART A)" is printed on your card.
Cost:
Most people get Part A automatically when they turn age 65. They do not have to pay a monthly payment called a premium for Part A because they or a spouse paid Medicare taxes while they were working.
If you don't automatically get premium-free Part A, you may be able to buy it if
- you (or your spouse) aren't entitled to Social Security because you didn't work or didn't pay enough Medicare taxes while you worked and you are age 65 or older, or
- you are disabled but no longer get premium-free Part A because you returned to work.
If you have limited income and resources, your state may help you pay for Part A and/or Part B. For more information, visit www.socialsecurity.gov on the web or call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. If you get benefits from the Railroad Retirement Board, call your local RRB office or 1-800-808-0772.
Part B (Medical Insurance)
Helps Pay For:
Doctors' services, outpatient care, and other medical services that Part A doesn't. Part B helps pay for these covered medical services and items when they are medically necessary. Part B also covers some preventive services. Information about your coverage under Medicare Part B can be found in the Your Medicare Coverage database.
Cost:
Starting January 1, 2007, your Part B premium will be based on your income. Most people pay the standard monthly Part B premium of $93.50 in 2007. For more information, see our FAQ: Medicare Part B Monthly Premiums in 2007.
In some cases this amount may be higher if you did not choose Part B when you first became eligible. The cost of Part B may go up 10% for each full 12-month period that you could have had Part B but didn't sign up for it, except in special cases. You may have to pay this penalty as long as you have Part B.
Enrolling in Part B is your choice. You can sign up for Part B from three months before you turn 65 to three months after you turn 65. To sign up, call the Social Security Administration at 1-800-772-1213 or visit or call your local Social Security office to sign up. If you choose to enroll in Medicare Part B, the premium is usually taken out of your monthly Social Security, Railroad Retirement, or Office of Personnel Management payment. In these cases, you won't get a bill for your premium. If you don't get any of these payments, Medicare sends you a bill for your Medicare Part B premium every three months. If you don't get your bill by the 10th of the month, call the Social Security Administration at 1-800-772-1213. TTY users should call 1-800-325-0778. If you get benefits from the Railroad Retirement Board (RRB), call your local RRB office or 1-800-808-0772.
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