Frequently Asked Questions
Here are frequently asked questions about Medicare. To see an answer, simply click on that question.
- Who is eligible for Medicare?
- How do I apply for Medicare?
- What is the Medicare Modernization Act?
- What are the basic parts of the Medicare program now?
- When can I switch Medicare health plans?
- What’s the difference between traditional Medicare and Medicare prescription drug coverage?
- Does Medicare cover hospice care?
Who is eligible for Medicare?
You are eligible for Medicare if you:
- Reach age 65 and are entitled to monthly Social Security benefits.
- Are age 65 or over and have a spouse entitled to Social Security benefits, even if you are not.
- Are age 65 or over and are the widow or widower of someone who was entitled to Social Security benefits.
- Are under age 65 and have received Social Security disability benefits for at least 24 months.
- Are entitled to Social Security benefits and need maintenance kidney dialysis or a kidney transplant, regardless of your age.
How do I apply for Medicare?
When you meet one of the eligibility requirements, simply sign up for Social Security benefits and your Medicare card will be sent to you in the mail. You can also sign up for Medicare during your Initial Election Period (starting three months before, the month of, and lasting for three months after you first qualify for Medicare). However, other rules apply if you:
- Collected Social Security benefits before turning age 65.
- Work past age 65.
- Are eligible for Medicare because of a disability.
What is the Medicare Modernization Act?
The Medicare prescription drug program and the changes to Medicare offered through private insurance companies, now known as Medicare Advantage, are the result of the Medicare Modernization Act. In 2003, Congress passed a new law to bring people with Medicare more choices in health care coverage and better health care benefits. This law preserved and strengthened the Medicare program and added important new preventive benefits. It also added a prescription drug benefit (Medicare Part D) that Medicare beneficiaries may purchase from a private insurer. This legislation also provided "Extra Help" to people with low incomes in paying the premiums and cost sharing for their Part D benefit.back to top
What are the basic parts of the Medicare program now?
- Part A (Hospital Insurance) is managed by the federal government to help pay for care in a hospital and skilled nursing facility, home health care, and hospice care — usually for no monthly premium.
- Part B (Medical Insurance) is managed by the federal government to help pay for doctors, outpatient hospital care, and other medical services — usually for a monthly premium, which is deducted from your Social Security check.
- Part C (Medicare Advantage Plans) is offered by private companies like Aetna, who contract with the federal government, to cover the same or more benefits than Original Medicare (Parts A and B). Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Some Medicare Advantage plans also include Medicare prescription drug coverage (MA-PD plans); others do not (MA plans).
- Part D (Medicare prescription drug coverage) is offered by private companies like Aetna, who contract with the federal government, to help cover your prescription costs only. This coverage is available as a Medicare prescription drug plan (PDP) or as part of a Medicare Advantage plan (MA-PD).
- Medigap (Medicare Supplement Plans) is offered by private companies like Aetna to help pay for certain benefits not covered by Original Medicare (Parts A and B). New Medicare Supplement policies no longer cover prescription drugs.
When can I switch Medicare health plans?
Generally, if you are age 65 and over or disabled and made your Medicare selections for the first time, you can make plan selections or changes to your current Medicare coverage only during the Annual Election Period which will be from October 15 through December 7, 2011. During this time you can select a new Medicare health and/or prescription drug plan for the next calendar year.
Generally, you may not make any other changes during the year unless you meet certain special exceptions for a Special Election Period (SEP). These exceptions include moving out of the plan's service area or newly becoming eligible for Medicare.back to top
What's the difference between traditional Medicare and Medicare prescription drug coverage?
Original Medicare — Parts A and B — helps cover hospitalization, outpatient medical services, and limited prescription drug coverage. The Medicare Prescription Drug Program (Part D) provides individuals with prescription drug benefit coverage.back to top
Does Medicare cover hospice care?
Yes. You may receive care from any Medicare-certified hospice program. Original Medicare will pay the hospice provider for the services you receive and will also pay for all of your Part A and Part B services. Your provider will bill Original Medicare while your hospice election is in force.back to top
Refer to www.Medicare.gov for more detailed information