Medicare Info
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We are Participating providers of Medicare and most State Medicaids. Approved Medicare reimbursements cover 80%. Medicaid and certain secondary insurances usually cover the remaining 20%; less any deductibles or copayment.
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Medicare has Two Parts:
- Part A (Hospital Insurance): Most people do not have to pay for Part A.
- Part B (Medical Insurance): Most people pay monthly for Part B.
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, hospice care, and some home health care. Information about your coverage under Medicare Part A can be found in the Your Medicare Coverage database.
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 (or your spouse) did not pay Medicare taxes while you worked and you are age 65 or older, you still may be able to buy Part A. If you are not sure you have Part A, look on your red, white, and blue Medicare card. It will show "Hospital Part A" on the lower left corner of the card. You can also call the Social Security Administration toll free at 1-800-772-1213 or call or visit your local Social Security office for more information about buying Part A. If you get benefits from the Railroad Retirement Board, call your local RRB office or 1-800-808-0772.
For More Information About Medicare Part A Coverage:
Visit the Your Medicare Coverage.
Call your Fiscal Intermediary about Part A bills and services. The phone number for the Fiscal Intermediary in your area can be found in the Helpful Contacts section.
Part B (Medical Insurance)
Helps Pay For:
Doctors' services, outpatient hospital care, and some other medical services that Part A does not cover, such as the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. Information about your coverage under Medicare Part B can be found in the Your Medicare Coverage database.
Cost:
You pay the Medicare Part B premium of $78.20 per month in 2005. This amount may change January 1, 2006. In some cases this amount may be higher if you did not choose Part B when you first became eligible at age 65. The cost of Part B may go up 10% for each 12-month period that you could have had Part B but did not sign up for it, except in special cases. You will have to pay this extra 10% for the rest of your life.
Enrolling in Part B is your choice. You can sign up for Part B anytime during a 7-month period that begins 3 months before you turn 65. Please 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 have Part B, the premium is usually taken out of your monthly Social Security, Railroad Retirement, or Civil Service Retirement payment. If you do not get any of the above payments, Medicare sends you a bill for your Part B premium every 3 months. You should get your Medicare premium bill by the 10th of the month. If you do not get your bill by the 10th, call the Social Security Administration at 1-800-772-1213, or your local Social Security office. If you get benefits from the Railroad Retirement Board, call your local RRB office or 1-800-808-0772.
For More Information About Medicare Part B Coverage:
Visit the Your Medicare Coverage.
Call your Medicare Carrier about bills and services. The phone number for the Medicare Carrier in your area can be found in the Helpful Contacts section.
You may have choices in how you get your health care including the Original Medicare Plan, Medicare Managed Care Plans (like HMOs), and Medicare Private Fee-for-Service Plans.
Who is Eligible for Medicare?
Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States. You might also qualify for coverage if you are a younger person with a disability or with End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant).
Here are some simple guidelines. You can get Part A at age 65 without having to pay premiums if:
- You are already receiving retirement benefits from Social Security or the Railroad Retirement Board.
- You are eligible to receive Social Security or Railroad benefits but have not yet filed for them.
- You or your spouse had Medicare-covered government employment.
- You have received Social Security or Railroad Retirement Board disability benefit for 24 months.
- You are a kidney dialysis or kidney transplant patient.
Note: You will be eligible for Medicare when you turn 65 even if you are not eligible for Social Security retirement benefits. For more information, please visit our retirement age FAQ. If you have questions about your eligibility for Medicare Part A or Part B, or if you want to apply for Medicare, please call the Social Security Administration toll-free at 1-800-772-1213 or visit or call your local Social Security office. The TTY-TDD number for the hearing and speech impaired is 1-800-325-0778. You can also get information about buying Part A as well as Part B if you do not qualify for premium-free Part A.
Enrolling in Medicare
Medicare Has Two Parts. They are:
- hospital insurance or Medicare Part A (hospital insurance), which helps pay for care in a hospital and skilled nursing facility, home health care and hospice care; and
- medical insurance or Medicare Part B (medical insurance), which helps pay for doctors, outpatient hospital care and other medical services.
To find out how you enroll in Medicare Part A & B, please go to My Medicare Enrollment.
General Enrollment Period
If you did not take Part B when you were first eligible for Medicare, you may sign up during the General Enrollment Period. The General Enrollment Period runs from January 1 through March 31 of each year.
Remember, the cost of your Part B may go up 10% for each 12-month period that you could have had Part B but did not take it, and you will have to pay this extra amount as long as you have Part B, except in special cases.
If you already have Medicare Part A and need Part B you can sign up for Part B at your local Social Security office or by calling 1-800-772-1213.
Medicaid Information:
Medicaid is health insurance that helps many people who can't afford medical care pay for some or all of their medical bills. Read more about Medicaid
Medicaid State Programs
Medicaid is a state administered program and each state sets its own guidelines regarding eligibility and services. Read more about your state Medicaid program. Click here or select your state from the list below:
Eligibility:
Medicaid eligibility is limited to individuals who fall into specified categories. The federal statute identifies over 25 different eligibility categories for which federal funds are available. These categories can be classified in to five broad coverage groups:
- Pregnant Women;
- Children and Teenagers;
- Person who is Aged, Blind, and Disabled
Select your state from the list of states below to find specific information regarding eligibility in your state.
What Medicaid Covers:
Medicaid is a state administered program. Each state sets its own guidelines subject to federal rules and guidelines. Certain services must be covered by the states in order to receive federal funds. Other services are optional and are elected by states.
Click here for general information about Medicaid Services.
To find specific information regarding services in your state, select your state from the list of states below.
State Children's Health Insurance Programs (SCHIP)
The State Children's Health Insurance Plan (SCHIP) offers health insurance plans for children, up to age 19, who are not already insured. Families who earn too much to qualify for Medicaid may be able to qualify for SCHIP. Read more about SCHIPAdditional Medicaid Resources & Topics