Professional Documents
Culture Documents
You already get retirement benefits from Social Security or the Railroad Retirement Board.
Youre eligible to get Social Security or Railroad benefits but havent filed for them yet.
You got Social Security or Railroad Retirement Board disability benefits for 24 months.
You have End-Stage Renal Disease (ESRD) and meet certain requirements.
In most cases, if you choose to buy Part A, you must also have Medicare Part B (Medical Insurance) and pay monthly premiums for both. Some people automatically get Medicare Part A (Hospital Insurance). Learn how and when you can sign up for Part A: https://medicare.gov/sign-up-change-plans/get-parts-a-and-b/get-parts-a-and-b.html Contact Social Security for more information about the Part A premium: http://www.ssa.gov/
If youre in a Medicare Advantage Plan or other Medicare plan, you may have different rules, but your plan must give you at least the same coverage as Original Medicare. Some services may only be covered in certain settings or for patients with certain conditions.
Hospital care Skilled nursing facility care Nursing home care (as long as custodial care isnt the only care you need) Hospice Home health services
Talk to your doctor or other health care provider about why you need certain services or supplies, and ask if Medicare will cover them. If you need something thats usually covered and your provider thinks that Medicare wont cover it in your situation, youll have to read and sign a notice saying that you may have to pay for the item, service, or supply.
Local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.
Medicare covers services (like lab tests, surgeries, and doctor visits) and supplies (like wheelchairs and walkers) considered medically necessaryto treat a disease or condition. If youre in a Medicare Advantage Plan or other Medicare plan, you may have different rules, but your plan must give you at least the same coverage as Original Medicare. Some services may only be covered in certain settings or for patients with certain conditions.
Medically-necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment. Part B covers things like:
Talk to your doctor or other health care provider about why you need certain services or supplies, and ask if Medicare will cover them. If you need something thats usually covered and your provider thinks that Medicare wont cover it in your situation, youll have to read and sign a notice saying that you may have to pay for the item, service, or supply.
Local coverage decisions made by companies in each state that process claims for Medicare. These companies decide whether something is medically necessary and should be covered in their area.
If you get Social Security, Railroad Retirement Board (RRB) benefits, or Civil Service benefits, your Medicare Part B (Medical Insurance) premium will get deducted from your benefit payment. If you don't get these benefit payments and you sign up for Part B, you'll get a bill.
You're a working disabled person under 65 You lost your premium-free Part A when you went back to work You aren't getting medical assistance from your state You meet the income and resource limits required by your state
Married couple monthly income limit* $1723 Program helps pay for: Part B premiums only Qualified Disabled and Working Individuals (QDWI) Program Individual monthly income limit* $3809 Married couple monthly income limit* $5129 Program helps pay for: Part A premiums only Note *Limits are slightly higher in Alaska and Hawaii. If you have income from working, you may qualify for benefits even if your income is higher than the limits listed.
Your home One car Burial plot Up to $15,000 for burial expenses if you have put that money aside Furniture Other household and personal items
Make sure your Medicare card is valid and that you've paid your Part B premium. Go to a doctor, other health care provider, or supplier that acceptsassignment. Read about how to get help with medical and prescription drug costs.
Medicare also has a tool that provides the names, addresses, and contact information for suppliers that provide services or products under the Medicare program. Please
visit: http://www.medicare.gov/Supplier/Include/DataSection/Questions/SearchCriteria.asp?version=default&b rowser=Chrome%7C21%7CWindows+7&language=English&defaultstatus=0&pagelist=Home&CookiesEnab ledStatus=True For more information, please visit: www.medicare.gov