Medicare is the US Federal Government Health Insurance Program for:
• People 65 years of age and older.
• Some people with disabilities under age 65.
• Individuals with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).
Medicare has Four 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.
• Part C (Medicare Advantage Plans)
Medicare Advantage plans are offered by private insurance companies as an alternative to Original Medicare; plans are government subsidized and regulated.
• Part D (Prescription Drug Coverage)
Part D Plans are offered by private companies to provide coverage for prescription drug costs; plans are government subsidized and regulated.
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, hospice care, and some home health care.
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 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.
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.
Cost:
Medicare beneficiaries pay a monthly Part B premium. The monthly Part B premium for 2016 is $104.90 for Medicare beneficiaries with incomes under $85,000 (single) and $170,000 (married). 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 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. The annual deductible for Part B in 2016 is $166.00.
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. Visit your local Social Security office, or call the Social Security Administration at 1-800-772-1213 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.
Part C (Medicare Advantage Plans NH)
Individuals with Medicare can get supplement to Medicare (the traditional fee-for-service program) or from Medicare private plans (the Medicare Advantage program also known as Medicare Part C). Depending on where you live, you may be able to enroll in a Medicare Advantage Plan offering one or more of the following types of health care: HMO, PPO, PFFS, MSA.
Original Medicare NH
If you choose coverage under the traditional fee-for-service Medicare program, you can generally get care from any doctor or hospital you want and receive coverage for your care anywhere in the country. However, traditional Medicare has high cost-sharing requirements and does not currently cover the costs of certain services. To help pay for uncovered benefits and to help with Medicare’s cost-sharing requirements, many people in the traditional Medicare program have supplemental insurance, known as Medicare Supplements or Medigap Plans (these supplemental insurance plans fill in gaps that Medicare does not cover but unlike Medicare Part C and Part D, these plans are not part of the government Medicare program).
Medicare Part D (Prescription Drug Coverage)
Medicare Part D is the federal government’s prescription drug program that covers both brand-name and generic prescription drugs at participating pharmacies in your area. The coverage is available to all people eligible for Medicare, regardless of income and resources, health status, or current prescription expenses. Medicare prescription drug coverage provides protection for people who have very high drug costs. For more details see What is Medicare Part D.