What is Medicare?
Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). It is administered by the Centers for Medicare and Medicaid Services. You can enroll through the Social Security Administration or Railroad Retirement Board.
Medicare covers certain services and supplies in hospitals, doctors' offices and other healthcare settings. Services are either covered under Medicare Part A (Hospital Insurance) or Medicare Part B (Medical Insurance). Medicare Part A and B are commonly referred to as Original Medicare.
What does Medicare Part A (Hospital Insurance) Cover?
- Inpatient care in hospitals
- Inpatient stays in a skilled nursing facility
- Hospice care services
- Some home health services
What does Medicare Part B (Medical Insurance) Cover?
- Doctors services
- Outpatient services
- Durable Medical Equipment (DME)
- Some home health services
- Preventive services
When can you sign up for Medicare Part A and/or Part B?
Initial Enrollment Period – When you first become eligible for Medicare. The 3 months before you turn age 65 to 3 months after the month you turn age 65.
General Enrollment Period – Between January 1 and March 31 each year. Coverage will be effective July 1 of the same year.
Special Enrollment Period – If you wait to sign up for Part B because you or your spouse (or family member if you are disabled) is working and has group health plan coverage through the employer or union, you have an 8-month enrollment period that begins the month the employment ends, or the coverage ends, whichever comes first. Other situations may qualify you for a special enrollment period.
Special Enrollment Period for International Volunteers – If you wait to enroll in Part B because you have health insurance while volunteering in a foreign country, you have a 6-month period to sign up when you are no longer volunteering outside of the United States, or the sponsoring organization is no longer tax exempt, or you no longer have health coverage outside the United States, whichever comes first.
Who Pays for Medicare Part A and/or Part B?
You usually do not pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working. If you are not eligible for premium-free Part A, you may be able to buy Part A.
You pay the Part B premium each month. Most people pay the standard premium amount. However, individuals with higher incomes will pay a slightly higher premium. You also pay a Part B deductible each year before Medicare starts to pay its share.
If you do not sign up for Medicare Part A and B when you first become eligible or during a special enrollment period, you may pay a late enrollment penalty (10% penalty for each full 12-month period that you could have had Part B, but did not sign up for it).
If you have limited income and resources, you may be able to get help to pay for Medicare Part A and/or Part B.
Contact GeorgiaCares at 866-552-4464 (Option 4) for the current Medicare Premium and Deductible Rates.