Medicare Basics

What is Medicare?
Medicare is a health insurance program for people over age 65 as well as for some people with disabilities under age 65 and people with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant).

There are two parts to Medicare:

1. Part A - Hospital Insurance
   This covers 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. Most people get Part A automatically when they turn age 65 and do not have to pay a monthly 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. The Social Security Administration (1-800-772-1213) can give 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.

2. Part B - Medical Insurance
   Most people pay a monthly premium for Part B. This portion of Medicare covers doctors, services, outpatient hospital care, and some other medical services that Part A does not cover, including 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.

   For 2006, the Medicare Part B premium is $88.50 per month. 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 seven-month period that begins three months before you turn 65. To enroll, call the Social Security Administration at 1-800-772-1213 . 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 three 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 contact your local Social Security office. If you get benefits from the Railroad Retirement Board, call your local RRB office or 1-800-808-0772.

Who is Eligible for Medicare?
Generally, you are eligible for Medicare if you meet all three of the following:

• you or your spouse worked for at least 10 years in Medicare-covered employment
• you are 65 years old
• you are a citizen or permanent resident of the United States.

You might also qualify for coverage if you are a younger than 65 and have a disability or have End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant).

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.