MEDICARE
Medicare is health insurance for people age 65 or older, for
certain people with disabilities who are under 65, and for people
of any age who have permanent kidney failure. If you are receiving
Social Security or railroad retirement benefits, you are automatically
enrolled in Medicare when you turn 65. All others should contact
Social Security three months before their 65th birthday. If you
are under 65, you may be eligible for Medicare if you have been
a Social Security disability beneficiary for 24 months. Persons
with permanent kidney failure may be eligible for Medicare at
any age if they receive maintenance dialysis or a kidney transplant,
and if they are covered under their own work record or the work
record of a spouse or parent.
|
|
If you need an attorney and don't have one, the Lawyer Referral and Information Service can help.
Call Us Monday - Friday from 8:30 AM - Noon and 1:15 PM - 3:00 PM at (814) 459-4411.
|
|
Part A of Medicare is hospital insurance that pays for inpatient
care in a hospital up to 90 days, subject to a deductible for
the first 60 days and a daily coinsurance after 60 days. Part
A pays for skilled nursing care following hospitalization, up
to 90 days with no deductible but is subject to a daily coinsurance
after the first 20 days of stay in the facility. Part A pays
for home health care, with unlimited number of visits by professional
care givers, and durable medical equipment, with co-insurance.
Part A provides free hospice care for terminally ill people for
an indefinite period.
Part B of Medicare is medical insurance that covers doctor's
services, ambulance transportation, outpatient hospital care,
bone mass measurement, x-rays, diagnostic and preventive services,
and supplies not covered by Part A. An annual deductible must
be met before Medicare Part B begins paying for covered services.
Part B covers influenza immunization once a year, pneumococcal
pneumonia vaccination once in a lifetime, and hepatitis B vaccination
if needed. Part B beneficiaries with diabetes are eligible
for diabetic infusion pumps, blood glucose monitors, testing
strips, lancets, and self-management education and training
with a doctor's certification. Part B female beneficiaries
are covered for screening pap smear and pelvic exam, including
a clinical breast exam, every three years. Part B female beneficiaries
who are 40 years old or older are covered once annually for
screening mammogram. Part B male beneficiaries age 50 and older
are covered for a digital rectal exam and a prostate specific
antigen (PSA) test every year. Part B covers beneficiaries
age 50 and older for a fecal occult blood test once a year,
and a flexible screening sigmoidoscopy every four years. Screening
colonoscopies are covered every 24 months for beneficiaries
at high risk for colorectal cancer.
Medicare will not pay for custodial care, nursing home care,
dental care and dentures, routine checkups and tests, most immunization
shots, most prescription drugs, routine foot care, eyeglasses
and hearing aids, personal comfort items, and services provided
outside of the United States.
Under the traditional fee-for-service system, Medicare pays
a percentage of your hospital, doctor, and other health care
expenses. You are responsible for certain deductibles and coinsurance
payments. Under a managed care program, Medicare contracts with
a Health Maintenance Organization (HMO) which must provide all
covered hospital and medical services. You must enroll in Part
B and pay the monthly premium. The HMO receives a monthly payment
from Medicare. In addition, the HMO may charge you a monthly
premium and a small copayment each time you use the service.
To enroll for Medicare or for more information, call Social Security
at 1-800-772-1213 or 452-6696. The Social Security office in
Erie is located at 823 Peach Street.
If you need an attorney and don't have one, the Lawyer Referral and Information Service can help.
Call Us Monday - Friday from 8:30 AM - Noon and 1:15 PM - 3:00 PM
at (814) 459-4411. |
