I have Medicare. What do I need to know?

You have a federally administered health care plan. Medicare is administered by the Centers for Medicare and Medicaid Services (CMS). You have a health insurance card that looks like this:

Many people have either Part A (Hospital), Part B (Outpatient), or they may have both Parts A and B. These Medicare "parts" are only for your health care and do not cover your prescription medications. Medicare Advantage Plans and Medigap plans are two types of Medicare Part C options.  You cannot have both a Medicare Advantage Plan AND a Medigap, you must choose between either a Medicare Advantage Plan or a Medigap. Prescription medications are covered under Medicare Part D.  Not sure what type of coverage you have?  Not sure if you qualify?  Contact the toll-free APPRISE Helpline 1-800-783-7067.

For individuals and Medicare beneficiaries with behavioral health (mental illness and/or substance use disorders), contact the Behavioral Health Connection at 1-866-588-0223 x115. All services are free and confidential.

How much does the Medicare Part A (Hospital) premium cost?

For most people, if they have at least a 10-year work history (they paid the Medicare tax during their employment), they will not pay a monthly premium for Medicare Part A. If a spouse worked and paid the Medicare tax during a 10-year work history, then an individual could also access Medicare Part A without a monthly premium under the spouse's Social Security number. If a person did not have the 10-year work history, did not have a spouse who worked and paid into the system, he/she may have a monthly premium for Part A. Contact the Social Security Administration to find out the amount.

How much does the Medicare Part B (Outpatient) premium cost?

For 2014, the Medicare Part B premium is $104.90 per month. Most people have this amount automatically deducted from their monthly Social Security Administration benefits. Have questions? Contact the Social Security Administration: 1-800-772-1213

How much do Medicare supplemental plans cost?

The costs for "supplemental plans" such as a Medicare Advantage plan or Medigap varies. Not sure which option is best for you? Contact us for free, unbiased information at 1-866-588-0223 x115 or bhc@olderpa.org.

Dates to remember...

When can I sign up for Medicare?

You may be eligible for Medicare due to a variety of reasons: 1) age (are you 65 years or older?), 2) disability (have you been disabled for at least 24 consecutive months?), or 3) chronic disease (HIV/AIDS, End Stage Renal Disease, etc.).  Contact the Social Security Administration (1-800-772-1213 or www.ssa.gov) for more information and to see if you qualify.

September: the new version of the "Medicare & You" books are usually released.  This book will provide information about Medicare updates as well as the Medicare Advantage and prescription drug plans available in your area.  If you currently have a Medicare Advantage Plan, Medigap and/or a Prescription drug plan, you will receive a letter from your insurance provider informing you of any changes the plan will make for the upcoming year, starting on January 1.  Pay attention to any changes as you may want to see if there is a different plan to better suit your needs.  Contact us during the "Annual Enrollment Period" listed below.

Annual Enrollment Period: October 15-December 7 of each year

This is an important time period to remember because it is when you can "shop around" to see if you should keep or change your medical or prescription drug plan.  As a person's medications and medical needs change, he/she may find a better health insurance option.  If someone changes to a different plan during October 15-December 7, the new plan will begin on January 1 of the following year.  For example, if Mary changes to Plan "X" on December 6, 2014, her new plan (Plan "Y") will begin coverage on January 1, 2015.

Each year during October 15-December 7, local APPRISE programs and the Behavioral Health Connection will be out in the community meeting with people one-on-one to discuss their options. Not sure what to do or what your best options are? Contact your local APPRISE program here:Find your local APPRISE program (click on the county you reside in), call the toll-free APPRISE Helpline 1-800-783-7067 or the Behavioral Health Connection 1-866-588-0223, all services are free and confidential.

New to Medicare?

If you have only Medicare and no other insurance coverage, you will want to discuss your options with a trained APPRISE counselor.  APPRISE counselors provide FREE and unbiased assistance/information to Medicare beneficiaries and their caregivers to determine what options are best.  APPRISE counselors are trained and monitored by the PA Department of Aging.  We are not insurance brokers/agents, therefore we do not make any financial gain and we do not try to "sell" any product(s) to Medicare beneficiaries. 

Want to speak with an APPRISE counselor?  Call the Behavioral Health Connection at 1-866-588-0223.  Or find your local APPRISE program here:Find your local APPRISE program (click on the county you reside in) or call the toll-free APPRISE Helpline 1-800-783-7067, all services are free and confidential.

Do you have Medicare AND behavioral health questions or needs?

The Behavioral Health Connection is an APPRISE program (Medicare counseling) designed to assist beneficiaries with behavioral health (mental illness and/or substance use disorders) consumers in PA.  Have questions?  Please call us: 1-866-588-0223. All services are free and confidential. 



 3544 North Progress Avenue, Suite 107 |  Harrisburg, PA 17110  |  717-857-3163Click here to go to the National Suicide Prevention Lifeline website

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