The Medicare Project   
a consumer's guide to Medicare Information resources

topics in this section: Medicare basics, Insurance, Medicare eligibility

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Medicare Basics & Eligibility
Web pages and brochures that help explain what Medicare is, how Medicare insurance works, and Medicare eligibility regulations.

This is one section of The Medicare Project, a series of consumer directories that help seniors through the maze of Medicare information in the hundreds of pages at government and private websites. Our editors have chosen these recommendations to help you find answers to questions about Medicare insurance and coverage. This section focuses on the basic understanding of how Medicare works, who it covers, and Medicare eligibility issues.

Medicare Basics

Medicare is a health or medical coverage program that helps people 65 or older and younger persons with certain disabilities.

Almost all seniors in America have Medicare health insurance.

People pay towards Medicare through deductions from their earnings during their working years -- similiar to the way we all pay towards Social Security.


Web pages and brochures from government, education, and non-commercial sites about these subjects:

brochure:
FACT SHEET - Fundamental Issues Facing Social Security and Medicare –

source:United States - Department of The Treasury
file size: 4 pgs; languages: English
from the brochure: (date:2005) "...The long-term funding challenges facing Social Security and Medicare are the result of a fundamental shift in the demographics of the U.S. population which results in fewer workers supporting our nation’s retirees..."

web page:
Medicare Program - General Information Overview

source:Centers for Medicare & Medicaid Services
languages: English
from the web page: "...Part A Hospital Insurance - Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits... "

how to use this data
brochure:
Got Medicare sign-up headache? Here's help

source:Kaiser Family Foundation
file size;25 pgs; languages: English
decription from the website: "This primer... explains key elements of the Medicare program that provides health coverage to nearly 44 million people—including about 37 million people age 65 and older and another 7 million younger adults with permanent disabilities. It looks at the characteristics of the Medicare population, what benefits are covered, how much people with Medicare pay for their benefits and the program’s overall costs and future financing challenges...."


brochure:
Medicare & You 2008

source:Medicare.gov - The Official U.S. Government Site for People with Medicare
file size:120 pgs; languages: English, Spanish
from the brochure: "Summary of Medicare benefits, rights and protections, and answers to the most frequently asked questions about Medicare..."
 
more from Medicare.gov
web page:
Copy of Initial Enrollment Period Package
languages: English
from the web page: "You can view and print a copy of the Initial Enrollment Period Package online by accessing the links below. The Initial Enrollment Period Package includes important information about the decisions you need to make about whether to keep Medicare Part B or not...."

brochure:
Welcome to Medicare!
languages: English
description from the web site: "a booklet that introduces you to the Medicare Program and explains some very important decisions you need to make. ..."

web page:
Prescription Drug Coverage: Basic Information
languages: English
from the web page: "...What is Medicare prescription drug coverage? Medicare prescription drug coverage is insurance that covers both brand-name and generic prescription drugs at participating pharmacies in your area. Medicare prescription drug coverage provides protection for people who have very high drug costs or from unexpected prescription drug bills in the future...."

web page:
Getting Started with Medicare

source:AARP
languages: English, Spanish
from the web page: " Medicare is a federal health insurance program for people who are 65 and over, for some younger people with disabilities, and for people with end-stage kidney disease. Medicare has: * Hospital insurance, called Medicare Part A, which helps pay for hospital bills * Medical insurance, called Medicare Part B, which helps pay for doctor bills * Prescription drug insurance, called Medicare Part D, which helps pay for prescription drugs ..."
 
more from AARP:
web page:
Your Medicare Rights
languages: English
from the web page: "You have important rights in Medicare, no matter which plan you have. Compared to most private health insurance, Medicare has some of the best consumer protections..."



web page:
Information about Replacing a Medicare Card

source:Social Security Online
languages: English, Spanish
from the web page: (October 2006) "If your Medicare card is lost, stolen or damaged, you can ask for a new one at this website...."

web page:
Question: Medicare and Medicaid

source:USA.gov
languages: English, Spanish
from the web page: "...Medicaid is a program that is funded by both the state and federal governments. Medicaid provides healthcare for individuals of all ages who cannot afford health insurance. Please visit the CMS Medicaid Overview web page for additional information.

Medicare is a federally funded and administered program. Medicare provides health insurance for people ages 65 and over, some disabled individuals, and dialysis patients. We recommend visiting the Medicare web site for additional information...."


web page:
Medicare

source:University of Iowa Hospitals and Clinics
languages: English, Spanish
from the web page: "Medicare is available to you if you are at least 65 and are eligible to receive Social Security benefits or have been on Social Security Disability Insurance for two years. You may also qualify for Medicare if you have been diagnosed with end-stage renal disease regardless of age and are receiving dialysis or have received a kidney transplant...."


Medicare Eligibility

Generally, Medicare's eligibilty rules are simple: your age, your resident status, and your work history (earnings). In addition, people under 65 --the minimum age for Medicare for most people-- can qualify if they meet certain disability and/or disease requirements.

There's more to it than this simple explanation, and there are issues concerning the different parts of Medicare such as Part A, Part B, and the Prescription Drug Plans, so be sure to research the materials available online to determine your actual Medicare eligibility status. You can telephone various hotlines for help also.


web page:
Who is Eligible for Medicare?

source:Medicare.gov - The Official U.S. Government Site for People with Medicare
file size:120 pgs; languages: English, Spanish
from the web page: "Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States. If you aren?t yet 65, you might also qualify for coverage if you have a disability or with End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant)..."
 
more from Medicare.gov
web page:
Welcome to My Medicare Enrollment
languages: English
from the web page: "This section of the site is designed to provide you with information about your Medicare eligibility and enrollment. You will be asked to answer a series of questions. The number of questions, as well as the questions themselves will be dynamic based on your answers. Once we have collected enough information, we will display detailed information tailored to your specific situation. Please note that the Social Security Administration will make the final decision on your eligibility and enrollment status..."

web page:
Eligibility for Medicare

source:CalMedicare.org
languages: English
from the web page: "People in the following categories are eligible for Medicare... * People age 65 and older who are citizens or legal residents of the United States and who have worked (or their spouse has worked) for at least 10 years (or 40 quarters) in Medicare-covered employment...

 
also at CalMedicare.org
web page:
Medicare Eligibility If You Move
languages: English
from the web page: "If you are enrolled in Original Medicare and you move out of California (or to a different service area within the state), your Medicare benefits will not change...."

web page:
Retirement & Medicare

source:Social Security Online
languages: English, Spanish
from the web page:..."If you are getting Social Security benefits when you turn 65, your Medicare hospital benefits start automatically. If you are not getting Social Security, you should sign up for Medicare close to your 65th birthday, even if you aren't ready to retire..."

web page:
Medicaid - Medicare Eligibility Information

source:Pro Seniors, Inc.
languages: English, Spanish
from the web page:"This site provides general information only and not legal advice. The law is complex and changes frequently. Before you apply any information to a particular situation, call Pro Seniors' Legal Hotline or consult an attorney in elder law. The numbers listed below change annually on the effective date listed in the first column..."

web page:
Changing the Age of Medicare Eligibility

source:The Urban Institute
languages: English, Spanish
from the web page:"Implications for Older Adults, Employers, and the Government..."

 

 

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