Medicare resources
Medicare is a government funded health insurance program for retired individuals who have reached the age of 65, or who become disabled. The official U.S. government site for people with Medicare provides information about the program and tools for comparing prescription drug plans, hospitals, home health agencies and more, or call 1.800.MEDICARE (1.800.633.4227).
- You have the right to appeal any decision about your Medicare services.
A Medigap policy is health insurance sold by private insurance companies to fill the “gaps” in Original Medicare Plan coverage. Medigap policies help pay some of the health care costs that the Original Medicare Plan doesn’t cover.
Some Medicare beneficiaries are eligible for Extra Help (800.772.1213) to pay for the costs—monthly premiums, annual deductibles, and prescription co-payments—related to a Medicare prescription drug plan.
Each state has a State Health Insurance Program (SHIP) which educates and assists Medicare beneficiaries, those eligible for Medicare, and caregivers about Medicare, Medicaid, Medigap, prescription drug benefits, and other issues related to health insurance benefits. Contact information for your SHIP can also be found by calling the Health Assistance Partnership at 202.737.6340.
The Medicare Rights Center (1.800.333.4114) helps answer questions about Medicare, and has caseworkers that can help you with a specific problem that you are having with Medicare including how to reduce premium and prescription drug costs, and how to appeal a denial by an HMO or Part D plan. Some helpful links on their site:
Medicare Part D (prescription drug coverage): If you have Medicare Part D, you may experience a gap in coverage (the donut hole) when your out-of-pocket costs reach a certain amount. To help with financial costs:
Other Medicare resources:
- Eldercare Locator connects older people and caregivers with information on senior services including Medicare.
- Benefits Checkup is designed for people over age 55 and can be used to connect patients to government programs that help pay for prescription drugs, health care, utilities and other needs.
Medicaid is a separate federal and state-funded safety net program that provides health insurance for eligible individuals with disabilities, the elderly, children and families, and pregnant women. Eligibility for Medicaid is dependent upon state-established income and resource guidelines.
- Medicaid is not the same as Medicare, however some people may be eligible for both Medicare and Medicaid if they meet the eligibility guidelines. To find out if you are eligible for both, contact your State Health Insurance Program (SHIP) or call 202.737.6340.
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