Understanding Otc Drug Cards
Medicare Advantage OTC cards are prepaid and you can get them through your Medicare Advantage plan. You can use this card to purchase qualifying OTC items at participating places. The products you can purchase differ depending on your plan and provider. Some of the products available for purchase include:
- Antibiotic creams/ointments
- Other Health Products
- Other Wellness Products
These cards are issued through your Medicare Advantage plan. Your Medicare Advantage insurance plan provider will manage your card including depositing it with funds each month, depending on your plan terms. One of the best features of this card is that it is accepted by the majority of big stores that sell OTC products.
Am I Eligible For Medicare
To receive Medicare, you must be eligible for Social Security benefits.
Part A Eligibility
Most people age 65 or older are eligible for Medicare Part A based on their own employment, or their spouse’s employment. Most people have enough Social Security credits to get Part A for free. Others must purchase it.
You are eligible for Medicare Part A if you meet one of the following criteria:
- You are eligible for Social Security or Railroad Retirement benefits, even if you do not receive those benefits.
- You are entitled to Social Security benefits based on a spouse’s, or divorced spouse’s work record, and that spouse is at least 62 years old.
- You have worked long enough in a federal, state, or local government job to be eligible for Medicare.
If you are under 65, you are eligible for Medicare Part A if you meet one of the following criteria:
- You have received Social Security disability benefits for 24 months.
- You have received Social Security benefits as a disabled widow, divorced disabled widow, or a disabled child for 24 months.
- You have worked long enough in a federal, state, or local government job and meet the requirements of the Social Security disability program.
- You have permanent kidney failure that requires maintenance dialysis or a kidney transplant.
- You are diagnosed with ALS or Lou Gehrig’s disease.
Part B Eligibility
If you are eligible for Part A, you can enroll in Medicare Part B which has a monthly premium.
Will I Need To Prove My Age?
What Is The Medicare Part A Deductible
To receive help covering this deductible, many beneficiaries enroll in a Medicare Supplement plan. The Medicare Part A deductible benefit period begins when you become an inpatient in the hospital.
Then, the benefit period continues until youve been out of the hospital for a minimum of 60 days. Any care in a skilled nursing facility after your hospital stay counts toward the benefit period.
Every time a new benefit period starts, you must meet the Part A deductible. Meaning, if you are out of the hospital for at least 60 days and then need to be re-admitted, you must meet the deductible again.
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To Qualify For Medicare You Need To Get Disability Benefits From:
- Social Security
- Railroad Retirement Board
If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
If you live in Puerto Rico or outside the U.S.
Documents You Need To Apply For Medicare
To begin the application process, youll need to ensure you have the following documentation to prove identity:
- A copy of your birth certificate
- Your drivers license or state I.D. card
- Proof of U.S. citizenship or proof of legal residency
You may need additional documents as well. Make sure to have on hand:
- Your Social Security card
- W-2 forms if still active in employment
- Military discharge documents if you previously served in the U.S. military before 1968
- Information about current health insurance types and coverage dates
If you are already enrolled in Part A and have chosen to delay enrollment in Part B, you will need to complete additional forms .
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How Much Does Medicare Cost
Original Medicare is divided into Part A and Part B .
- Part A helps pay for inpatient hospital care, some skilled nursing care, home health care and hospice care.
- Part B helps pay for doctor services, outpatient hospital care, durable medical equipment, home health care not covered by Part A, and other services. Medicare was never intended to pay 100% of medical bills. Its purpose is to help pay a portion of medical expenses. Medicare beneficiaries also pay a portion of their medical expenses, which includes deductibles, copayments, and services not covered by Medicare. The amounts of deductibles and copayments change at the beginning of each year.
Part A – Monthly Premium
If you are eligible, Part A is free because you or your spouse paid Medicare taxes while you were working. You earn Social Security “credits” as you work and pay taxes. For each year that you work, you earn 4 credits.
You are 65 or older, and you receive or are eligible to receive full benefits fr om Social Security or the Railroad Retirement Board
You are under 65, and you have received Social Security disability benefits for 24 months You are under 65, and you have received Railroad Retirement disability benefits and you meet Social Security disability requirements You or your spouse had Medicare-covered government employment You are under 65 and have End-Stage Renal Disease
How To Apply Online For Just Medicare
If you are within three months of turning age 65 or older and not ready to start your monthly Social Security benefits yet, you can use our online retirement application to sign up just for Medicare and wait to apply for your retirement or spouses benefits later. It takes less than 10 minutes, and there are no forms to sign and usually no documentation is required.
To find out what documents and information you need to apply, go to the .
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How Do I Check On My Online Medicare Application
You can check on the status of your Medicare application at any time using your My Social Security account. You can use the confirmation number you received when you submitted your application.
Youll be able to see when your application has been received, is processing, and is approved. You can also call Social Security at 800-722-1213 to check on your status.
Youll receive a decision letter in the mail when Social Security is done processing your application.
Youll also receive your Medicare card in the mail, as long as your application was approved. It generally takes less than a month from the time you apply to the time you receive your card in the mail.
If Your Income Has Gone Down
If your income has gone down due to any of the following situations, and the change makes a difference in the income level we consider, contact us to explain that you have new information and may need a new decision about your income-related monthly adjustment amount:
- You married, divorced, or became widowed.
- You or your spouse stopped working or reduced your work hours.
- You or your spouse lost income-producing property because of a disaster or other event beyond your control.
- You or your spouse experienced a scheduled cessation, termination, or reorganization of an employers pension plan.
- You or your spouse received a settlement from an employer or former employer because of the employers closure, bankruptcy, or reorganization.
If any of the above applies to you, we need to see documentation verifying the event and the reduction in your income. The documentation you provide should relate to the event and may include a death certificate, a letter from your employer about your retirement, or something similar. If you filed a federal income tax return for the year in question, you need to show us your signed copy of the return. Use Form Medicare Income-Related Monthly Adjustment Amount Life-Changing Event to report a major life-changing event. If your income has gone down, you may also use Form SSA-44 to request a reduction in your income-related monthly adjustment amount.
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If Youre New To Medicare
Youll have to manually apply for Medicare if:
- You live in Puerto Rico. You may get automatically enrolled in Part A as described above, but youll need to sign up for Part B.
- You arent receiving retirement benefits yet.
- You have end-stage renal disease .
If you have end-stage renal disease , you can apply for Medicare at any time. Otherwise, youre first eligible to enroll during your seven-month Initial Enrollment Period, which typically starts three months before you turn 65, includes the month of your 65th birthday, and ends three months later. When your Medicare coverage begins and when you get your Medicare card depends on the month you sign up during this period.
If you dont enroll in Medicare during your Initial Enrollment Period, in most cases youll have to wait until the General Enrollment Period, which takes place from January to March 31 every year. You may have to pay a late-enrollment penalty for Medicare Part B .
Some people decide to delay Medicare Part B enrollment if they have other coverage, since Part B comes with a premium. If youre working and have health coverage through an employer, you can sign up for Part B with a Special Enrollment Period when you stop working or that coverage ends. You wont have to pay a late enrollment penalty if you sign up during a Special Enrollment Period.
If you worked for a railroad, youd apply for Medicare through the Railroad Retirement Board. Otherwise, youd sign up through Social Security.
Keep Your Information Secure
Identity theft affects millions of people each year and can cause serious financial and identity-related problems. Protect yourself by securing your personal information, taking the time to understand the threat of identity theft, and exercising caution.
Protect Yourself From Fraud
Social Security is diligently working at national, regional, and local levels to combat the fraud that undermines our mission to serve the American public.
There are steps you can take to help protect your personal information:
- Do not routinely carry your Social Security card.
- Never say your Social Security number aloud in public.
- Beware of phishing scams to trick you into revealing personal information.
- Create a mySocial Security account to help you keep track of your records.
- Visit If You Want Extra Security to learn about extra verification steps we can add to your account.
Report Suspicious Activity
If you receive a suspicious call from someone claiming to be from Social Security, hang up and then report details of the call to the Office of the Inspector General. You can do this by submitting a report online.
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Exempt From The Three Month Waiting Period
Canadian Armed Forces Dependents
The spouse or dependent of a regular member of the Canadian Armed Forces who has entered the province from another Canadian province or territory are entitled to first-day coverage providing they have established residence in the province of New Brunswick.
Foreign Nationals/Out of Country Residents moving back to New Brunswick
As of June 17, 2010, Foreign Nationals or Canadians moving back to New Brunswick from another country are entitled to Medicare coverage from their first day of arrival in the province providing they are deemed by the Director to have established a permanent residence within New Brunswick. Decisions will be made on a case by case basis.
NOTE: If you have moved to New Brunswick from another Canadian province or territory, it is recommended that you contact your former place of residence to ensure continuous coverage during the three month waiting period.
Aging In To Medicare Coverage
As soon as you or anyone else covered by your health insurance becomes eligible for Medicare, that person must enroll in both Part A and Part B . You must have Medicare parts A and B to enroll in retiree insurance and prescription drug programs. If you, your spouse, or your dependents don’t enroll in Medicare Part B when first eligible, the insurance for that person will be canceled and there is a six-month wait to reenroll.
Tell ORS your Medicare number and effective dates for parts A and B
Once you are enrolled in Medicare you will receive your Medicare card from Social Security. As soon as you receive your card, tell ORS your Medicare number and effective dates for parts A and B.
- Log in to miAccount and send a secure message on Message Board, using the Submit My Medicare Number category. Include the name, Medicare number, and effective dates for parts A and B in your message for the individual going on Medicare.
- Use miAccount to update your Medicare information and complete a plan change to enroll in the Medicare health and prescription drug plan. Print the confirmation page and mail or fax it to ORS.
- Make a copy of your Medicare card. Write your name, member ID, address, and date of birth on the copy and mail or fax the copy of your card.
- Mail or fax a completed Insurance Enrollment/Change Request form to ORS with your Medicare information.
Medicare enrollment is automatic for most people if:
- You have paid into Medicare for 10 years.
- You are turning 65.
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If You Need A New Medicare Card Sooner
Have a doctors appointment? If you cant wait 30 days for your new card to arrive, you can visit your local Social Security office or call 1-800-772-1213 Monday through Friday, from 7AM to 7PM.
The agency will mail you a letter that you can use as proof of Medicare eligibility until you receive your new Medicare card. You should receive this letter within 10 days of submitting the request.
If you receive Railroad Retirement Board benefits, you should call your local RRB office or 1-877-772-5772. TTY users can dial 1-312-751-4701. Representatives are available Monday through Friday, from 9AM to 3:30PM.
Under 65 And Disabled
If you are disabled and you have been receiving Social Security benefits for 24 months, you will automatically be enrolled in Medicare Part A and Medicare Part B at the beginning of your 25th month. You will receive a Welcome to Medicare packet in the mail three months before your 25th month of receiving Social Security benefits, which will include your Medicare card.
When Can You Sign Up If You Missed The Initial Enrollment Period
If you didnt sign up when you were first eligible and you dont have current healthcare coverage elsewhere , youll have to wait for the next General Enrollment Period which runs each year from January 1 through March 31.
Your coverage will then begin in July of that year, and you may have to pay a late enrollment penalty on your Medicare Part B premium for as long as you have Part B coverage. Your premium will go up by 10% for every 12-month period you werent enrolled.
How To Enroll In Medicare Online
To be clear, you dont have to sign up for Medicare online. You can do so over the phone or in person, but if youre looking to save time, completing an online application is probably the best way to go.
The first step in enrolling in Medicare online is creating an account on the Social Security Administrations web site. You do not need to sign up for Social Security at the same time as Medicare, so if thats not your plan, worry not. Youll be asked whether you wish to enroll in one program or both during the signup process.
Next, youll need to provide some basic information like your name, address, and telephone number, and youll also need your Social Security number to complete your application. In addition, youll need information that helps identify you, such as your birth certificate, drivers license, or proof of U.S. citizenship if you werent born in the U.S. If youre not a citizen, youll need your permanent resident card number.
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Explore Your Other Medicare Coverage Options
Once you are enrolled in Original Medicare, you can explore additional coverage options.
You can decide to:
- Add a Medigap supplement insurance policy.
- Add a Part D prescription drug plan.
- Switch to a Medicare Advantage plan also known as Part C to replace your Original Medicare coverage.
Medicare Part D, Medigap and Medicare Advantage are all administered by private insurance companies that contract with CMS.
You can apply for these benefits online.
Use the Medicare Plan Finder tool to explore and compare plans in your area.
Monthly Medicare Premiums For 2021
The standard Part B premium for 2021 is $148.50. If youre single and filed an individual tax return, or married and filed a joint tax return, the following chart applies to you:
|Modified Adjusted Gross Income||Part B monthly premium amount||Prescription drug coverage monthly premium amount|
|Individuals with a MAGI of less than or equal to $88,000 Married couples with a MAGI of $176,000 or less||2021 standard premium = $148.50|
|Your plan premium + $77.10|
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