Medicare Has Four Parts
Collectively, Medicare has four parts and a supplement.
Medigap supplemental coverage is the additional component. Effectively, it closes the gap of cost Original Medicare leaves to beneficiaries in Parts A and B for medically necessary and preventive health services.
The below-itemized descriptions cover the essential parts of Medicare.
Status Of Medicare Advantage And Part D
A Medicare Advantage, or Part C, plan is administered by a private health insurance company that contracts with Medicare.
You can check the status of a Medicare Advantage plan application by contacting the private insurer who administers your plan.
A Medicare Part D plan provides prescription drug coverage. Like Medicare Advantage, Part D plans are administered by private insurance companies.
To check your application status, contact the member services department of your Part D plan for more information.
You can also ask your pharmacy to check the status of your Part D enrollment by sending a test claim to the company.
How Do You Get Another Medicare Card
My card is lost or damaged Log into your Medicare account to print an official copy of your Medicare card. You can also call us at 1-800-MEDICARE to order a replacement card. TTY users can call 1-877-486-2048.
My name changed Your Medicare card shows the name you have on file with Social Security. Get details from Social Security if you legally changed your name.
Protect your identity
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Supplies Covered By Medicaid
The following medical supplies could be covered by Medicaid, depending on the state and the individual plan:
Bladder control pads, pull-on underwear, adult briefs, & more.
Catheters, insertion kits, lubricant, condom catheters, & more.
Test strips, blood glucose monitors, lancets, test solution, & more.
Skin barriers, 2 piece pouch systems, drainage bags, & more.
Bandages, foam dressings, tape, gauze, hydrogels, & more.
Using Your Healthy Connections Plan
Q. What medical services does Medicaid cover? A. Within certain limits, Medicaid will pay for services that are medically necessary. Examples of services that may be covered include doctor visits, medications, hospital visits, and many other medical services.
If you have any questions about what is covered, to view a chart that shows each health plan and what they cover. You can also contact Healthy Connections toll-free at 1-888-549-0820.
Q. How long will my Medicaid benefits remain active? A. Eligibility for most Healthy Connections programs lasts for 1 year. After 1 year, South Carolina Health and Human Services will review your case annually.
Q. I was enrolled in S.C. Healthy Connections Choices and now am told I must choose between health plans. What should I do? A. The Healthy Connections Choices website offers comprehensive information on its health plans. Members may utilize a Quick Start Guide, search for doctors, compare plans, and more. Please visit S.C. Healthy Connections Choices for more information.
Q. Do I need to tell South Carolina Healthy Connections when I move or change jobs? A. Yes. If you have any changes to your income, resources, living arrangements, address or anything else that might affect your eligibility you must report these changes to Healthy Connections right away at 1-888-549-0820.
Q. What if my Medicaid card is lost or stolen? A. Report a lost or stolen card to Healthy Connections immediately at 1-888-549-0820.
Medicare Offers Easy Enrollment
The best way to find out if one has Medicare is to apply. The main websites for Medicare and Social Security have short and simple online application pages. One can apply and get an official answer very quickly. The sites state the qualifications needed, and they process moves quickly for most applicants.
The Medicare system requires choices. One must choose the all-in-one plans of Medicare Advantage or the Original Medicare with Prescription drug and Medigap benefits added.
Comparison shopping is the ideal tool for making selections of private health, prescription drug, and gap insurance plans.
Should I Sign Up For Medical Insurance
With our online application, you can sign up for Medicare Part A and Part B . Because you must pay a premium for Part B coverage, you can turn it down.
If youre eligible at age 65, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after that birthday.
If you choose not to enroll in Medicare Part B and then decide to do so later, your coverage could be delayed and you may have to pay a higher monthly premium for as long as you have Part B. Your monthly premium will go up 10 percent for each 12-month period you were eligible for Part B, but didnt sign up for it, unless you qualify for a “” .
If you dont enroll in Medicare Part B during your initial enrollment period, you have another chance each year to sign up during a general enrollment period from January 1 through March 31. Your coverage begins on July 1 of the year you enroll. Read our publication for more information.
Who Is Eligible For Medicare
Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease . Medicare has two parts, Part A and Part B . You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:
- You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
- You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
- You or your spouse had Medicare-covered government employment.
To find out if you are eligible and your expected premium, go the Medicare.gov eligibility tool.
If you did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:
- You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months.
- You are a kidney dialysis or kidney transplant patient.
While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.
Take Advantage Of Open Enrollment
Medicare holds its open enrollment period from October 15 through December 7 of each calendar year. This period is the ideal time to review current enrollment coverage and consider ways to improve coverage and reduce costs. Beneficiaries can perform many tasks during open enrollment including the below-listed changes.
- Change from Original Medicare to Medicare Advantage
- Switch from Medicare Advantage to Original Medicare
- Switch Medicare Advantage Plans
- Add a Part D Prescription Drug Plan
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Medicare Coverage For Breast Cancer Treatment
If you are diagnosed with breast cancer, both Part A and Part B cover different parts of your treatment. For example, Part A would cover:
- Inpatient hospital stays, including cancer treatments you get while an inpatient
- Skilled nursing facility care
- Home health care
- Mental health services
Specific to breast cancer treatment, Medicare also covers:
- Surgically implanted breast prostheses after a mastectomy Part A would cover if implanted in an inpatient setting, and Part B if it takes place in an outpatient setting
- External breast prostheses, including a post-surgical bra
Co-payments, co-insurance, or deductibles may apply for each service, and you must continue to pay your Part B premium. To learn how much a test, item, or service would cost, contact Medicare or talk to your provider.
Does The Eligibility Age Change For Types Of Medicare Coverage
No. If you want to enroll in a Medicare Advantage or Medicare Supplement insurance plan, you must have Medicare Parts A and B. Youll need Part A and/or Part B if you sign up for a stand-alone Medicare prescription drug plan.
So, unless you qualify for a Medicare Advantage plan due to disability, you wont be able to get one if youre under 65.
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Signs Of Breast Cancer
The most common symptom of breast cancer is a new lump or mass. The lump can be painless, hard, and irregular, or tender, soft, or round. It may also be painful. However, other signs to look out for include:
- Swelling of part or all of the breast
- Skin dimpling
- Breast or nipple pain
- Nipple or breast skin that is red, dry, flaking, or thickened
- Nipple discharge
- Swollen lymph nodes
- Changes in size or shape of the breast
- A change in color of the breast skin
Keep in mind symptoms can be caused by other things and may not mean breast cancer, but you should talk to your provider right away to get any additional screenings or tests you may need. Your provider can help you determine whether something you notice is cause for concern, or if it’s a benign condition.
Will I Get Medicare At 62 If I Retire Then
No. Even if your spouse is eligible for Medicare when you retire at 62 , youre not eligible unless you qualify by disability.
if you retire before age 65, you may be able to continue to get medical insurance coverage through your employer, or you can purchase coverage from a private insurance company until you turn 65. While waiting for Medicare enrollment eligibility, you might want to visit healthcare.gov, or your state insurance agency on your states official website, to learn about your options.
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Get Information Online By Phone Or Mail
The federal and state governments have taken a lot of steps to make information about Medicare available to everyone. The best advice for someone approaching the age of 65 is to make a study of the benefits and requirements for Medicare. Eligibility, application procedures, and timing matter the outcomes can be better or worse depending on the actions you take. You can also get information online, call Medicare or Social Security, or write.
How Old Do You Have To Be To Get Medicare
Early Medicare: Do you want to know when you can start receiving Medicare benefits? For most people in the United States, Medicare coverage begins at age 65 and continues for the rest of their lives. You can get Medicare before you turn 65 if you qualify for it due to a handicap.
If youre under the age of 65 and meet the following criteria, you may be eligible for Medicare.
For at least 24 months, youve been receiving Social Security disability benefits. When you turn 25, youre usually automatically enrolled in Medicare.
You have kidney disease that has progressed to the final stage . You may be eligible for Medicare, but you are not immediately enrolled. You should contact Social Security or go to their website, www.socialsecurity.gov.
You have Lou Gehrigs disease, also known as amyotrophic lateral sclerosis . Youve been signed up automatically.
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The Parts Of Medicare
Social Security enrolls you in Original Medicare .
- Medicare Part A helps pay for inpatient care in a hospital or limited time at a skilled nursing facility . Part A also pays for some home health care and hospice care.
- Medicare Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.
Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.
- Supplemental policies help pay Medicare out-of-pocket copayments, coinsurance, and deductible expenses.
- Medicare Advantage Plan includes all benefits and services covered under Part A and Part B prescription drugs and additional benefits such as vision, hearing, and dental bundled together in one plan.
- Medicare Part D helps cover the cost of prescription drugs.
Most people age 65 or older are eligible for free Medical hospital insurance if they have worked and paid Medicare taxes long enough. You can enroll in Medicare medical insurance by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. To learn more, read .
Understanding Medicare Part A Eligibility
- You’re 65 and already receive benefits from Social Security.
- Youre 65 and already receive benefits from the Railroad Retirement Board .
- You’re under 65, have a disability, and are receiving disability benefits.
- You have ALS or ESRD .
If any of the above Medicare Part A eligibility qualifications apply to you, then youre considered Medicare eligible. Your Medicare card will be mailed to you three months before your 65th birthday or on your 25th month of disability.
If you arent getting benefits from Social Security at least four months before you turn 65, you’ll need to sign up with Social Security directly.2
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What Are My Rights As A Medicare Beneficiary
As a Medicare beneficiary, you have certain guaranteed rights. These rights protect you when you get health care, they assure you access to needed health care services, and protect you against unethical practices.
You have these rights whether you are in Original Medicare or another Medicare health plan.
Your rights include, but are not limited to:
The Right to Receive Emergency Care
If you have severe pain, an injury, or a sudden illness that you believe may cause your health serious danger without immediate care, you have the right to receive emergency care. You never need prior approval for emergency care, and you may receive emergency care anywhere in the United States.
The Right to Appeal Decisions About Payments or Services for Medical Care
If you are enrolled in Original Medicare, you have the right to appeal denial of a payment for a service you have been provided. If you are enrolled in another Medicare health plan, you have the right to appeal the plan’s denial for a service to be provided.
The Right to Information About All Treatment Options
You have the right to know about all your health care treatment options from your health care provider. Medicare forbids its health plans from making any rules that would stop a doctor from telling you everything you need to know about your health care. If you think your Medicare health plan may have kept a provider from telling you everything you need to know about your health care options, then you have the right to appeal.
Understanding Original Medicare Coverage
Original Medicare is government-run medical care and insurance coverage. It uses a fixed price for services a type of managed care. Members have freedom to choose any doctor or hospital in the network. They do not need referrals or special permissions for the majority of available services.
The Original Medicare network is broad ad diverse. It includes thousands of doctors and medical care facilities across the United States.
What Are The Parts Of Medicare
The different parts of Medicare help cover specific services:
- Medicare Part A Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
- Medicare Part B Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
- Medicare Part D Helps cover the cost of prescription drugs .
People Who Have Both Medicare & Medicaid
People who have both Medicare and full Medicaid coverage are dually eligible. Medicare pays first when youre a dual eligible and you get Medicare-covered services. Medicaid pays last, after Medicare and any other health insurance you have.
If you choose to join a Medicare Advantage Plan, there are special plans for dual eligibles that make it easier for you to get the services you need, include Medicare coverage , and may also cost less, like:
- Special Needs Plans
- Medicare-Medicaid Plans
- Program of All-Inclusive Care for the Elderly plans can help certain people get care outside of a nursing home
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How Can I Check To See If I Have Medicare
There are several ways to check the status of your Medicare coverage:
Lastly, you can check your status on the Medicare enrollment page, by logging in with the following information at hand:
- ZIP code
- date of birth
- Medicare Part A effective date
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