Medicare is a federal medical insurance program that helps to pay the medical bills of individuals at least 65 years of age and of disabled people.
Who is eligible?
Medicare is available to all citizens and certain legal aliens who are at least 65 years of age, who have permanent kidney failure, or who receive Social Security payments based upon age or disability. Medicare insurance is available based upon disability in cases in which entitlement to disability benefits has lasted for 24 months.
What benefits are provided?
Part A Medicare insurance covers hospital services, skilled nursing facilities, home health services, and hospice care. Medicare pays Part A providers directly, with recipients being responsible for a deductible and a 20 percent co-insurance requirement. Part A coverage may be purchased through the payment of a premium by individuals who are at least 65 years of age and do not qualify for Social Security.
Part B Medicare insurance, which requires the payment of a premium in all cases, covers physician services, outpatient hospital care, lab tests, and certain other medical services, equipment and supplies. There is a deductible and a 20 percent co-insurance requirement. Some Medicare managed care plans include coverage of other medical expenses, such as dental care, eyeglasses, hearing aids, and prescription drugs, within their Part B coverage. Providers of Part B services may elect to “accept assignment,” in which case they will accept payment directly from Medicare, and not charge more than what Medicare pays for, plus the co-insurance requirement. Medicare participants often purchase privately offered “medigap” insurance to help cover remaining medical expenses. Medicare requires open enrollment periods for this insurance. Medicare recipients with a household income below the federal poverty level who meet a financial resources test may use Medicaid to pay for Medicare premiums, deductibles, and co-insurance requirements, under the Qualified Medical Beneficiary program. If your household income is less than 120 percent of the poverty level and you meet the resources test, you still may use Medicaid to pay for your Part B premium, under the Special Low-Income Beneficiary program. You may apply for this assistance through the local Medicaid office of the Florida Department of Children and Families.
How do I apply?
You may apply for Medicare through your local Social Security office. There is a toll-free Social Security application number, 1-800-772-1213, and a toll-free TDD application number, 1-800-325-0778, for the deaf or hearing-impaired that may be used to contact your local office.
