Who is eligible for Medicare?

You are eligible for Medicare if you:

• Reach 65 and are entitled to monthly Social Security benefits.
• Are 65 or over and have a spouse entitled to Social Security benefits, even if you are not.
• Are 65 or over and are the widow or widower of someone who was entitled to Social Security benefits.
• Are under age 65 and have received Social Security disability benefits for at least 24 months.
• Are entitled to Social Security benefits and need maintenance kidney dialysis or a kidney transplant, regardless of your age.

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How do I apply for Medicare?

When you meet one of the eligibility requirements simply sign up for Social Security benefits and your Medicare card will be sent to you in the mail. Many people sign up during the three months prior to their 65^th birthday. However, other rules apply if you:

• Collected Social Security benefits before turning 65.
• Work past age 65.
• Are eligible for Medicare because of a disability.

For more information, contact Social Security at 1-800-772-1213 (TTY/TDD: 1-800-325-0778) Monday through Friday, 7 a.m. to 7 p.m., or visit the Social Security Administration website at www.ssa.gov.

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What is the Medicare Modernization Act?

The Medicare prescription drug program and the changes to Medicare managed care, now known as Medicare Advantage, are the result of the Medicare Modernization Act. In 2003, Congress passed a new law to bring people with Medicare more choices in health care coverage and better health care benefits. This law preserves and strengthens the current Medicare program and adds important new preventive benefits. It also adds a prescription drug benefit (Medicare Part D) that Medicare beneficiaries may purchase from a private insurer. The benefit also provides extra help to people with low incomes.

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What are the basic parts of the Medicare program now?

Part A (Original Medicare Plan) is managed by the federal government to cover inpatient hospital and skilled nursing facility care, home health agency services and hospice benefits - usually for no monthly premium.
Part B (Original Medicare Plan) is managed by the federal government to cover doctor services and outpatient care for a low monthly premium, which is deducted from your Social Security check.
Part C (Medicare Advantage Plans) is offered by companies like Aetna, who contract with the federal government, to cover the same or better benefits than the Original Medicare Plan (Parts A and B). Some Medicare Advantage plans include Medicare prescription drug coverage (MA-PD plans), others do not (MA plans).
Part D (Medicare prescription drug coverage) is offered by companies like Aetna, who contract with the federal government, to help cover your prescription costs only. This coverage is available as a Medicare Prescription Drug Plan (PDP) or as part of a Medicare Advantage plan (MA-PD).
Medigap (Medicare Supplement Plans) are offered by companies like Aetna to help pay for select benefits not covered by the Original Medicare Plan (Parts A and B). As of 2006, new Medicare supplement policies will not cover prescription drugs.

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When can I switch Medicare health plans?

Generally, you can only make plan selections or changes to your current Medicare coverage during certain times of the year. From November 15 through December 31, known as the annual enrollment period, anyone with Medicare can select a new Medicare health and/or prescription drug plan for the new plan year. This is also the time that anyone with Medicare can make changes to their current coverage.

Generally, you may not make any other changes during the year unless you meet certain special exceptions, such as if you move out of the plan's service area or if you have Medicaid coverage. Later in the year, from November 15 through December 31, anyone with Medicare can select a new Medicare health plan.

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What's the difference between traditional Medicare and Medicare prescription drug coverage?

Original Medicare - Parts A and B - covers hospitalization and outpatient medical services. Prescription drug coverage was not included in the Original Medicare plan. Medicare prescription drug coverage (Medicare Part D) now makes the opportunity available for an individual to receive a prescription drug benefit through the Medicare program.

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