Health Care Choices For Minnesotans On Medicare - Metropolitan ...

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Health Care Choices for Minnesotans on MedicareMedicare Basics and Beyond in 2010What is Medicare?Medicare is a federal health insurance program thatbegan in 1965. States are not involved in the program’sadministration. In general, the rules governing Medicare’soperation are the same nationwide, though payment ratesoften vary from one region to another.CMS, SSA, RRBThe Centers for Medicare & Medicaid Services (CMS) isthe federal agency that administers Medicare and Medicaid(known as Medical Assistance in Minnesota). CMSheadquarters are in Baltimore, with ten Regional Offices.The Regional Office for Minnesota is located in Chicago.CMS manages Medicare’s program operations includingclaims processing, monitoring the quality of care forpatients, handling complaints and reviewing appeals.The Social Security Administration (SSA) handles Medicareeligibility and enrollment for Social Security recipients.SSA sends enrollment packets and Medicare cards to newMedicare beneficiaries. It also processes applications forMedicare Part D Extra Help (also known as Low IncomeSubsidy–LIS) program.The Railroad Retirement Board (RRB) handles Medicareeligibility and enrollment for Railroad Retirees.Medicare is a national health insurance program for:• People age 65 or older• People under age 65 with certain disabilities• People of any age with End-Stage Renal Disease (ESRD)–permanent kidney failure requiring dialysis or a kidneytransplantImportant! Medicare age is not based onSocial Security benefits age. Even though the retirementage for full Social Security benefits is increasing until itreaches 67, you will still get Medicare at age 65, eventhough you may not yet be eligible for Social Securityretirement benefits. The age eligibility date for Medicareremains age 65.The Basics: A, B, C, and D of MedicareOriginal Medicare: Medicare Part A and Medicare Part BMedicare Part A is hospital insurance.• Most people do not pay a premium for Part A. Theyreceive it premium-free because they have worked andhave more than 40 credits in Social Security-coveredemployment or they can receive Social Security benefitsbased on a spouse’s earnings.• You can get Medicare Part A at 65 without having to paypremiums if:nYou already get retirement benefits from Social Securityor the Railroad Retirement Board.nYou are eligible to get Social Security or Railroadbenefits but haven’t yet filed for them.nYou or your spouse had Medicare-covered governmentemployment.• If you are under 65, you can get Part A without havingto pay premiums if you have:nReceived Social Security or Railroad Retirement Boarddisability benefits for 24 months.nEnd-stage renal disease (ESRD) and meet certainrequirements.• In 2010, those with fewer than 40 credits, can buy PartA coverage for $461 per month (with 29 or less credits)or $254 per month (with 30 to 39 credits).• Who can purchase Medicare Part A?nU.S. citizens age 65 and older who do not have enoughwork credits.nPermanent resident aliens aged 65 and older whohave lived in the U.S. for 5 years before applying forMedicare.• A late enrollment penalty of 10% of the current monthlypremium must be paid if enrollment is a year or moreafter your 65 th birthday.Medicare Part A includes:• Inpatient hospital, including critical access hospitals,inpatient rehabilitation facilities, long-term care hospitalsand psychiatric hospitals• Skilled nursing facility• Home health care• Hospice care8
A publication of the Minnesota Board on Aging Senior LinkAge Line ®Medicare Part A Late Enrollment Penalty:If you are not automatically enrolled into Medicare Part A and do not sign up for it when first eligible, you may have topay a penalty unless you are eligible for a Special Enrollment Period (SEP). Individuals who enroll in Medicare Part A12 or more months after they are initially able to enroll, will be charged a 10% higher premium. This increased premiumwill be charged to the Medicare beneficiary for two times the number of years that the beneficiary was late in enrolling.Example: Mr. Lowry was one year late in enrolling in Medicare Part A, so he will pay increased premiums for two years.Medicare Part B is medical insurance.• In 2010, most people will pay a Part B monthly premium of $110.50. Part B premiums may be higher depending onyour income.• Current Medicare beneficiaries (enrolled as of 12/31/09) will continue to pay the 2009 monthly premium amount of$96.40 in 2010 if they had their Medicare Part B premiums withheld from their Social Security payment AND haveincomes of $85,000 or less (single filers) or $170,000 (joint filers) in 2009. Refer to chart below.• If you are eligible for Part A, you are also eligible for Part B.• People age 65 and older who are U.S citizens or permanent resident aliens for 5 years, who are not entitled toPart A can enroll in Part B without enrolling in Part A.Will you pay a higher Medicare Part B monthly premium in 2010?Income ThresholdLess than or equal to $85,000 ($170,000 couples)and did have Social Security withhold MedicarePart B premiums in 2009Less than or equal to $85,000 ($170,000 couples)and did not have Social Security withhold MedicarePart B premiums in 2009Greater than $85,000 and less than or equal to$107,000 ($170,000 to $214,000 couples)Greater than $107,000 and less than or equal to$160,000 ($214,000 to $320,000 couples)Greater than $160,000 and less than or equal to$214,000 ($320,000 to $428,000 couples)Part B Individual Monthly Premium$96.40$110.50$154.70$221$287.30Greater than $214,000 ($428,000 couples) $353.609
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