Below are some of the most frequently asked questions about the federal health insurance programs Medicare and Medicaid. To read more about Medicare, you can visit its site.
Question: How can I get a replacement Medicare card?
Answer: If you lose your card, you can obtain a replacement card by phone at (800) 772-1213, or online at the Social Security Administration Web site. Make sure you have your Medicare number ready when you call. You should receive your new card in about four weeks.
Question: How can I find out if I have Medicare coverage?
Answer: You must call the Social Security Administration at (800) 772-1213 or contact your local Social Security Office to verify your Medicare Part A and Part B coverage. This information can also be found on your red, white, and blue Medicare card.
Question: Will I automatically be enrolled in Medicare when I turn 65?
Answer: If you are receiving Social Security or Railroad Retirement or disability benefits, you will be automatically enrolled in Medicare Part A and Part B. About three months prior to your 65th birthday or 24th month of disability, you will be sent an Initial Enrollment Package that will contain information about Medicare, a questionnaire and your red, white and blue Medicare card. If you want both Medicare Part A (hospital insurance) and Part B (medical insurance), you should sign your Medicare card and keep it in your wallet. If you don't want Part B coverage, you must put an "X" in the refusal box on the back of the Medicare card form; sign the form and return it with the card to Social Security at the address shown. You will then be sent a new Medicare card showing that you only have Part A.
Question: Does Medicare pay for dental services?
Answer: Medicare does not cover routine dental care or most dental procedures such as cleanings, fillings, tooth extractions or dentures. There are rare cases in which Medicare Part B will pay for certain dental services. In addition, there are some situations in which Medicare Part A will pay for certain dental services delivered on an inpatient basis. You should contact your local Carrier for more information. Check the Helpful Contacts section of the Medicare Web site for the phone number.
Question: Who submits my bills to Medicare? How much do I have to pay?
Answer: If you are in Original Medicare, your doctor or other health care provider will file your claim with Medicare. You'll receive a statement showing how much you'll need to pay. If you do not receive a Medicare statement (Medicare Summary Notice or Explanation of Medicare Benefits), you'll need to contact your local carrier to have them send you a copy. Check the Helpful Contacts section of the Medicare Web site for the phone number of your carrier. If you have supplemental insurance or Medigap, they may pay part of your costs. Check with your supplemental insurance company to find out what they will pay.
Question: What is Medicaid and who does it cover?
Answer: Medicaid is a health insurance program for certain low-income people. It covers children, the aged, the blind and disabled, and people who are eligible to receive other federal assistance.
Question: Does Medicare pay for eye exams?
Answer: Medicare does not pay for routine eye exams and eyeglasses. Medicare will help pay for one set of eyeglasses or contact lenses after cataract surgery. You should call your Durable Medical Equipment Regional Carrier for more information. Check the Helpful Contacts section of the Medicare Web site for the phone number for your Durable Medical Equipment Regional Carrier. Effective Jan. 1, 2002. Medicare now covers an annual (once every 12 months) dilated eye examination for all people with Medicare at high risk for glaucoma. This includes people with diabetes or a family history of glaucoma. The screening must be done or supervised by an eye doctor who is legally allowed to do this service in your state. Medicare covers 80 percent of the Medicare-approved amount for glaucoma screening after the individual has paid the $100 deductible for Part B services. You should check with your local Medicare carrier for specific coverage information for glaucoma screening. The contact telephone number for your local Medicare Carrier can be found in the Helpful Contacts. Medicare pays for many preventive services. These benefits are described in the Medicare Preventive Services to Help Keep You Healthy publication.
Question: What medical supplies and equipment does Medicare Part B cover?
Medicare Part B helps pay for durable medical equipment such as oxygen equipment, wheelchairs, and other medically necessary equipment that your doctor prescribes to use in your home. Other items covered by Medicare include:
- arm, leg, back and neck braces
- medical supplies such as ostomy pouches, surgical dressings, splints and casts
- breast prostheses following a mastectomy
- one pair of eyeglasses with an intraocular lens after cataract surgery
Medicare pays for different kinds of durable medical equipment in different ways. Some equipment must be rented, other equipment must be purchased. Your Durable Medical Equipment Regional Carrier can provide more specific information. Check the Helpful Contacts section of the Medicare Web site for the phone number for your Durable Medical Equipment Regional Carrier.
Question: Who is eligible for Medicare Part A (hospital insurance)?
Answer: If you have worked at least 10 years in Medicare covered employment you will qualify for premium free Medicare Part A (Hospital Insurance). To qualify, you must be:
- 65 or older; or
- disabled and receiving disability benefits from Social Security or the Railroad Retirement Board for 24 months; or
- have permanent kidney failure treated with dialysis or a transplant
You should contact the Social Security Administration to file an application. Check the Helpful Contacts section of the Medicare Web site for the phone number of the Social Security Office in your area.
Question: What diabetic supplies does Original Medicare cover?
Answer: Medicare covers the same supplies for both insulin and non-insulin dependent diabetics. They include:
- glucose testing monitor
- blood glucose test strips
- spring-powered devices for lancets
- glucose control solutions
Some frequency limitations may apply. Medicare does not cover insulin and syringes. Contact your Durable Medical Equipment Regional Carrier for more information. Check the Helpful Contacts section of the Medicare Web site for the phone number.
Question: What is a Medicare deductible?
Answer: A deductible is the amount you must pay each year before Medicare begins paying its portion of your medical bill. There are deductibles for both the Part A (Hospital Insurance) and Part B (doctor services) portions of Medicare. Your deductible is taken out of your claims when Medicare receives them. Medicare will not start paying on your claims until you have met your annual deductible. The Medicare Part A deductible for 2002 is $812 per benefit period. The Medicare Part B deductible for 2002 is $100. If you have any questions on the status of your deductible, please contact your Medicare carrier.
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