Medicare Casework - FAQs
Click on the Topic Headings for More Information
Basic Questions
Hospital & Doctor's Visits (Part A & Part B)
Medicare's Prescription Drug Plan (Part D)
Basic Questions
How do I replace my Medicare Card?
If you lose or damage your Medicare card, you can obtain a replacement
card from the Social Security Administration one of the following ways:
- Order
a new card online, which will be mailed to you in 30 days.
- If you need proof right away that you have Medicare, contact your local
Social Security Office or call the toll-free number at 1-800-772-1213.
The people there can give you proof that you can use until you get your
replacement Medicare card.
How do I enroll for Medicare Coverage?
If you are receiving SSA benefits when you turn 65 years old you will
be automatically enrolled (you have the right to refuse Part B). If you
are disabled and receive benefits you will be automatically enrolled after
24 months. You will not have to wait the 24 month period if you are in
end-stage renal disease. For more detailed information about enrolling
in Medicare, please
visit their website or call Medicare at 1-800-633-4227.
Is there an online tool to help me figure out when I will be
eligible for Medicare?
You can visit
Medicare's online eligibility calculator.
Does Medicare have an easy to read "handbook" explaining
benefits, rights, and protections?
Each year Medicare publishes "Medicare
& You" to provide enrollees with this information in an easy
to understand format. It
is available online here.
Hospital & Doctor's Visits (Part A & Part B)
What are the differences between Part A and Part B?
Medicare Part A helps pay for: inpatient hospital care, skilled nursing
facility care, home health care and hospice care. Medicare Part B helps
pay for: doctors services, out patient hospital services, home health,
diagnostic X-ray, laboratory and other tests, necessary ambulance services
and other medical services and supplies. Medicare does not pay for custodial
care, dentures or routine dental care, eye glasses, hearing aides, nursing
home care (except skilled care), prescription drugs and routine check-ups
and tests. There is no premium for Medicare Part A, however; there is
a premium for Part B. You may qualify for help with your premium if you
meet the income eligibility guidelines set by the Pennsylvania Department
of Welfare. For
more detailed information, Medicare's website has developed a publication
explaining these two benefit programs.
Does Medicare have a tool to help me look up coverage for specific
visits and procedures?
Visit the "Your
Medicare Coverage Database" to find out detailed and personalized
information about your coverage.
What happens if I don’t apply when originally eligible
for Part B?
You will need to enroll in the “Special Enrollment Period”,
which is between January 1st through March 31st, however there will be
a 10% increase for each 12 month period you were eligible to enroll.
I’m covered by other insurance, how do I enroll when I
no longer have coverage?
You will be able to enroll without the 10% penalty if you enroll any time
while you are still covered by the other insurance or if you enroll during
the eight month period that begins with the month your original health
coverage ends.
What preventive services are covered by Medicare?
2003's Medicare Modernization Act significantly increased the level of
preventive services, screenings, and tests covered by Medicare. Visit
Medicare's website to learn more about these important health tools.
I have questions about Medicare Health Plans, Medicare Advantage,
and/or Medigap policies. What information is out there to help me make
sense of these programs?
Medicare health plans provide different ways to get your health care coverage
in the Medicare program. The Medicare health plan that you choose affects
many things like cost, benefits, doctor choice, convenience, and quality.
Visit Medicare's
webpage on Medicare Health Plans for detailed information on these
plans or call Medicare at 1-800-633-4227.
Medicare's Prescription Drug Plan (Part D)
Where can I find basic information on the Prescription Drug Plan?
You can visit
Medicare's website or call Medicare directly at 1-800-633-4227.
Is there help out there to pick a Medicare Part D plan?
You can call Medicare at 1-800-633-4227 or call you local Active Aging
or Area Agency on Aging and an APPRISE volunteer will be able to help
you pick the plan that best suites your needs. Medicare's
website has a comprehensive website dedicated to helping you find and
understand a prescription drug plan that meets your needs. In addition,
please consult Medicare's
list of issues to consider when picking a drug plan.
I am looking to see if a drug I take now or may be taking in
the future is included on a drug plan's list of covered drugs (formulary).
Where can I find this information?
Medicare has provided a listing
of all drug plan forumlaries for each individual state online. In
addition, you can call Medicare at 1-800-633-4227.
I’m currently on PACE, have VA coverage or am enrolled
in a private plan coverage. Should I enroll in a Medicare Part D Prescription
Plan?
If you are enrolled in PACE you do not need to join one of the Medicare
Part D plans. However; if the state dissolves the PACE program it is considered
“credible” insurance and you will be able to enroll in a plan
with no penalties. This is also true for those who currently obtain their
prescriptions with the Department of Veterans Affairs. If your private
plan is deemed “creditable” you do not have to enroll in a
Medicare Part D, however; if the plan dissolves or you lose coverage you
will be able to enroll with no penalties. For more information about PACE
Plus Medicare Part D, please
visit PACE's website or contact PACE at 1-800-225-7223.
I am Dual Eligible with Medicare and Medicaid do I need to enroll
in a Medicare Part D prescription plan?
If you were duel eligible or become duel eligible you will be automatically
enrolled in a prescription plan and will not be charged a premium. Medicare's
website has detailed answers to questions you may have regarding a specific
coverage situation.
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