Medicare: How will it help me?

Medicare is a benefit provided by the federal government that accrues to you according to your prior earnings in a way similar to Social Security benefits. For each and every year that you work your Medicare eligibility increases. You will be eligible for Medicare at the age of 65, although you may actually apply three months prior to your 65th birthday. People who are already receiving Social Security benefits are automatically enrolled in Medicare one month before their 65th birthday. Also, some people are eligible for Medicare if they are under 65 if they have been permanently and totally disabled for at least 24 months.

Medicare: How do I apply?

If for some reason you're not eligible for Medicare through your earnings history, you can purchase it as long as you're within the age requirements. You cannot be denied Medicare because of your medical history.

You may enroll in Medicare (or Social Security) by calling 1-800-772-1213 or by visiting your local Social Security office (check the government pages in your telephone book for office locations). It is probably a good idea to enroll in Medicare as soon as you are eligible rather than waiting until you need it. It is a good idea to get the paperwork out of the way so that you can access the benefits when you really need them.

How is Medicare administrated?

Medicare is usually contracted by the federal government to private insurance companies to administer the benefits. Your plan may be administered by Blue Cross or one of the other local health insurance companies in your area. Health Maintenance Organizations (HMO’s) also administer Medicare. If you're covered by an HMO you will need to choose one of their doctors and follow their rules for referrals when you need services. Having your Medicare plan administered by an HMO offers some benefits, but also creates some detriments to getting the care you want from the physicians you choose. It also provides an additional layer of administration to deal with. A Medicare cost plan allows you to choose where you will receive care, although usually you will pay more of the cost out of your own pocket. You may also choose a preferred provider organization (PPO), which allows you to use your primary care provider, who will then make referrals to specialists such as orthopedic doctors, psychologists etc.

Information from Seniors Rights by Brette McWhorter Sember

Additional information and web page by Paul Susic M.A. Licensed Psychologist Ph.D. Candidate Clinical Director- Senior Care Psychological Consulting