Marci’s Medicare Answers, information from the Medicare Rights Center

Dear Marci,

Every year my Medicare Part B premium is higher. What will it be this year?                                                           -Scott

Dear Scott,

In 2007, most people’s Medicare Part B premium will be $93.50. For the first time ever, the Part B premium is based on income. If your annual income is above $80,000 ($160,000 for couples) your Part B premium will be higher than $93.50. To find out what you will pay, call Social Security at 1-800-772-1213 or check http://www.medicarerights.org/newmedicarecosts.html.       -Marci

Dear Marci,
I plan to spend the winter in Florida. Will Medicare cover my health care there?

Mary

Dear Mary,

Dear Marci,

I'll turn 65 in August, but my Social Security benefits do not begin until December. When and how do I sign up for Medicare?

—Paul

Dear Paul,

You can sign up for Medicare during the three months before, the three months after, and the month that you turn 65. To enroll in Medicare, either go to your local Social Security office or mail Social Security a dated letter that includes your name, signature, Social Security number and the date you want to be enrolled in Medicare. Be sure to note who you spoke with and keep copies of any letters, so you can prove that you tried to enroll in Medicare when you were first eligible. You will be charged a premium penalty if you delay enrolling in Medicare Part B, unless you have employer health insurance through your or your spouse's job at a company that employs at least 20 people. Call 800-772-1213 to locate your local Social Security office, or 800-MEDICARE if you have questions about your Medicare coverage.

Marci

Dear Marci,

My mother broke her hip and was in the hospital for four days. Now her doctor recommends that she enter a skilled nursing facility. Will Medicare cover this?

—Mary

Dear Mary,

Medicare will cover your mother's care in a Medicare-certified skilled nursing facility (SNF) if she was in the hospital for at least three days during the 30 before being admitted in to the SNF, needs either skilled nursing care seven days a week (like injections) or skilled therapy (like physical or speech therapy) at least five days a week, and became eligible for Medicare before she was discharged from the hospital. If your mother meets these requirements, Medicare will pay the full cost of her first 20 days in a Medicare-certified SNF, and part of the next 80 days each benefit period. A benefit period begins the day she enters the SNF and ends when she no longer receives SNF care for 60 days in a row. To learn more about SNFs, or to find a Medicare-certified one for your mother, speak with her doctor and the hospital discharge planner, or call the Eldercare Locator at 800-677-1116.

Marci

Dear Marci,

I've been in the same Medicare HMO for years, but now my doctor has left the plan's network. Can I drop the HMO?

Eddy

Dear Eddy,

You have until March 31 to drop your Medicare HMO and switch to Original Medicare or another Medicare private health plan (such as an HMO or PPO). Every year, everyone with Medicare can drop or change their health plan one time between January 1 and March 31 during the Open Enrollment Period, with coverage effective the next month. You can also change your choice of Medicare health coverage between November 15 and December 31, with new coverage effective on January 1. You cannot decide to add or drop Medicare drug coverage (Part D) during the Open Enrollment Period.

Marci

If you would like to speak to one of our counselors about Medicare, please call one of the following hotlines:

Consumer Hotline. Through the Consumer Hotline (800-333-4114), MRC provides counseling to individuals who need answers to Medicare-related questions or help getting care. Hotline counselors are available Monday through Friday, 9AM - 1PM.

RxHelp Hotline for Professionals. MRC operates a national Rx Help hotline (877-RxHelp-0) for professionals with questions on the new Part D prescription drug benefit. Rx Help is staffed by Medicare specialists committed to providing accurate, non-biased information and resources to nonprofit professionals serving the Medicare population. With support from the Brookdale Foundation Group, hotline counselors are available Monday through Friday 10am – 6pm (Eastern Standard Time).

HMO Hotline. MRC operates a national Medicare HMO Appeals hotline (888-HMO-9050) to assist Medicare HMO members who are appealing HMO denials of care or coverage.

LINCS hotline. Linking Individuals in Need to Care and Services (LINCS) is a service that links low-income New Yorkers with Medicare to programs that will reduce their prescription drug costs, by calling 888-RX-LINCS (888-795-4627). LINCS counselors will complete and submit Extra Help applications for New Yorkers with Medicare who qualify.