How Medicare Works

I am disabled and receiving my widows pension. Was told at 52 I go to Medicare instead of Medicade. Is this true

My brother lives in NJ he has beginning of Alzheimer's his wife and him wants to move to Florida I live in palm coast Florida can recommend some location

To quote the 3 Amigos, there are plethora of free services that can you help you learn more about Medicare: 1. State Health Insurance Assistance Programs (SHIP) 2. Medicare Rights Center 3. AARP (great basic information) You can also research ways to save costs through targeted programs: 1. Medicare Savings Programs (Medicare.Gov) 2. State Pharmaceutical Assistance Programs

Hi my mother lives with me and she has Alzheimer's I need a day care have her be during the day I live in Orlando,Florida can recommend some locations

Re: G'ma42young comment: Yes, the plan F does pay the copays, etc, but you do pay a premium for that if you have purchased it as a Medicare supplement and if you consider what it costs you every month, most of the time the premium exceeds what you would have paid in the HMO copays. Especially if you purchase one that covers your prescriptions also, which the HMOs cover as well.

I find it unfair that other plans beside HMO's are not discussed here nor, are they advertised bc the gov't would rather we all take these type of HMO's so they do not have to process anything. The ins co's do it all but there are co pays,deductibles and limits. I have a plan "F" and do not pay any of that. This is not a service to the elderly.

Medicare is a great alternative to private insurance but before completely relying on the said government program, why not assess your needs first and find out if this program provides benefits that can satisfy your needs? This is very important because this federal program has its limitations and this might create inconveniences and financial problems to you in the future. I suggest you determine your needs first, do a little bit more research about long term care, and it can also help if you ask the help of a specialist.

I am 69 ,I got my green card in October 2012' which rules me out of Medicare Advantage.

Am I correct that if I am still fully employed at age 65 and covered by my employer's health plans, that I am NOT required to take Medicare Part B until after I stop working; and then I will not be penalized so long as I enroll in the first year I am not covered by my employer's health plan?

My advice is not try to deal with the Social Security Administration without an attorney. Lawyers advertise extensively about the two-thirds of disabilty claims denied until the client obtains legsl assistance when 75% of the claims are validated. I have had the same experience dealing with the SSA for Medicare. The SSA's main goal is to eliminate subscribers, to impose penalties which would make a loan shark blush with shame, and to even interfere with the provision of services by private insurance companies. After my experiences with the SSA I would prefer an IRS audit any day than to deal this tyrannical federal agency.

In your article you have OMITTED COMPLETELY the Medigap coverage called Plans A thru J. We are very happy with our Plan F, purchased through USAA. We found that the Medicare Advantage plans were difficult to understand and predict, changed (usually to company's benefit) with yearly market conditions, and seemed like a gamble for the individual. Thanks for great articles. I am a frequent reader.

It was spelled out simply and clearly.

I know better how to prepare. Thought once one was eligible for Social Security Medicare was automatic - know how to prepare as the time draws nigh...

There is FREE help with any questions, problems, decisions or possible fraud concerning Medicare by state certified volunteers. These are people who are NOT selling any health insurance, give any legal advce, or get paid for their time. Each state has Senior Health Insurance Program (SHIP). They go by different names in each state, but they can be contacted by calling Medicare (1-800-Medicare, 1-800-633-4227), and asking for the state's SHIP 800 telephone number; then calling and getting the county's local SHIP number. It may take quite a bit of time, but it is worth the effort. You will get someone who has been certified by the state to be a help to any Medicare beneficiary. They have been mandated in the original Medicare legislation back in 1965 when Pres. Johnson signed Medicare into law that the states were to assist the Medicare beneficiaries with any difficulties with Medicare. I know this because I am one of these volunteers and we are usually recruited through other organizations like AARP, senior centers, community centers, or retireement organiztions. We are "the best kept secret about Medicare. If you have any questions, any SHIP would be able to answer it or get you referred to the proper place or handle any appeals legally. Medicare .

For those of you who did not understand what "financial Assistance" said, Medicare part F is just a Medicare supplement policy that covers the Part A and B deductibles and copays. That would mean everything is covered but just remember, these supplements that do these are usually very expensive, 150 to 200.00 a month for good policies that roll over from Medicare and do not need separate billing. And most people that are pretty healthy would not pay that in copays on an HMO in a month or in the 20 percent of Medicare allowable in Medicare office visits. But if you have lots of illnesses and go into hospitals a lot, it would be worth it with the big inpatient deductibles.

A person eligible for medicare must be aware that the costs associated with dementia and Alzheimer's are paid at a lower rate than other medical costs. And that amount fluctuates according to when the treatment was administered. Be careful!

I would like to know why we have the HMO's crammed down our throats in the form of TV commercials however, I have a Plan F that covers More than the HMO's. I have no co-pays, no deductibles and my Plan F is billed by Medicare. I do nothing. The Government is taking advantage of the elderly and it makes me angry that we can't even get all of the available facts. There are plans that go clear to J but AARP (the supposedly help for the elderly ) has done everything to capitalize on all so the seniors are in the dark. This is disgusting. If I was to get cancer, I would have to come up with a huge co-pay before I could get chemo with the HMO's with mine, I have to come up with nothing. Is our government telling all that to our seniors???? I think not. I will not belong to AARP when they have taken advantage of seniors. They charged me 3X 's for my house and auto insurance under Hartford. Wrong!Q!!Q

Have not seen it laid out these plainly before.

Concise lists of coverages.

This article is very helpful in a general sort of way. It needs updating. The new dates for the open enrollment period have been moved to October 15 to December 7 starting in 2011. That means to be able to make any changes in your health insurance, without a penalty, is between those dates. Those changes will take effect the next January 1. Also, there is a penalty in Part D that can be very severe. You are penalized if you do NOT select a "credible" drug plan when you are first eligible. For more complete information, go to www.Medicare.gov and get the full story. Other than these two glaring problems, the article lays out the major emphasis.

So much is a mystery about medicaid.

Hi sherr421, Thank you very much for your comment. I am very sorry to hear about your situation. That must be very difficult for you. If you'd like you can post your question in our Ask & Answer section, here : ( http://www.caring.com/ask ). I hope that helps. Take care -- Emily | Community Manager

This is a long story my mother got severly sick cva, while she was in hospital my sister took allher belonging house , money, ect said she did ent them and dident even pay a small bill to sears. I disowened im a sister before my mom was sick she took my son collected his child support . I was hard for me to go to moms it was so intense and i was very very sad, it was all over money, then she slander my name to all my relitives from fla to va. I tried to dight but i was tolld i made too much money for free help to get him back. but with my sister having a business they let her have free help and i signed a paper i though was for medical . i was going through a bad devorice and i had to go to va to get rid od cancer flA wouldent help. . so i left my son till i got back . only i lost him cause of it . I dident do drugs but i was on house arrest cause i coulent pay a 200 fine they wouldent waive fla.I never seen the poa or anything . she broke her hip my sister was out of town and no one could find poa i never seen her finances or anything . i know she had around 25,000 that got spent. my sister filed a lawsuit again either ormc or a nursing home way out in middle of fla which i cloudent get to. I asked what she got from lawsuit she wouldent respond. so now my mom is in nursing home sitting there alll alone . she will let her immidate family live there but not me im hard up . i take alot hardships she sold all the cars after my moms boyfriend died a few days after he was burried . i had no vehicle at time. She has helped lots of strangers in my moms house . i was in there only cause it was vacant to long but it was neglecter or it would have to tear down. I have been unemployed gone through hell is there anything i can do or do i got to accept this abuse . slander my name so eveyone in my family hate me. cause she wanted everything forher self . i was told by here once to go to a homeless sheter. any advice is this legal

This was a great source, thanks

It is important to know who pays first - Medicare or your HMO or PPO. While we pay the Medicare premium (deducted from our Social Security checks), our HMO pays first. I never even show my Medicare card.

mainly good for info for a friend who hasn't enrolled in MC yet even though she is now 68 - still works.....

If you are having trouble with prescriptions not being covered by Medicare/Medicaid or other insurance you should contact : www.pparx.org or print a free prescription savings card at www.SuperRxcard.com or order your medicines from an online Canadian pharmacy. The free SuperRxcard can be used at local pharmacies. Canadian pharmacies have the cheapest prices. pparx.org might be able to help you get into a free or reduced price program if you qualify. Try SuperRxcard.com or any of the free drug cards online first.

Good article! Love to see it so well explained. We do a one page (back and front) fact sheet every year to help people w/the various "parts" as well as updated costs: http://www.agingwisely.com/2011-medicare-fact-sheet/ (here is 2011's). To most people (even many who have been on Medicare for years) it's all a bunch of alphabet soup...

Your website is very informative,and yes,this article on Medicare was very informative to me,and thank you for having such a good,caring,website for people to help each other find help to take care of their relatives..All states should offer a pay to whoever is taking care of their elderly parent,or family member..It would save the government alot of money,instead of plopping them all in nursing homes..which alot of loneliness,and some abuse can be found.They are also finding out its cheaper for the relative to take care of them,especially with not many jobs for people to find right now,with the unemployment so high,the government could give the person a job,and save alot of money,considering what a nursing home costs these days..My ex fatherinlaw was in one,for assisted living,and it was $4000 a month,plus..now he cannot get himself up out of his wheelchair,and the new nursing home is costing him $6,000 a month,its a good thing he has minors black lunch,and a good pension or he would be in one that probably wouldn't take as good of care as the nice one he's in right now..this channeling of the money,could serve two purposes,its a win/win situation..I take care of my Dad at home,and retired from working from the school system for 30 yrs.so,for me,it wasn't a big wage loss,as I get a good pension..and my dad is fairly comfortable..we can afford to pay someone to watch him,when I need to pick up his pills,shop,or for me to go to the doctors..we are very lucky..alot of peoplel aren't,and my heart goes out to them..There will be more people like my dad,since the baby boomers are the largest population in the country right now,arrp can prove that..and they are (the ones who didn't take care of themselves)going to need alot of help in the next 8 yrs..anyway,thank you for your site,its very informative..I can feel for all of you caretakers..my dad just fell sept.15 and broke his hip,he is mending at home very well,after rehab,and surgery,and he has good medical coverage..which I think made a big difference in his recovery...also,he only has some dementia,and is 88 yrs.young(he thinks he's young,he doesn't like to use a cane,since he said only old people use one)he's funny..and was a good dad,and still is(most of the time)he gets sundowners sometimes,and we clash at times..but I love him,and he loves me,and as long as I can take care of him,I will..I do think the government should start some type of system to pay the caregivers,maybe we can all write to our legislators,and start some kind of tea party..the squeaky wheel gets the oil..and the acknowledgement.. Good luck to you all..C.M.

I like my doctor very much. How can I find out if he accepts medicare once I enter the program?

This was really helpful. Thanks!

Is there information somewhere about the 'donut hole' in part D?

Thanks for this article. It's cleared up several misconceptions I had!

My specific question is when a doctor accepts medicare and supplemental like blue cross blueshield, can they still bill you for thedifference between what they charge and what the above covers? Ddoes accepting assignment mean they can still bill, or must they accept what medicare and supplemental pay?

I found your article informative, but I need to understand why a care provider is necessary. I don't want to be restricted as to what doctors I can see or be told who can give me the care I need. As we communicate, I'm disappointed in the medicare system.