Medicare Frequently Asked Questions

To qualify for Medicare Part A, 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

  If you have worked at least 10 years in Medicare covered employment you will qualify for premium free Medicare Part A (Hospital Insurance).
  
  You should contact the Social Security Administration at 800-772-1213 to file an application.

Medicare Part B helps pay for doctors' services, outpatient hospital care, blood, medical equipment and some home health services. It also pays for other medical services such as lab tests and physical and occupational therapy. Some preventive services such as mammograms and flu shots are also covered.

Medicare Part B does NOT cover routine physical exams; eye glasses; custodial care; dental care; dentures; routine foot care; hearing aids; orthopedic shoes; or cosmetic surgery. It also does not cover most health care you get while traveling outside the United States (except under limited circumstances).

You are eligible for Medicare Part A (hospital insurance) if you are under 65 and have been getting Social Security or Railroad Retirement Disability checks for more than 24 months. You may also enroll in Part B (medical insurance) for a standard monthly premium of $170.10 for Medicare beneficiaries in 2022.

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 3 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 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.

Some people are not automatically enrolled in Medicare. You need to file an application if you are:

• Eligible for Social Security or Railroad Retirement benefits but have not yet signed up for them;
• have permanent kidney failure treated with dialysis or a transplant; or
• are not eligible for Premium Free Part A;
• or are a government employee who is not eligible for Social Security or Railroad Retirement benefits.

You can apply online through the Social Security Administration website, http://www.ssa.gov or go to your local Social Security Office. Social Security will take your application, determine if you are eligible for Medicare and send you a Medicare card.

You qualify to enroll in Medicare during a Special Enrollment Period if you delayed enrolling in Part B because you were working and had group health insurance through your employer or your spouse's employer. If you sign up during the Special Enrollment Period, you do not have to pay the Part B premium surcharge. Signing up for Medicare Part B will begin your 6 month open enrollment period for buying a Medigap policy. You can enroll in Part B: any month in which you are still covered under your current enrollment; or the 8-month period beginning with either the date your employment ends or the date your group health plan ends, whichever comes first.

You should contact the Social Security Administration at 1-800-772-1213 to file an application. You can download the required forms through Medicare.gov. Fill out an Application for Enrollment in Part B (CMS-40B) and a Request for Employment Information (CMS-L564). Get the Application for Enrollment in Part B (CMS-40B) in Spanish. Get the Request for Employment Information (CMS-L564) in Spanish.

You can call the Social Security Administration at 800-772-1213, contact your local Social Security Office, or log in to your My Social Security account (https://www.ssa.gov/myaccount/) to verify your Medicare Part A and Part B coverage. This information can also be found on your red, white, and blue Medicare card.

You can call the Social Security Administration at 800-772-1213, contact your local Social Security Office, or log in to your My Social Security Account to request a replacement Medicare card. Make sure you have your Medicare number ready when you call. You should receive your new card in about four weeks. You may also log into your Medicare.gov account and print your Medicare Card.

Do you have Medicare Part A or hospital insurance?

You may qualify for a Medicare Savings Program if you have limited income and resources. 

2021 Income Limits (2022 FPL released in January 2022)

Resource limits for 2022 are $8,400 for an individual and $12,600 for a married couple. These limits do not include up to $1,500 per person for designated funeral or burial funds. Resources do not include your primary residence or vehicles.

How to apply:

• Call a SHICK counselor at 800-860-5260 for assistance on the phone or in person to complete the application
• Go online and print the Application/Re-determination Medicare Savings Program at https://kancare.ks.gov/consumers/apply-for-kancare and fax it to the KanCare Clearinghouse at 844-264-6285

An online application is available at https://kancare.ks.gov/consumers/apply-for-kancare. You will need to contact the KanCare Clearinghouse with KDHE to file an application for Medicaid. They will determine if you qualify for help in paying your medical and hospital bills. They may also help pay your Medicare premiums, deductibles, and co-insurance. For more information call 800-792-4884.

If you are in Original Medicare, your doctor or other health care provider will file your claim with Medicare. You'll receive a Medicare Summary Notice statement showing how much you'll need to pay. 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.

Medicare Advantage plans are various health plan options available to Medicare beneficiaries as an alternative to Original Medicare Parts A & B. A Medicare Advantage plan may also encompass Medicare Part D Prescription Drug Coverage.

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 bags, 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 MAC (Medicare Administrative Contractor) can provide more specific information.

Medicare offers prescription drug coverage to everyone with Medicare through Medicare Part D. If you decide not to join a Medicare Prescription Drug Plan when you're first eligible, and you don't have other creditable prescription drug coverage, or you don't get Extra Help, you'll likely pay a late enrollment penalty.

To get Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and drugs covered.

From Oct. 15 to Dec. 7 each year, you may purchase a Medicare Part D drug plan. If you choose not to enroll and do not have credible coverage under another plan, you will pay a penalty at the time you do enroll. Information is available at 1-800-Medicare, www.medicare.gov or Senior Health Insurance Counseling for Kansas, 1-800-860-5260.

Medicare Part B does cover some drugs in certain cases such as immunosuppressive drugs (for transplant patients) and oral anti-cancer drugs. You should call your Part B MAC for more information.

Extra help is available if , in 2021, your monthly income is at or below $1,610 if you are single and $2,178 if you are married and your resources are at or below $13,290 if you are single and $26,520 if you are married. These amounts do not include up to $1,500 per person for designated funeral or burial funds.

Resources do not include your primary residence or vehicles.

If you qualify for extra help Medicare will pay for 75 percent or more of your prescription drug costs.

You will automatically receive help paying for:

• Premiums
• Deductibles
• Co-pays for your Medicare prescription drug coverage
• There is no coverage gap

How to apply:

• Call a SHICK counselor at 800-860-5260 for assistance on the phone or in person to complete the application
• Go online at https://secure.ssa.gov/i1020/start and apply online
• Visit your local Social Security office for assistance filling out the application

Supplemental insurance policies are sometimes called Medigap plans. Medigap plans are private health insurance policies that cover some of the costs the Original Medicare Plan does not cover. Some Medigap policies will cover services not covered by Medicare such as Foreign Travel Emergencies. Medigap has 10 standard plans called Plan "A" through Plan "N". Each plan covers basic benefits and an expanding list of additional benefits. Your State Insurance Department can answer questions about the Medigap policies sold in your area.

Medicare covers the same supplies for both insulin and non-insulin dependent diabetics. They include:

• Glucose testing monitor;
• Blood glucose test strips;
• Lancets;
• Spring powered devices for lancets
• Glucose control solutions

Some frequency limitations may apply. Contact your Durable Medical Equipment Medicare Administrative Contractor for more information.

These services are covered if you have Medicare Part B

Medicare covers a one-time preventive visit within the first 12 months that you have Medicare Part B. This is a great way to get up-to-date information on important screenings and shots as well as visiting with your doctor about your family history and how to stay healthy.

• Abnormal Aortic Aneurysm Screening
• Alcohol Misuse Screening and Counseling
• Bone Mass Measurement
• Breast Cancer Screening (Mammogram)
• Cardiovascular Disease Screening
• Cervical and Vaginal Cancer Screening
• Colorectal Cancer Screening
• Fecal Occult Blood Test
• Flexible Sigmoidoscopy
• Colonoscopy
• Barium Enema
• Depression Screening
• Diabetes Screening
• Diabetes Self-Management Training
• Flu Shots
• Glaucoma Tests
• Hepatitis B Shots
• HIV Screening
• Medical Nutrition Therapy services
• Obesity Screening and Counseling
• Pneumococcal Shot
• Prostate Cancer Screening
• Sexually transmitted infection screening and counseling
• Tobacco use cessation counseling (for people with no sign of tobacco related disease)
• Yearly "Wellness" visit

To track your preventive health information, get a two year calendar of your Medicare covered tests and screenings you are eligible for, and print a personalized "on the go" report to take to your next doctor's appointment, sign up at www.mymedicare.gov.

For more information, visit http://www.medicare.gov/coverage/preventive-and-screening-services.html.

More detailed information on each service can be found in the Medicare publication, Your Guide to Medicare's Preventive Services, available at https://www.medicare.gov/Pubs/pdf/10110-Medicare-Preventive-Services.pdf

Medicare Advantage plans are required to cover the same preventive services as Original Medicare, but may have a different cost share than Original Medicare. Please contact your Medicare Advantage plan for more information.

Medicare does not cover routine dental care or most dental procedures such as cleanings, fillings or 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.