Published On: Wed, Mar 27th, 2013

Medicare information for EBCI tribal members

What is Medicare Part A & B?

(you know that red, white and blue card)

Medicare is a federal health insurance program  for people 65 and older.

Medicare is:

Hospital Insurance (Part A)

This part helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital Stay), some home health care and hospice care.  Certain conditions must be met.  Most people pay for Part A through their payroll taxes when they are working.

Medical Insurance (Part B)

This part helps pay for doctors’ services and many other medical services and supplies that are not covered by hospital insurance, only when they are medically necessary. Most people pay a monthly premium for Part B.

Who Is eligible to receive Medicare?

Most people age 65 or older, people who have been entitled to Social Security disability benefits for 24 months, people with End-Stage Renal Disease (permanent kidney failure requiring maintenance dialysis or a kidney transplant) or amyotrophic lateral sclerosis (Lou Gehrig’s disease) may also qualify for the program.

What is the cost for this insurance?

Most people do not have to pay a monthly premium for Part A.  This is because they or their spouse paid Medicare taxes while they were working.

In 2013 the Medicare Part B premium is $104.90 per month. This amount may change Jan. 1, 2014. In some cases, your premium will be higher if you didn’t sign up for Part B when you first became eligible.  You will have to pay this penalty for as long as you have Part B.

How can I sign up?

If you are already getting Social Security retirement or disability benefits, you will be contacted a few months before you become eligible for Medicare and sent the information you need.  You will be enrolled in Medicare Parts A and B automatically.  However, because you must pay a premium for Part B coverage, you have the option of turning it down.

If you are not already getting retirement benefits, you should contact the Social Security Administration three months before your 65th birthday to sign up for Medicare.

This information was taken from Social Security pamphlets and the Centers for Medicare & Medicaid Services 2013 Handbook.

 

Attention: Notification of benefits to EBCI tribal members

 If you are age 65 and over or on Social Security Disability and you have or are eligible to receive Medicare, please contact the EBCI SHIP Office.  They may be able to reimburse you the $104.90 that comes out of your Social Security check each month.

The guidelines for reimbursement are:

  • You must be an EBCI tribal member with valid enrollment card.
  • Must be at least 18 years old
  • You must be enrolled in Medicare Part B
  • The premium has to be deducted from your Social Security check
  • Or you are being billed by Centers for Medicare & Medicaid for premium payment

Info: Denise Bradley, EBCI SHIP Office, 43 John Crowe Hill, Cherokee, NC  28719, 554-6183

– EBCI SHIP Office 

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