Medicare is the national health insurance program for older adults and people with disabilities. It covers many basic health services including, but not limited to: inpatient hospital services, physician services, some home health care, prescription drugs, durable medical equipment and hospice. The program serves people aged 65 or older, individuals with disabilities under age 65, and people of any age with End-Stage Renal Disease (ESRD).
The Centers for Medicare & Medicaid Services (CMS) administers the program. Medicare is funded in great part by general revenues, payroll tax revenues, premiums paid by beneficiaries, and taxes on Social Security benefits.
Medicare covers individuals aged 65 years or older or permanently disabled, regardless of income, medical history, or health status who meet one of the following criteria:
Note: Individuals who are not otherwise eligible for Medicare, but who are aged 65 years or older may purchase Medicare coverage by paying a monthly premium.
Learn More: Use this tool to determine your eligibility for Medicare.
There are four parts to your Medicare benefits:
Medicare beneficiaries will receive a red, white and blue Medicare card in the mail to be used when hospital, medical or other health services are needed. Medicare cards show which program(s) members enrolled in and when coverage begins. The card will have a Medicare Number unique to the holder which should only be given to health care providers and trusted individuals.
Medicare can be a complex program to understand. Visit Medicare.gov or call 1-800-Medicare (1-800-633-4227) to learn more.
Individuals can also use Connecticut’s Health Insurance Assistance, Outreach, Information and referral, Counseling, Eligibility Screening (CHOICES). CHOICES helps people understand Medicare coverage and healthcare options. To receive health insurance unbiased, free counseling, application assistance, and educational resources, call CHOICES at 1-800-994-992 or find a counselor near you.
Finally, for in-depth information about eligibility, services covered, your rights and how to enroll, go to the Center for Medicare Advocacy website.
It is important to note that Medicare beneficiaries do not need to sign up for coverage each year. However, plans and coverage should be reviewed annually as there could be changes to coverage.
Medicare beneficiaries can also enroll in Medicare Supplement Insurance, also called Medigap, which fills in the gaps not covered by Original Medicare. Medigap is offered by private, approved insurance companies. These plans pay for costs such as coinsurance, co-payments, and deductibles.
In Connecticut, Medigap cannot be used as a stand-alone plan and is designed to use in combination with Original Medicare (Parts A and B). It helps fill in the gaps of Original Medicare such as premiums, coinsurance, co-payments, and deductibles, which are generally private pay, out-of-pocket expenses. The State offers up to 10 standardized policy options, each labeled with a letter. All plans of the same letter offer the same benefits, no matter which insurance company offers the plan.
Visit the Connecticut Insurance Department for the names, rates and contact information for Medigap insurers.
Financial assistance is available to eligible Medicare enrollees through the State’s Medicare Savings Program, funded by Medicaid. The Department of Social Services will pay qualifying applicants’ Part B monthly premiums. Some programs may offer additional financial assistance for deductibles and coinsurance.
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