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Medicare Overview

from: Kyle Besser

Medicare is a federal health insurance program for people over the age of 65 and eligible people with a disability under the age of 65. The Medicare insurance program is operated by the Centers for Medicare and Medicaid Services (CMS), which used to be called the Health Care Financing Administration.

Medicare insurance offers choices. A senior may choose the original Medicare insurance plan or choose from a variety of other plans referred to as Medicare Advantage. Individuals who choose the Medicare Advantage plan are still covered under Medicare and still get the coverage offered under the original Medicare plan in most cases. With Medicare Advantage, they get additional coverage for certain examinations, tests, and medical services that are not included in the basic plan. However, they may have to stay within a "network" of doctors and other health-care providers and may not be able to choose their own doctors.

Factors to determine which Medicare plan seniors should use to choose are how much they are willing to pay upfront, what their health care needs are, extra benefits needed, which doctors they want to see or where the doctors are located. For the most part, a senior may switch from one Medicare insurance plan to another at any given time. Some plans, however, limit the number of individuals they will take and don't accept new members once they have reached their maximum, except for individuals with end-stage renal disease.

A Medicare card is given to anyone who receives Social Security benefits or benefits from the Railroad Retirement Board when they turn 65 years old. If a senior doesn't receive Social Security benefits because he/she is still working or because neither he/she or spouse paid Medicare taxes while they were working, he/she may still apply for Medicare. To do so, they need to contact their local Social Security office or the Social Security Administration at 800-722-1213 or at their website at www.ssa.gov.

Some seniors may need help to oversee their Medicare insurance coverage. If they are able, they can give another authorization to access their records by completing form SSA 1696-U4, which is available through the Social Security Administration at 800-772-1213 or from their website at www.ssa.gov. For a senior who is not able to fill out form SSA 1696-U4, contact the local Social Security office and ask about authorization data to access records, receive bills, checks and other correspondence.

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