Enrolling in Medicare Part A & Part B

CENTERS for MEDICARE & MEDICAID SERVICES

Enrolling in Medicare Part A & Part B

The information in this booklet describes the Medicare Program at the time this booklet was printed. Changes may occur after printing. Visit or call 1-800-MEDICARE (18006334227) to get the most current information. TTY users should call 1-877-486-2048.

"Enrolling in Medicare Part A & Part B" isn't a legal document. Official Medicare Program legal guidance is contained in the relevant statutes, regulations, and rulings.

You have the right to get the information in this booklet in an alternate format. Visit about-us/nondiscrimination/nondiscrimination-notice.html, or call 1-800-MEDICARE for more information.

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Contents

5 Section 1--The Medicare Program

5 What's Medicare? 5 Medicare has different parts 5 Medicare Part A (Hospital Insurance) 6 Medicare Part B (Medical Insurance) 9 Can I get Part B if I don't have Part A? 9 How do I know if I have Part A or Part B? 10 Medicare Part C (also known as Medicare Advantage) 10 Medicare Part D (prescription drug coverage) 10 For more information

11 Section 2--Part A & Part B Enrollment

11 When can I sign up? 13 Getting Part A and Part B automatically 17 Signing up for Part A and Part B 19 Turning 65 and you or your spouse is still working 21 Medicare and End-Stage Renal Disease (ESRD) 24 Retiree coverage 24 Can I still get Medicare at 65? 26 Veterans' benefits 26 I have Health Insurance Marketplace coverage 27 I have coverage through a health savings account (HSA) 28 Living outside the U. S.

29 Section 3--For More Information

29 Where to get more information 29 Medicare publications

31 Section 4--Definitions

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Section 1--The Medicare Program

Words in blue are defined on pages 31?33.

What's Medicare?

Medicare is health insurance for: People 65 or older Under 65 with certain disabilities People of any age with End-Stage Renal Disease (ESRD) (permanent

kidney failure requiring dialysis or a kidney transplant)

Medicare has different parts

Medicare Part A (Hospital Insurance)

Part A helps cover your inpatient care in hospitals. Part A also includes coverage in critical access hospitals and skilled nursing facilities (not custodial or longterm care). It also covers hospice care and home health care. You must meet certain conditions to get these benefits.

Can I get Part A? Generally, you're eligible for Part A if you: Are 65 or older and you meet the citizenship and residency

requirements. Get disability benefits from Social Security or the Railroad

Retirement Board for at least 25 months. Get disability benefits because you have ALS (Amyotrophic Lateral

Sclerosis, also called Lou Gehrig's disease). Have ESRD and meet certain requirements.

How much does Part A coverage cost? You usually don't pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes for at least 10 years while working. If you aren't eligible for free Part A, you may be able to buy Part A if you're: 65 or older and you have (or are enrolling in) Part B and meet the

citizenship and residency requirements. Under 65, disabled, and your free Part A coverage ended because you

returned to work. (If you're under 65 and disabled, you can continue to get free Part A for up to 8 ? years after you return to work.)

6 Section 1--The Medicare Program

Words in blue are defined on pages 31?33.

In 2016, people who have to buy Part A pay premiums up to $411 each month. In most cases, if you choose to buy Part A, you must also have Part B and pay monthly premiums for both.

What's a Part A late enrollment penalty?

If you get Part A for free, you won't have to pay a Part A late enrollment penalty if you decide to enroll after you first become eligible. If you aren't eligible for free Part A, and you don't buy it when you're first eligible, your monthly premium may go up because you may have to pay a late enrollment penalty.

The penalty is 10% for every 12 months you didn't have the coverage. You'll have to pay the late enrollment penalty for twice the number of years you could have had Part A, but didn't sign up. For example, if you were eligible for Part A for 2 years but didn't sign up, you'll have to pay a 20% higher premium for 4 years. Usually, you don't have to pay a penalty if you meet certain conditions that allow you to sign up for Part A during a Special Enrollment Period. See page 13 for more information about Special Enrollment Periods.

Medicare Part B (Medical Insurance)

Part B helps cover medically necessary services like doctors' services, outpatient care, and other medical services that Part A doesn't cover. Part B also covers many preventive services. Part B coverage is your choice. However, you need to have Part B if you want to buy Part A.

How much does Part B coverage cost?

You pay the Part B premium each month. Most people will pay the standard premium amount, which is $121.80 in 2016 if you sign up for Part B when you're first eligible. This amount can change every year. You can find up-to-date premium amounts on .

Important: In most cases, if you don't sign up for Part B when you're first eligible, you'll have to pay a late enrollment penalty for as long as you have Part B. Also, you may have to wait until the General Enrollment Period (from January 1?March 31) to enroll in Part B and coverage will start July 1 of that year.

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Most people will pay the standard premium amount. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay more.

If your yearly income in 2014 was

File individual tax return

$85,000 or less above $85,000 up to $107,000 above $107,000 up to $160,000 above $160,000 up to $214,000 above $214,000

File joint tax return

$170,000 or less above $170,000 up to $214,000 above $214,000 up to $320,000 above $320,000 up to $428,000 above $428,000

File married & separate tax return $85,000 or less N/A

N/A

above $85,000 up to $129,000 above $129,000

You pay (in 2016)

$121.80 $170.50 $243.60 $316.70 $389.80

If you have questions about your Part B premium, call Social Security at18007721213. TTY users should call 1-800-325-0778.

What's a Part B late enrollment penalty?

In most cases, if you don't sign up for Part B when you're first eligible, you'll have to pay a late enrollment penalty for as long as you have Part B. The late enrollment penalty takes the standard premium amount and increases it by 10% for each full 12-month period that you could have had Part B, but didn't. For example, if you were first eligible for Part B in July 2013, but didn't enroll until January 2016, you'd have a 20% late enrollment penalty. The standard premium amount would be increased by 20% for as long as you have Part B.

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How can I pay my Part B premium? If you get Social Security, Railroad Retirement Board (RRB), or Office of Personnel Management (OPM) benefits, your Part B premium will be automatically deducted from your benefit payment. If you don't get these benefit payments, you'll get a bill. If you choose to buy Part A, you'll always get a bill for your premium. There are 4 ways to pay these bills: 1. Mail your premium payments to:

Medicare Premium Collection Center P.O. Box 790355 St. Louis, MO 63179-0355

If you get a bill from the RRB, mail your premium payments to: RRB Medicare Premium Payments P.O. Box 979024 St. Louis, MO 63197-9000

2. Pay by credit card. To do this, complete the bottom portion of the payment coupon on your Medicare bill and mail it to the address above.

3. Sign up for Medicare Easy Pay, a free service that automatically deducts your premium payments from your savings or checking account each month. Visit to learn more and to find out how to sign up.

4. Make an online bill payment. Ask your bank if it allows customers to pay bills online. Not all banks offer this service and some may charge a fee. You'll need to give the bank this information:

Account number: your Medicare number without dashes (you'll find this number on your red, white, and blue Medicare card.)

Biller name: CMS Medicare Insurance Remittance address:

Medicare Premium Collection Center P.O. Box 790355 St. Louis, MO 63179-0355

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