Social Security: Don't be afraid to ask questions about Medicare coverage

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June 11, 2011

Social Security: Don't be afraid to ask questions about Medicare coverage

Anonymous Daily Star The Daily Star Sat Jun 11, 2011, 03:30 AM EDT

In last month's column, I addressed the very confusing topic of Medicare. I talked about Parts A and B, and did my best to explain when to apply for each.

The response I received from people was overwhelming. "That's so confusing!" "When do I apply?" "I still don't get it." What can I say? I did my best to explain an extremely complicated subject. This month, we are moving onto the other parts of Medicare _ Medicare Advantage plans and prescription drug plans, otherwise known as Part C and Part D.

The first thing I want to tell you about these plans is this: Social Security DOES NOT take applications for Parts C or D. To be honest, our knowledge in this area is limited.

Here's what I can tell you: If you have Medicare Parts A and B, you can join a Medicare Advantage plan. They are offered by private insurance companies and approved by Medicare.

These plans include Medicare managed care plans, preferred provider organization plans, private fee-for-service plans and specialty plans. If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental and health and wellness programs. Most include Medicare prescription drug coverage (Part D). If you don't have interest in the Part C, you still have the option of choosing a prescription drug plan. To join a Medicare Prescription Drug Plan, you must have Medicare Part A or Part B. Cost and coverage varies with each plan. If you are interested in one of these plans, go to www.medicare.gov and use the Medicare Plan Finder.

This tool can help you compare plans in your area and choose one that is right for you.

You can also contact Medicare by phone at 1-800-MEDICARE.

One thing Social Security does handle is the application for Extra Help with Medicare prescription drug costs. To qualify for this program, a person must have limited income and resources and already be on Medicare. Your resources must be limited to $12,640 for an individual or $25,260 for a married couple living together. Resources include such things as bank accounts, stocks and bonds. We do not count your home, car, and any life insurance policy as resources. Your annual income must be limited to $16,335 for an individual or $22,065 for a married couple living together. Even if your annual income is higher, you still may be able to get some help.

If you think you may qualify for the Extra Help, please go to our website, www.socialsecurity.gov, and click on the "Get extra help with Medicare prescription drug costs" link. If you don't have access to the Internet, contact our office at (877) 628-6581 to set up an appointment. We can take the application in the office or by phone. We can also mail you a paper application.

I know many of you feel this is a daunting subject. I have written two columns and haven't come close to covering everything there is to know about Medicare. My advice to you is this: If you aren't sure what Medicare coverage you need, ask questions. Talk to your employer's human resource department, contact your local Office for the Aging, or give Social Security a call.

If we can't help you, we will point you in the right direction.

Tracey L. Weaver is district manager of the Oneonta office of the Social Security Administration.