Medicare Insurance: What are the Facts?

Medicare insurance is a federal health insurance program for people over the age of 65 and some people with 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 known as the Health Care Financing Administration.

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 your loved one doesn't receive Social Security benefits (because he/she is still working or because neither she nor her husband paid Medicare taxes while they were working or for many other reasons) they may still apply for Medicare. To do so they need to contact their local Social Security office or the Social Security Administration (800-722-1213 or www.ssa.gov ).

Contrary to popular belief, Medicare insurance offers choices. Your 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, however, they get additional coverage for certain examinations, tests, and medical services that are not included in the basic plan. However, they may not be able to choose their own doctors and may have to stay within a "network" of doctors and other health-care providers.

One of the factors to determine which Medicare plan your senior should choose will have to do with how much they are willing to pay upfront, what their health care needs are, extra benefits necessary, which doctors they want to see or where the doctors are located. For the most part, your 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 accept as new members when they have reached their maximum. (The roles are different for individuals with end-stage renal disease. You may contact Medicare for more information on this issue.)

To oversee your parent's Medicare insurance coverage, you should contact the local Social Security office and ask for authorization data to access their records, receive bills, checks and other correspondence. If your elder’s able, they can give you authorization to access the records by completing a form (form SSA 1696-U4), which is available through the Social Security Administration. You can call (800-772-1213) or you may download it on the Internet at www.ssa.gov .

Some information from How to Care for Aging Parents by Virginia Morris

Additional information and web page by Paul Susic M.A. Licensed Psychologist Ph.D. Candidate Clinical Director- Senior Care Psychological Consulting