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 | People 65 years of age and older |
| Certain younger people with disabilities |
| People with End-Stage Renal Disease (people with permanent kidney failure
who need dialysis or a transplant). |
Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States. You might also qualify for coverage if you are a younger person with a disability or with chronic kidney disease.
Here are some simple guidelines. You can get Part A at age 65 without having to pay premiums if:
| You are already receiving retirement benefits from Social Security or the Railroad Retirement Board. |
| You are eligible to receive Social Security or Railroad benefits but have not yet filed for them. |
| You or your spouse had Medicare-covered government employment. |
If you are under 65, you can get Part A without having to pay premiums if:
| You have received Social Security or Railroad Retirement Board disability benefits for 24 months. |
| You are a kidney dialysis or kidney transplant patient. |
While you do not have to pay a premium for Part A if you meet one of those conditions, you must pay for Part B if you want it. The Part B monthly premium in 2009 begins at $96.40 per month. It is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check.
If you have questions about your eligibility for Medicare Part A or Part B, or if you want to apply for Medicare, call the Social Security Administration. The toll-free telephone number is: 1-800-772-1213. The TTY-TDD number for the hearing and speech impaired is 1-800-325-0778. You can also get information about buying Part A as well as Part B if you do not qualify for premium-free Part A.
The Original Medicare Plan is the traditional pay-per-visit arrangement. You can go to any doctor, hospital, or other health care provider who accepts Medicare. You must pay the deductible. Then Medicare pays its share and you pay your share (coinsurance). The Original Medicare Plan has three parts: Part A (Hospital Insurance), Part B (Medical Insurance) and Part D (Prescription Insurance). If you are in the Original Medicare Plan now, the way you receive your health care will not change unless you enroll in another Medicare health plan.
Part A (Hospital Insurance) helps pay for care in hospitals and skilled nursing facilities, and for home health and hospice care. If you are eligible, Part A will be premium free -- that is, you don't pay a premium because you or your spouse paid Medicare taxes while you were working. Your SHIP Counselor will be able to help you answer many of your questions. Please call (702) 486-3478 or (800) 307-4444.
You are eligible for premium-free Medicare Part A (Hospital Insurance) if:
| You are 65 or older. You are receiving or eligible for retirement benefits from Social Security or the Railroad Retirement Board, or |
| You are under 65. You have received Social Security disability benefits for 24 months, or |
| You are under 65. You have received Railroad Retirement disability benefits for the prescribed time and you meet the Social Security Act disability requirements, or |
| You or your spouse had Medicare-covered government employment, or |
| You are under 65 and have End-Stage Renal Disease. |
If you don't qualify for premium-free Part A, and you are 65 or older, you may be able to buy it. (Contact the Social Security Administration.)
Part B (Medical Insurance) helps pay for doctors, outpatient hospital care and some other medical services that Part A doesn't cover, such as the services of physical and occupational therapists. Part B covers all doctor services that are medically necessary. Beneficiaries may receive these services anywhere (a doctor's office, clinic, nursing home, hospital, or at home).
You are automatically eligible for Part B if you are eligible for premium-free Part A. You are also eligible if you are a United States citizen or permanent resident age 65 or older. Part B costs begin at $96.40 per month in 2009. (See below.)
Part B is voluntary. If you choose to have Part B, the monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement payment. Beneficiaries who do not receive any of the above payments are billed by Medicare every 3 months.
If you didn't take Part B when you were first eligible, you can sign-up during 2 enrollment periods:
| General Enrollment Period: If you didn't take Part B, you can only
sign up during the general enrollment period, January 1 through March 31 of
each year. Your Part B coverage is effective July 1. Your monthly Part B
premium may be higher. The Part B premium increases 10% for each 12-month
period that you could have had Part B but did not take it. |
| Special Enrollment Period: If you didn't take Part B because you or
your spouse currently work and have group health plan coverage through your
current employer or union, you can sign up for Part B during the special
enrollment period. Under the special enrollment period, you can sign up at
any time you are covered under the group plan. In addition, if the
employment or group health coverage ends, you have 8 months to sign up. The
8-month period starts the month after the employment ends or the group
health coverage ends, whichever comes first. Generally, your monthly Part B
premium is not increased when you sign up for Part B during the special
enrollment period. Contact the Social
Security Administration to sign up.
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The Original Medicare Plan pays for much of your health care, but not all of it.
Your "out-of-pocket" costs for health care will include your monthly
Part B premium. In addition, when you get health care services or prescriptions,
you will also have to pay deductibles, coinsurance and/or co-payments.
You also pay for routine physicals, custodial care, most dental care, dentures,
routine foot care, or hearing aids. Physical therapy and occupational therapy
services, except for those you get in hospital outpatient departments, are
subject to annual limits. The Original Medicare Plan does pay for some
preventive care, but not all of it.
Your Out-of-Pocket Costs May Depend On:
| Whether your doctor accepts assignment. |
| How often you need health care. |
| What type of health care you need. |
If You Choose Another Medicare Health Plan or Purchase a Supplemental Policy, Out-of-Pocket Costs May Also Depend On:
| Which Medicare health plan you choose. |
| What extra benefits are covered by the plan. |
| What your supplemental health insurance covers. |
For certain older, low-income or disabled individuals entitled to Medicare Part A, your State Medicaid program will pay some or all of Medicare's premiums, and may also pay Medicare's deductibles and coinsurance if you have Part A, and your bank accounts, stocks, bonds, or other resources do not exceed $4,000 for an individual, or $6,000 for a couple, you may qualify for assistance. For more information go to Medicaid.
Information is available. Call:
| Contact your local Welfare office if you have questions or to request an application. The application is also available on the Nevada State Welfare Division's website. |
| State Health Insurance Assistance Program
(SHIP) for more information. Their number is 486-3478 in Las Vegas
or 1-800-307-4444 statewide. |
Deductible: Per Benefit Period $1,024
Coinsurance: Days 61-90 $267
Lifetime Reserve Days (60) $534
Skilled Nursing Facility
Coinsurance: Days 21-100 $133.50
Monthly Premium:
40 quarters of Social Security work credit ----------------- Free
30-39 quarters of Social Security work credit ------------- $244
Less than 30 quarters of Social Security work credit ---- $443
Deductible: Per Calendar Year $135
Premium: *$96.40
*Beginning in 2007 the Part B premium paid will be based on adjusted gross income from prior year’s tax return. Individuals who have to pay a higher Part B premium in 2009 include:
· Individuals with income greater than $85,000
· Individuals who are married but file separately with incomes greater than $85,000
· Married filing a joint tax return with income greater than $170,000
The 2009 Part B monthly premium rates to be paid by beneficiaries who file an individual tax return (including those who are single, head of household, qualifying widow[er] with dependent child, or married filing separately who lived apart from their spouse for the entire taxable year), or who file a joint tax return are:
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Beneficiaries who file an individual tax return with income: |
Beneficiaries who file a joint tax return with income: |
Income-related monthly adjustment amount |
Total monthly premium amount |
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Less than or equal to $85,000 |
Less than or equal to $170,000 |
$0.00 |
$96.40 |
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Greater than $85,000 and less than or equal to $107,000 |
Greater than $170,000 and less than or equal to $214,000 |
$38.50 |
$134.90 |
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Greater than $107,000 and less than or equal to $160,000 |
Greater than $214,000 and less than or equal to $320,000 |
$96.30 |
$192.70 |
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Greater than $160,000 and less than or equal to $213,000 |
Greater than $320,000 and less than or equal to $426,000 |
$154.10 |
$250.50 |
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Greater than $213,000 |
Greater than $426,000 |
$211.90 |
$308.30 |
In addition, the monthly premium rates to be paid by beneficiaries who are married, but file a separate return from their spouse and lived with their spouse at any time during the taxable year are:
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Beneficiaries who are married but file a separate tax return from their spouse: |
Income-related monthly adjustment amount |
Total monthly premium amount |
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Less than or equal to $85,000 |
$0.00 |
$96.40 |
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Greater than $85,000 and less than or equal to $128,000 |
$154.10 |
$250.50 |
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Greater than $128,000 |
$211.90 |
$308.30 |
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Additional Medicare information can
be obtained
from the Federal Medicare website: www.medicare.gov
If you would like to view the Nevada
Medicare Supplemental
Insurance Comparison Guide (Medigap),
click
here.
To have one mailed to you, email us by
clicking here.
Questions or Comments for the
Aging and Disability Services Division? Last Updated: 01/27/10 Disclaimer Search Regional Offices / Contact Us |
