Medicare
Part A & Part B
COMPREHENSIVE ANSWERS TO MEDICARE PART "A" AND PART" B
What’s Medicare?
Medicare is health insurance for:
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People 65 or older
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Under 65 with certain disabilities
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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 long-term 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:
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Are 65 or older and you meet the citizenship and residency requirements.
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Get disability benefits from Social Security or the Railroad Retirement Board for at least 25 months.
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Get disability benefits because you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease).
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Have ESRD and meet certain requirements.
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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:
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65 or older and you have (or are enrolling in) Part B and meet the citizenship and residency requirements.
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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 ½ years after you return to work.)
In 2018, people who have to buy Part A pay premiums up to $422 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 10%. You’ll have to pay the higher premium for twice the number of years you could’ve 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 10% 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)
Words in blue are defined on pages 31–33.
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 $148.50 in 2021, if you sign up for Part B when you first become eligible. This amount can change every year. You can find up-to-date premium amounts on Medicare.gov.
Important: In most cases, if you don’t sign up for Part B when you’re first eligible, you may be subjected to a late enrollment penalty. 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.
Most people will pay the standard premium amount. However, if your modified adjusted gross income as reported on your IRS tax return form, you may pay more.
* You pay each month (in 2021)
File individual tax return
$88,000 or less
File joint tax return
$176,000 or less
File married & separate tax return
$88,000 or less
$148.50
* More than $88,000 up to $111,000
More than $176,000 up to $222,000
Not applicable
$207.90
* More than $111,000 up to $138,000
More than $222,000 up to $276,000
Not applicable
$297.00
* More than $138,000 up to $165,000
More than $276,000 up to $330,000
Not applicable
$386.10
*More than $165,000 up to 500,000
More than $330,000 up to $750,000
More than $88,000 up to $412,000
$475,20
More than or equal to $500,000
More than or equal to $750,000
$504,90
If you have questions about your Part B premium, call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.
International Major Medical Insurance Plan
This plan is not Affordable Care Act (ACA) compliant.
Foreign nationals traveling to the United States on business or for vacation may not be aware of the expensive cost of medical treatment in the US. Imagine the shock and stress that could overwhelm you upon the realization that they are fiscally responsible for medical care in the event of an accident! With International Major Medical plan you can help protect yourself in the event of an accident or illness ( see brochure for pre-existing coverage details) while you are traveling in the USA. With our online application, getting coverage couldn’t be easier.
Other Uses
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Foreign Nationals visiting the USA.
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Foreign Nationals moving to the USA.
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Foreign Nationals employed by a US company who reside in their home country.
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Foreign Nationals employed by a US company working outside their home country.
It can be confusing to navigate a foreign country with different customs, restrictions, and guidelines. But, with the International Major Medical Insurance plan, you can travel in the US virtually worry-free. The International Major Medical is specially designed for people visiting the United States on business or vacation. This plan can provide medical coverage for up to one year with benefits up to $1 million.
Options available:
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Accidental Death & Dismemberment up to 10x income
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Hazardous Sports & Activities
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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 2015, but didn’t enroll until January 2018, 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.
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:
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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
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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.
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Sign up for Medicare Easy Pay, a free service that automatically deducts your premium payments from your savings or checking account each month. Visit Medicare.gov to learn more and to find out how to sign up.
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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:
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Account number: your Medicare number without dashes (you’ll find this number on your red, white, and blue Medicare card.)
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Biller name: CMS Medicare Insurance
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Remittance address:
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Medicare Premium Collection Center
P.O. Box 790355
St. Louis, MO 63179-0355
If you have questions about your premiums or need to change your address on your bill, call Social Security at 1-800-772-1213.
TTY users can call 1-800-325-0778. If your bills are from the RRB, call 1-877-772-5772. TTY users can call 1-312-751-4701.
Can I get Part B if I don’t have Part A?
If you aren’t eligible for free Part A, you can buy Part B without having to buy Part A, if you’re:
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65 or older
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A resident of the U.S., and one of these:
—a U.S. citizen
—an immigrant lawfully admitted for permanent residence who has lived in the U.S. without a break for the 5-year period immediately before the month you file for enrollment in Part B
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