Issue link: http://educator.cta.org/i/556394
Prior to Medicare, only 50 percent of Americans 65 and older had health insur- ance, and more than a third lived in poverty. Today, the program covers more than 54 million people. Medicare helps with the cost of health care, but does not cover all medical expenses or the cost of most long-term care. There are two main ways to get Medicare coverage — original Medicare and Medicare Advantage plans (see Part C below). The different parts of Medicare help cover specific services: Part A (hospital insurance) Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care. Part A is "premi- um-free" to most people. Part B (medical insurance) Part B covers certain doctors' services, outpatient care, medical supplies and pre- ventive services. Part C (Medicare Advantage plans) Medicare Advantage plans are offered by private companies that contract with Medi- care to provide you with all your Part A and Part B benefits. Plans include Health Main- tenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans and Medicare Medical Savings Account Plans. Part D (prescription drug coverage) Part D helps pay for the cost of prescription drugs. A Medigap policy, such as those offered through NEA Member Benefits, can help pay some of the costs not covered by Parts A and B, such as co-payments, coinsurance and deductibles. Medigap policies are sold by private insurance companies and carry their own monthly premiums, in addition to the Part B premium. They are not needed by those who have a Medicare Advantage plan. When and how to sign up for Part A and Part B You can sign up for Medicare even if you are not ready to start receiving retirement benefits. You have a seven-month enrollment period, which includes the three months before you turn 65, the month you turn 65, and the three months following. Educators (and covered spouses) who are still working and whose health insurance is covered through a group plan, however, can sign up for Part A and Part B anytime while they're employed. They also have an eight- month special enrollment period to sign up after employment ends or the group health plan coverage ends, whichever comes first. (Note: COBRA and retiree health plans are not considered current employer coverage.) Part A. You get Part A at no cost if you or your spouse (living, deceased or divorced) paid Medicare taxes during at least 10 years of work. You can sign up for Part A anytime after eligibility begins. IMPORTANT: Check with your employer to make sure you have been contribut- ing to Medicare (and if you did not earn Medicare through another employer or a spouse). Prior to April 1, 1986, public education employees in California partic- ipating in CalSTRS did not automatically contribute to Medicare. CalPERS school e m p l oye e s , h owe ve r, d o c o n t r i b u t e t o Medicare automatically. Medicare resources Get more information and sign up: • By phone: Call 800-772-1213 7 a.m. to 7 p.m. Monday through Friday. Those who are hearing impaired can call TTY 800-325-0778. • In person: Visit your local Social Security office. (Call first to make an appointment.) • Online: Go to medicare.gov, or go to socialsecurity.gov and search for Medicare. P a r t B . M o s t p e o p l e p a y a s t a n d a r d monthly premium for Part B, which is $104.90 in 2015. Some pay a higher pre- mium based on their income or if they don't enroll when they are first eligible. IMPORTANT: If you did not sign up for Part B when you first became eligible and don't qualify for a special enrollment period, you can only sign up during the general enrollment period Jan. 1 to March 31 each year; coverage begins July 1. Your monthly premium will go up 10 percent for each 12-month period you were eligible for Part B but didn't sign up for it, unless you qualify for a special enrollment period. NEA members age 65 and over (and spouses/domestic partners) who are cov- ered by Parts A and B are eligible to enroll in any of the Medicare supplement plans (Medigap) through the NEA Retiree Health Program. In addition to providing the same options and benefits of other Medigap policies, the NEA plans offer discounts on dental care, chiropractic care, vision care, hearing care and vitamins. NEA also offers a group Part D program that provides pre- scription drug coverage. NEA's Member Benefits, in f act, has detailed information about Medicare and the enrollment process, so it's a good place to start. Visit neamb.com. This year is the 50th anniversary of Medicare. 55 V O L U M E 2 0 I S S U E 1