What if I don't have any health insurance coverage?
If you don't have health insurance coverage, and/or your income and resources
are limited, you may be able to get help paying for your health care from your
state.
- If you are over 65, call your State Health Insurance Assistance Program.
- If you are under 65, call your State Medical Assistance Office.
Their telephone numbers are in the
medicare.gov/Helpful Contacts- Opens in a new window
website.
Does your employer or union provide health insurance?
If your employer or union provides you with health insurance, check your
plan materials, or contact your benefits administrator to find out about
hospital coverage.
Are you enrolled in or eligible for Medicare?
If you are 65 years or older, under 65 with certain disabilities, or
have end-stage renal disease (permanent kidney failure requiring
dialysis or a kidney transplant), you may be covered by Medicare. For
information about enrolling in Medicare, read the
Enrolling in Medicare
booklet.
Medicare Eligibility Tool
This web tool is designed to provide you with information about your Medicare eligibility and enrollment.
You will be asked to answer a series of questions. The number of questions, as well as the questions themselves
will be dynamic based on your answers. Once we have collected enough information, we will display detailed information
tailored to your specific situation. Please note that the Social Security Administration will make the final
decision on your eligibility and enrollment status.
Select here to go to the Medicare Eligibility tool- Opens in a new window
.
What does Original Medicare cover?
In Original Medicare, Medicare Part A (Hospital Insurance) helps pay
for:
- inpatient hospital stays for medically necessary care
- a semiprivate (shared) room,
- meals,
- general nursing, and
- other hospital services and supplies,
- care you get in critical access hospitals, and
- mental health care. Inpatient mental health care in a psychiatric facility
is limited to 190 days in a lifetime.
Medicare Part A doesn't cover
- private duty nursing,
- a television or telephone in your room, or
- a private room unless it is reasonable and medically necessary.
What do I pay for hospital stays in Original Medicare?
The amounts shown are for 2010. These amounts may change each year.
YOU pay:
- $1,132.00 deductible and no coinsurance for days 1-60 each benefit period.
- $283.00 per day for days 61-90 each benefit period.
- $566.00 per “lifetime reserve day” after day 90 each benefit period (up to 60 days over your lifetime).
If you have insurance from an employer or union, or Medigap (Medicare Supplement
Insurance), your costs may be different.
What do Medicare Advantage Plans cover?
Medicare Advantage is the new name for Medicare + Choice. Medicare
Advantage Plans are available in many areas of the country. They
currently include Medicare Managed Care Plans, Medicare Preferred
Provider Organization Plans, Medicare Private Fee-for-Service Plans, and
Medicare Specialty Plans. If you receive your Medicare health care from one
of these types of plans, you receive all the Medicare-covered hospital
services as shown above. However, what you pay may be different, you may
have limits on which hospitals you can go to, and you may have extra
coverage. Check your Medicare plan materials, or contact a plan administrator
to receive more information about hospital coverage.
For more information about Medicare coverage of hospital care, read the
Medicare & You 2011
This handbook is mailed to all Medicare households every fall.