当地的22名消防/护理

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第五大街415号. 费城., PA 19123.

医疗保险指南

联系社会保障

浏览社会保障网站 www.社会保障.政府, 您可以:

  • 创建一个我 社会保障 account to review your 社会保障 Statement, 验证您的收益, 打印一份利益验证信, 更改您的直接存款信息, 申请一张新的医保卡, 更换1099/ 1042S, 和更多;
  • 申请医疗保险处方药计划费用的额外帮助;
  • Apply for retirement, disability, and 医疗保险 benefits;
  • Get the address of your local 社会保障 office;
  • Find copies of 社会保障 Publications; and
  • 获取常见问题的答案.

打给社会保险-免费的 1- 或者TTY数, 1-, 如果你耳聋或听力不好.

  • 一般信息
  • 地址变更
  • 医疗保险替代卡通过自动电话服务一天24小时.

Case specific questions are taken 7am to 7pm Monday thru Friday. All calls are confidential and may be monitored by a second 社会保障 Representative.

医疗保险

This booklet provides basic information about what 医疗保险 is, 是谁了, and some of the options you have for choosing 医疗保险 报道. 浏览有关医疗保险的最新资讯, visit the website or call the toll-free number listed below.

网站: www.医疗保险.政府
免费nu1nber: 1 - 800 -医疗保险
(1-}
电传号码: 1-

医疗保险是什么?

医疗保险是我国为65岁以上的人提供的健康保险计划. People younger than age 65 with certain disabilities, 或者是永久性肾衰竭, or amyotrophic lateral sclerosis (Lou Gehrig’s disease), 也有资格享受医疗保险吗. The program helps with the cost of health care, 但它并不能支付所有的医疗费用或大多数长期护理费用. 你 have choices for how you get 医疗保险 报道. If you choose to have original 医疗保险 报道, 你可以从私人保险公司购买医疗保险补充政策(被称为医疗补助计划)来支付一些医疗保险没有支付的费用.

A portion of the payroll taxes paid by workers and their employers cover most 医疗保险 expenses. Monthly premiums, usually deducted from 社会保障 checks also cover a portion of the costs.

医疗保险中心 & 医疗补助服务是负责医疗保险项目的机构. 但, 你可以通过社会保险申请医疗保险, dafabet网页手机登录可以给你关于医疗保险计划的一般信息.

医疗保险包括四个部分

  • 医疗保险A部分(医院保险)帮助支付住院病人在医院或专业护理机构的护理费用(住院后). Part-A: – also pays for some 家庭健康护理, and hospice
  • 医疗保险B部分(医疗保险)帮助支付医生和其他卫生保健提供者提供的服务, 门诊医疗, 家庭健康护理, 耐用医疗设备, 和一些预防
  • 医疗保险C部分(医疗保险优势计划)在许多地区都有. 拥有医疗保险A部分和B部分的人可以选择通过医疗保险批准的私人保险公司来提供他们所有的医疗保健服务
  • 医疗保险 Part D (医疗保险 prescription drug 报道) helps cover the cost of prescription

你 can get more details about what 医疗保险 covers from 医疗保险 & (出版. cms - 10050). To get a copy, call the toll-free number or go to the 医疗保险 website shown on the previous page.

再说说医疗补助

你 may think Medicaid and 医疗保险 are the same, but they’re two different programs. 医疗补助计划是一个为低收入人群提供医院和医疗保险的国家运作的项目. 每个州都有自己的规定,关于谁有资格享受医疗补助,以及医疗补助覆盖的范围. Some people qualify for both 医疗保险 and Medicaid. For more information about the Medicaid program, 联系当地的医疗援助机构或社会服务办公室.

谁能享受医疗保险?

医疗保险A部分(医院保险)

65岁或以上的人, who are citizens or permanent residents of the United States, 有资格享受医疗保险部分吗

  1. 你’re eligible for “Part A” at no cost at age 65 if:
    • 你 receive or are eligible to receive 社会保障 benefits; or
    • 你 receive or are eligible to receive railroad retirement benefits; or
    • 你的配偶(在世或已故, including divorced spouses) receives or is eligible to receive 社会保障 or railroad retirement benefits; or
    • 你 or your spouse worked long enough in a 政府ernment job through which you paid 医疗保险 taxes; or
    • 你 are the dependent parent of a fully insured deceased

如果你不满足这些要求, 你可以通过每月支付保险费来获得医疗保险A部分. Usually, you can purchase this 报道 only during designated enrollment periods.

注意:尽管社会保障的法定退休年龄已不再是65岁, 你应该在65岁生日前三个月申请医疗保险. 你可以在dafabet网页手机登录的网站上申请 www.社会保障.政府.

在65岁之前,如果:

  • 你’ve been entitled to 社会保障 disability benefits for 24 months; or
  • 你 receive a disability pension from the railroad retirement board and meet certain conditions; or
  • 你 receive 社会保障 disability benefits because you have Lou Gehrig’s disease (amyotrophic lateral sclerosis); or
  • 你 worked long enough in a 政府ernment job through which you paid 医疗保险 taxes, and you’ve been entitled to 社会保障 disability benefits for 24 months; or
  • 你’re the child or widow(er) age 50 or older, 包括一个离婚的寡妇, of someone who’s worked long enough in a 政府ernment job through which 医疗保险 taxes were paid, and you meet the requirements of the 社会保障 disability program; or
  • 你有永久性的肾衰竭你需要接受维持性透析或者肾移植
  • 你’re eligible for or receive monthly benefits under 社会保障 or the railroad retirement system; or
  • 你’ve worked long enough in a 医疗保险-covered 政府ernment job; or
  • 你是一名工人(在世或已故)的子女或配偶(包括离婚的配偶),他们在社会保障或医疗保险覆盖的政府工作中工作了足够长的时间.

医疗保险B部分(医疗保险)

任何有资格免费享受医疗保险A部分的人都可以通过每月支付保险费来注册医疗保险B部分. 一些高收入的人将支付更高的每月B部分保险费. 欲了解更多信息,请阅读 医疗保险 Premiums: Rules for Higher-Income Beneficiaries (出版. 05 - 10536),或访问 www.社会保障.政府 / mediinfo.htm.

If you’re not eligible for Part A at no cost, 你可以买B部分, 而不需要购买A部分, 如果你已经65岁或以上,并且你:

  • A U.S. citizen; or
  • A lawfully admitted noncitizen, who has lived in the United States for at least five years

你只能在指定的注册期内注册B部. If you don’t enroll in Part B when you’re first eligible for it, you may have to pay a late enrollment penalty for as long as you have Part B 报道. 读 注册医疗保险 10页.

医疗保险 Part C (医疗保险 Advantage plans)

如果你收到你的Part A和Part B利益直接从政府, 你有原始的医疗保险. 如果你从医疗保险优惠组织或其他经医疗保险批准的公司领取福利, 你有医疗保险优惠计划. Many of these plans provide extra 报道 and may lower your out-of-pocket costs.

如果你有医保A部分和B部分,你可以加入医保优势计划. 得到医疗保险批准的私营公司提供医疗保险优惠计划. 与这些计划, 你不能有医疗补助政策, because 医疗保险 Advantage plans cover many of the same benefits a Medigap policy covers. 这包括一些福利,比如在你使用了医疗保险覆盖的天数之后,你可以在医院多待几天.

医疗保险优惠计划包括:

  • 医疗保险管理式医疗保健计划;
  • 医疗保险 preferred provider organization plans;
  • 医疗保险 private fee-for-service plans; and
  • 医疗保险专业

If you decide to join a 医疗保险 Advantage plan, 你使用你从你的医疗保险优势计划提供商那里获得的健康卡. 也, 你可能需要每月为你的医疗保险优势计划支付保险费,因为它提供了额外的福利.

你可以在你的初始注册期间参加医疗保险优势计划(详见下文解释) 签约 医疗保险 10页), the first time you’re eligible 医疗保险. 你也可以在每年10月15日至12月7日的年度医疗保险开放注册期间注册. 入学日期为新学年的1月1日. There are also special enrollment periods for some situations.

医疗保险 Part D (医疗保险 prescription drug 报道)

任何拥有医疗保险A部分或B部分的人都有资格享受D部分(医疗保险处方药覆盖). Joining a 医疗保险 prescription drug plan is voluntary, and you pay an extra monthly premium for the 报道. Some beneficiaries with higher incomes will pay a higher monthly Part D premium. 欲了解更多信息,请阅读 医疗保险 Premiums: Rules for Higher-Income Beneficiaries (出版. 05 - 10536),或访问 www.社会保障.政府 / mediinfo.htm. 如果你第一次有资格参加医疗保险药物计划, you may pay a late enrollment penalty if you join a plan later. 你’ll have to pay this penalty for as long as you have 医疗保险 prescription drug 报道. 然而, you won’t pay a penalty if you have Extra Help (see below), or another creditable prescription drug plan. 是可信的, 保险责任必须赔偿, 平均, at least as much as 医疗保险’s standard prescription 报道.

您可以在初始注册期间注册(如下文所述 注册医疗保险 10页), the first time you’re eligible 医疗保险. 你也可以在每年10月15日至12月7日的年度医疗保险开放注册期间注册. 入学日期为新学年1月1日. There are also special enrollment periods for some situations.

帮助一些低收入人群

如果你无力支付医疗保险和其他医疗费用, you may be able to get help from your state. 各州为有资格享受医疗保险的低收入人群提供项目. Some programs may pay 医疗保险 premiums and some pay 医疗保险 deductibles and coinsurance. To qualify, you must have 医疗保险 Part A and have limited income and resources.

你 can go online to get more information about these programs from the Centers 医疗保险 & 医疗补助服务网站. 访问 www.医疗保险.政府 /出版物 并找到 获得医疗保险费用方面的帮助 (出版. CMS-10126) at the “你r 医疗保险 Costs” tab.

只有你所在的州可以决定你是否有资格获得这些项目的帮助. 找出, 联系你所在的州或当地的医疗援助机构, 社会服务, 或福利办公室.

你也可以得到额外帮助支付每年的免赔额, 每月的费用, and prescription co-payments related to the 医疗保险 prescription drug program (Part D). 如果你的收入有限(与联邦贫困水平相关),资源有限,你就有资格获得额外帮助. These income and resource limits usually change each year, and you can contact us for the current numbers.

如果你有医疗保险,并且满足以下条件之一,你就自动符合资格,不需要申请额外帮助:

  • 拥有全面的医疗补助计划;
  • Have Supplemental Security Income (SSI); or
  • Take part in a state program that pays your 医疗保险

了解更多关于如何帮助你支付处方药费用的信息, call 社会保障’s toll-free number or visit our website. 你也可以在网上申请 www.社会保障.政府 / extrahelp.

注册医疗保险

我应该什么时候申请?

If you’re already getting 社会保障 benefits or railroad retirement checks, dafabet网页手机登录会在你有资格享受医疗保险的几个月前把信息发给你. If you live in one of the 50 states, Washington, D.C., the Northern Mariana Islands, Guam, American Samoa, or the U.S. 维尔京群岛,dafabet网页手机登录会自动登记你在医疗保险A和B部分. 然而, because you must pay a premium for Part B 报道, you can choose to turn it down.

NOTE: Residents of Puerto Rico or foreign countries won’t receive Part B automatically. 他们必须选择这项福利.

如果你还没有得到福利, 你应该在65岁生日前3个月联系社会保障,办理医疗保险. 即使你不打算在65岁退休,你也可以申请医疗保险.

在你参加医疗保险之后, 你会收到红色, 白色, and blue 医疗保险 card showing whether you have Part A, 乙部或两者兼有. 把你的卡放在安全的地方,当你需要的时候就可以拿着. 如果您的卡丢失或被盗, you can apply for a replacement card online by setting up a my 社会保障 account at www.社会保障.政府 / myaccount, or call 社会保障’s toll-free number. 你还会收到 医疗保险 & 你 手册(出版. cms - 10050),描述您的医疗保险福利和计划选择.

特殊的招生情况

在以下情况下,您还应该联系社会保障部门申请医疗保险:

  • 你’re a disabled widow or widower between age 50 and age 65, 但还没有申请伤残津贴,因为你已经获得了另一种社会保障津贴;
  • 你是一名政府雇员,在65岁之前残疾;
  • 你、你的配偶或你的孩子患有永久性肾衰竭;
  • 你 had 医疗保险 Part B in the past, but dropped the 报道;
  • 你 turned down 医疗保险 Part B when you first got Part A; or
  • 你 or your spouse worked for the railroad

B部的首次登记期

When you first become eligible 医疗保险 Part A, you have a seven-month period (your initial enrollment period) in which to sign up for Part B. 如果你在65岁时符合条件, 你的初始注册期在你65岁生日前三个月开始, 包括你65岁的那个月, 三个月后就结束了. If you’re eligible 医疗保险 based on disability 或者是永久性肾衰竭, your initial enrollment period depends on the date your disability or treatment began.

注意:如果你在第一次有资格参加B部分时没有参加, you may have to pay a late enrollment penalty for as long as you have Part B 报道. 此外,你可能不得不等待登记,这将推迟这一覆盖.

When does my enrollment in Part B become effective?

If you accept the automatic enrollment in 医疗保险 Part B, or if you enroll during the first three months of your initial enrollment period, your 报道 will start with the month you’re first eligible. 如果你是在过去四个月入学的, 您的保险将在您登记后一至三个月开始.

以下图表显示了您的医疗保险B部分何时生效:

If you enroll in this month of your initial enrollment period 然后你的B部分医疗保险开始覆盖
One to three months before you reach age 65 你65岁的月份
你65岁的月份 再过一个月你就65岁了
在你65岁后的一个月 入学后两个月
Two or three months after you reach age 65 Three months after the month of enrollment

乙部一般注册期

如果您在初始注册期间没有参加医疗保险B部分, 每年1月1日至3月31日的“普通注册期”,你都有机会注册. 你r 报道 begins on July 1 of the year you enroll. 然而, you may have to pay a late enrollment penalty for as long as you have Part B 报道. 你r monthly premium will go up 10 percent for each 12个月的期限内你有资格申请Part B但是 没有报名参加.

Special enrollment period for people leaving _Part C

If you’re in a 医疗保险 Part C (医疗保险 Advantage plan), you can leave that plan and switch to original 医疗保险 from January 1 through February 14. 如果你使用这个选项, you also have until February 14 to join a 医疗保险 Part D (医疗保险 prescription drug plan). 你r 报道 begins the first day of the month after the plan gets your enrollment form.

Special enrollment period for people covered under an employer group health plan

如果你65岁或以上,并且参加了个人或配偶的团体健康计划 当前的就业, you may have a “special enrollment period” in which to sign up 医疗保险 Part B. 这意味着您可以延迟注册在医疗保险B部分,而不必等待一般注册期和支付罚款,迟注册. 这是有限制的,所以dafabet网页手机登录强烈建议您联系医疗保险中心 & 医疗补助服务 (CMS) for more information. The CMS contact information is on page 4 of this booklet. 规则允许你:

  • 当你有一个基于当前就业或的团体健康计划时,任何时候都可以参加医疗保险B部分
  • 在就业结束或团体健康保险结束后的第一个月开始的8个月期间参加医疗保险B部分, 无论发生第一次. 如果你的工作或雇主提供的团体健康计划在你的第一次登记期间结束,你不能使用特殊登记期登记. 当你参加医疗保险B部分时,你仍然在团体健康计划中, 或者在第一个完整的月,当你不在计划中, 您的保险范围开始:
    • On the first day of the month you enroll; or
    • By your choice, on the first day of any of the following three

If you enroll during any of the remaining seven months of the “special enrollment period,“你的医疗保险B部分的保险从下个月的第一天开始.

If you don’t enroll by the end of the eight-month period, you’ll have to wait until the next general enrollment period, 从明年的1月1日开始. 你 may also have to pay a late enrollment penalty for as long as you have Part B 报道, 如前所述.

如果你获得了社会保障的残疾福利,并且在一个大的团体健康计划中覆盖了你自己或家人当前的工作, you may also have a special enrollment period. If so, you have premium rights similar to those for current workers age 65 or older. For more information, contact the Centers 医疗保险 & 医疗补助服务.

NOTE: COBRA and retiree health 报道 don’t count as current employer 报道.

接受保健服务的选择

医疗保险受益人可以选择获得医疗保健服务.

你 can get more information about your health care choices from the following publications:

  • 医疗保险 & (出版. cms - 10050)- CMS会在人们加入医疗保险后将本指南邮寄给他们,并在之后每年向他们发送更新版本
  • 选择医疗补助政策:有医疗保险的人的健康保险指南 (出版. 本指南描述了其他健康保险计划是如何补充医疗保险的,并为查看这些计划的人提供了一些购物提示. To get a copy of these publications, visit 医疗保险.政府 /出版物, 或拨打免费电话, 1 - 800 -医疗保险(l). If you’re deaf or hard of hearing, call TTY 1-.

如果你有其他的医疗保险

医疗保险A部分(医院保险)几乎对所有人免费. 你必须每月为医疗保险B部分(医疗保险)支付保险费。. If you already have other health insurance when you become eligible 医疗保险, is it worth the monthly premium cost to sign up for Part B?

The answer varies with each person and the kind of other health insurance you have. 虽然dafabet网页手机登录不能给你“是”或“不是”的答案,但dafabet网页手机登录可以提供帮助你决定的信息. We can also advise if you’ll be subject to a late enrollment penalty if you delay signing up.

如果你有私人保险计划

Get in touch with your insurance agent to see how your private plan fits with 医疗保险 Part B. This is especially important if you have family members who have 报道 under the same policy. And remember, just as 医疗保险 doesn’t cover all health services, most private plans don’t either. In planning your health insurance 报道, 请记住,大多数养老院的护理不包括在医疗保险或私人健康保险政策之内. One important word of caution: For your own protection, do not cancel any health insurance you now have until your 医疗保险 报道 begins.

如果你参加了雇主提供的团体健康计划

由法律规定, 拥有20名或以上员工的雇主的团体健康计划必须向年龄在65岁(或以上)的在职员工及其配偶提供与年轻员工相同的健康福利.

If you or your spouse are still working and covered under an employer-provided group health plan, 在报名参加医疗保险B部分前,请与人事办公室联系.

If you have health care protection from other plans If you have TRICARE (insurance for active-duty, 军队退休人员, 和他们的家人), 当你有资格享受医疗保险时,你的医疗福利可能会改变或终止. 这适用于任何原因,无论年龄或居住地. 如果你是退伍军人或退伍军人的家庭成员, you must enroll in Part A and Part B when first eligible to keep TRICARE 报道. 你 can find a military health benefits adviser at milconnect.dmdc.密耳, or call the Defense Manpower Data Center, toll-free at 1- (TTY 1-) 在决定是否参加医疗保险(B部分)之前.

如果你有印度卫生服务机构的医疗保护, 退伍军人事务部, 或者国家医疗援助计划, contact those offices to help you decide if it’s to your advantage to have 医疗保险 Part B.

IMPORTANT: If you have VA 报道 and don’t enroll in Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Part B 报道. 此外,你可能不得不等待登记,这将推迟这一覆盖.

For more information on how other health insurance plans work with 医疗保险, visit 医疗保险.政府 /出版物 浏览小册子 医疗保险和其他健康福利:谁先付钱的指南 (出版. CMS-02179), or call the 医疗保险 toll-free number, 1 - 800 -医疗保险(1 -). If you’re deaf or hard of hearing, call TTY 1-.

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