Medicare Benefits
Medicare is a government health insurance program, that provides assistance to people ages 65 and older, people under 65 with certain disabilities, and any age person with End-Stage Renal Disease or permanet kidney failure requiring dialysis or kidney transplant.
Learn about the types of Medicare Coverage and how to get help navigating it through a program called SHIP.
Types of Medicare Coverage
There are three types of Medicare coverage:
- Medicare Part A: Hospital Insurance
- Medicare Part B: Medical Insurance
- Medicare Part C: Advantage Plans
- Medicare Part D: Prescription Drug Plans
Part A: Hospital Insurance
Medicare Part A covers expenses like:
- inpatient hospital care
- skilled nursing facilities
- inpatient rehabilitation
- hospice care
- some home health care services
Look at the Medicare card to determine if Part A coverage is included.
If you have Part A, you will see “HOSPITAL (PART A)” printed on the card.
Most people don’t have to pay for Part A.
It's based on Medicare-covered employment, as determined by the Social Security Administration.
Part B: Medical Insurance
Medicare Part B is medical Insurance, which helps cover medically necessary services like:
- doctor visits
- outpatient care
- durable medical equipment (DME)
- certain home health services
- other medical care not covered by Part A
- some preventive services
Most people pay monthly for Part B. There is also an annual deductible.
The Centers for Medicare & Medicaid Services runs the program and details expected premiums for Part B.
Part C: Extra Coverage by Private Companies
Private companies approved by Medicare offer Medicare Part C, and provide additional coverage.
This may include:
- vision
- hearing
- dental
- health and wellness programs
Most also include Medicare prescription drug coverage (Part D).
Part D: Prescriptions
Medicare Part D provides prescription drug coverage to all individuals with Medicare.
To get Medicare prescription drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare.
Each plan can vary in cost and the drugs it covers.
Maryland SHIP: Get Help Finding the Right Plan
Trained volunteers with the Maryland State Health Insurance Assistance Program (SHIP) offer free counseling to help individuals decide which Medicare plan to choose.
SHIP counselors can help individuals:
- understand costs and coverage
- compare options
- enroll or change plans
- fix billing errors or issues
Local SHIP counselors can help with all parts of Medicare, A-D.
In addition, they can help with financial assistance for low-income beneficiaries and with Medicare fraud and abuse.
Contact Maryland SHIP
Find a local SHIP counselor:
- Allegany County – 301-783-1710
- Anne Arundel County – 410-222-4257
- Baltimore City – 410-396-2273
- Baltimore County – 410-887-2059
- Calvert County – 410-535-4606
- Carroll County – 410-386-3800
- Caroline County – 410-479-2535
- Cecil County – 410-996-8174
- Charles County – 301-934-9305
- Dorchester County – 410-376-3662
- Frederick County – 301-600-1234
- Garrett County – 301-334-9431
- Harford County – 410-638-3025
- Howard County – 410-313-7392
- Kent County – 410-778-2564
- Montgomery County – 301-255-4250
- Prince George’s County – 301-265-8471
- St. Mary’s County – 301-475-4200 Ext. 1064
- Somerset County – 410-742-0505
- Talbot County – 301-475-4200 Ext. 231
- Queen Anne’s County – 410-758-0848 Option 3
- Washington County – 301-790-0275
- Wicomico County – 410-742-0505
- Worcester County – 410-742-0505
Dial 211
Talk to a caring and compassionate person 24/7. They can also connect you to resources.
Medicare Open Enrollment
Every year, recipients should review their Medicare coverage and compare plans during the specified open enrollment in the fall.
You can join a new Medicare Advantage Plan or Part D prescription drug plan, switch from Original Medicare to a Medicare Advantage Plan, or switch from a Medicare Advantage Plan to Original Medicare (with or without a Part D plan).
You can also get a Medigap plan (Medicare Supplement) in Maryland.
How to review a Medicare plan
Ask yourself these questions about your Medicare Advantage Plan:
- How much are the premiums each month, if any?
- How much are the deductible and co-insurance/copay for the services I need?
- What is the annual out-of-pocket cost?
- What is the plan’s service area?
- Are my doctors and hospitals in network?
- What rules must I follow to access health care services and my prescription medications?
- Does the plan cover additional health care benefits that are not covered by Original Medicare?
- What is the plan’s star rating?
- Will this plan affect the additional coverage that I have?
Compare your plan to others, estimate out-of-pocket costs and look at the star system to understand the plan’s rating for quality and performance.
Special Enrollment Periods
In addition to open enrollment, there are special enrollment periods depending on personal circumstances. You will qualify to enroll in Medicare if:
- You move.
- You’re eligible for Medicaid.
- You qualify for Extra Help with Medicare drug costs.
- You’re getting care at an institution such as a skilled nursing facility or long-term care hospital.
- You want to switch to a plan with a 5-star overall quality rating.
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