.What Is Medicare?
Medicare is a government health insurance program for:
- People 65 or older
- People under 65 with certain disabilities
- People of any age with End-Stage Renal Disease (ESRD), permanent kidney failure requiring dialysis or a kidney transplant
If you’re over 65 (or turning 65 in the next three months) and you do not already receive Social Security benefits, you can sign up for Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). Enrollment is not automatic.
You can contact your local Social Security office or Medicare for enrollment questions or apply online. You can also call 1-800-MEDICARE (1-800-633-4227).
Medicare Coverage
Part A – Hospital insurance that helps pay for things like inpatient hospital care, hospice care and some home health care. Most people don’t have to pay for Part A. To find out if you have Part A coverage, look on your red, white, and blue Medicare card. If you have Part A, “HOSPITAL (PART A)” is printed on your card.
Part B – Medical Insurance helps cover medically-necessary services like doctor visits, outpatient care, medical equipment, home health services, and other medical care. Part B also covers some preventive services. Most people pay monthly for Part B.
Part C – Medicare Advantage is like an HMO or PPO. It is offered by private companies approved by Medicare. These plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).
Part D – offers prescription drug coverage to everyone 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 drugs covered. Look for a Part D prescription plan.
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.
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, get an estimate of out-of-pocket costs and look at the star system to understand the plan’s rating for quality and performance.
Medicare Help From Maryland SHIP
Get help deciding which Medicare plan to choose for your personal health needs.
Trained and volunteer counselors offer free support to guide Medicare beneficiaries through open enrollment. Get information, counseling, and assistance through the State Health Insurance Assistance Program (SHIP).
SHIP counselors can help you understand costs and coverage, compare options, enroll or change plans and fix billing errors or issues.
Local SHIP counselors can help with all parts of Medicare:
- Medicare Part A: Hospital Insurance
- Medicare Part B: Medical Insurance
- Medicare Part C: Advantage Plans
- Medicare Part D: Prescription Drug Plans
In addition, they can help with financial assistance for low-income beneficiaries and Medicare fraud and abuse.
The SHIP counselor can also help you understand costs and coverage, compare options, enroll in or change plans and correct billing issues.
Find a local SHIP counselor in your county:
- 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
You can also learn more about the SHIP program and open enrollment from the Maryland Department of Aging.
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.
