Medicare

ADRC Your Unbiased Medicare Expert
Medicare is the federal health insurance program for individuals over the age of 65 or younger persons who have received Social Security disability payment for 25 months. Social Security Administration determines eligibility. Eligible persons receive a red, white, and blue Medicare ID card in the mail from the Center for Medicaid and Medicare Services (CMS).

You’ve paid into the Medicare trust fund during your working life. Once you start on Medicare you will pay a premiums and may have co-pays. These costs vary depending on the Medicare program you select. Medicare is administered by CMS who contracts with private insurers who offer Medicare Advantage and Medigap Plans.

 

Workshops

Workshops are cancelled through April 30, 2020

ABCDs of Medicare: Learn about the full scope of the Medicare program; including different parts of Medicare, enrollment information, and coverage options.

Medicare Tools: Managing your Benefits On-line: Learn about on-line tools available to navigate and manage your Medicare benefits. Individual assistance is available.

Check back for Upcoming Workshops at ADRC scheduled after April 30.

We Take the Mystery out of Medicare

Medicare is complicated. ADRC staff and specially trained volunteers are here to answer your questions and take the mystery out of Medicare. Below are a few sample questions.

I’m 65 still working and have coverage with my employer, am I required to sign-up for Medicare?
Not everyone who is turning 65 or who is eligible for Medicare due to disability payments may be required to enroll in Medicare. Call us to talk about your individual situation.
I am about to turn 65 and am getting a lot of mail from insurance companies.

There are many Medicare health plans to choose from. The ADRC does not sell insurance. We do provide unbiased information about your Medicare options.

Attending one of our Medicare workshops (see above) provided monthly throughout the year will help you understand how Medicare works so you can make an informed decision about the plan that will work best for you.

Do I have choice in selecting Medicare coverage options?

Medicare coverage options can be confusing. This very basic Medicare Coverage: Your Options Chart illustrates your options. Call us 920-448-4300 we will explain the details of how each option works.

My Medicare coverage is expensive, is there a way to save money?
Medicare can be very costly. Are you on the plan that is best for you? Contact us for a benefits check-up to determine if you qualify for a Medicare Savings Plan and/or show you how to do a plan comparison.
What does Medicare Cover?

Download this Medicare Chart to learn which benefits are covered under original Medicare Part A and Part B. You can see if your particular test, item, or service is covered under original Medicare by going to www.medicare.gov/coverage.

Medicare Money Savings Programs

Below is a short description of some plans that can help reduce the cost of Medicare. ADRC is your best source to determine if you qualify and how to apply.

Medicare Savings Program

At the low end this program pays for Part B premiums at the high end it pays Part A and B premiums along with deductibles and coinsurance for original Medicare. Eligibility is subject to gross income and asset requirements. This Medicare Savings Program flyer has more information.

Senior Care

Prescription drug assistance program for Wisconsin residents age 65 or older who meet enrollment requirements. It can be used to meet Medicare’s drug coverage requirement or with other Medicare drug plans to lower medication costs. Annual growth income used to determine eligibility and coverage. Go to www.dhs.wisconsin.gov/seniorcare or call an ADRC Benefit Specialist to learn more or pick up an application at ADRC.

Extra Help (Low Income Subsidy-LIS)

It can help pay premiums, deductible, and co-pays for prescription medications. Income and resource limits apply. Limits change annually. Medicaid recipients are automatically eligible but others are encouraged to apply.
Go to www.ssa.gov/benefits/medicare/prescriptionhelp to apply.

Patient Assistance Program

Offered by pharmaceutical companies to help eligible patients purchase costly medications. Not all medications have assistance programs. Programs have financial and coverage restrictions. A portion of the application will need to be completed by the prescribing physician. To see if you medication has an assistance program search by the med name on these sites: www.needymeds.org or www.goodrx.com

Medicaid

Other Insurance

Medicare

Medicare Supplement or Medigap Policies Questions

Wisconsin Medigap Helpline: 1-800-242-1060 or dhs.wisconsin.gov/aging/medigap.htm

Medicare Website

medicare.gov Great source for information about Medicare for new, soon to be and current recipients and their caregivers.

Medicare Forms

medicare.gov/forms-help-resources/medicare-forms Forms organized by situations to help you find the form to fit your individual situation.

Medicare & You Booklet

medicare.gov/medicare-and-you Provided by CMS annually to all Medicare participants this booklet gives a lot of valuable information about Medicare. Find the booklet in different formats, i.e.: audio, electronic, and languages other than English.

Wisconsin Senior Medicare Patrol (SMP)

gwaar.org/senior-medicare-patrol Call 888-818-2611 or email: smp-wi@gwaar.org. Help for Medicare recipients to prevent, detect, and report Medicare fraud, errors, and abuse.

WP Feedback

Dive straight into the feedback!
Login below and you can start commenting using your own user instantly