Medicare Eligibility, Applications, and Appeals

<p>Find information about Medicare, how to apply, report fraud, and submit complaints.</p><h3>What help is available?</h3><p>Medicare is the federal health insurance program for people:</p><ul><li><p>Age 65 or older</p></li><li><p>Under 65 with certain disabilities</p></li><li><p>Any age with end-stage renal disease. This is permanent kidney failure requiring dialysis or a kidney transplant.</p></li></ul><h4>Medicare has <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices#">four parts</a>:</h4><ul><li><p><a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/what-medicare-covers/what-part-a-covers">Part A</a> is hospital insurance.</p></li><li><p><a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/what-medicare-covers/what-part-b-covers">Part B</a> is medical insurance.</p></li><li><p><a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans">Part C Medicare Advantage Plans</a> are a private insurance option for covering hospital and medical costs.</p></li><li><p><a href="https://webharvest.gov/congress117th/20221219220114/https://www.usa.gov/medicare#item-36132">Part D</a> covers prescription medications.</p></li></ul><p>Medicare is managed by the Centers for Medicare & Medicaid Services (CMS). The Social Security Administration works with CMS by enrolling people in Medicare.</p><h3>Am I eligible?</h3><ul><li><p>To find out when you are eligible, you need to <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/eligibilitypremiumcalc">answer a few questions</a> and learn how to calculate your premium.</p></li><li><p>If you are eligible, <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-does-medicare-coverage-start">learn about the enrollment period</a>.</p></li></ul><h3>How do I apply?</h3><p>There are several ways to enroll in Medicare:</p><ul><li><p>Before you apply, learn about your coverage options. <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices#1360">Decide if you want Original Medicare (Part A and Part B)</a>. Or, find out <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans/how-to-join-a-medicare-advantage-plan">how to enroll in a Medicare Advantage Plan (Part C)</a>.<a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/your-medicare-coverage-choices.html#1360"> </a></p></li><li><p>Determine if you want coverage for <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/drug-coverage-part-d">prescription drugs</a>.</p></li><li><p>Next, use the <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/plan-compare/#/?lang=en&year=2021">Medicare Plan Finder Tool</a> and search to find more accurate cost estimates and coverage information.</p></li><li><p><a href="https://webharvest.gov/congress117th/20221219220114/https://www.ssa.gov/medicare/">Apply online for Medicare only</a> if you’re not ready to also begin receiving your Social Security benefits.</p></li><li><p>Apply in person for Medicare at your <a href="https://webharvest.gov/congress117th/20221219220114/https://secure.ssa.gov/ICON/main.jsp">local Social Security office</a>.</p></li></ul><h3>How do I check the status of my application?</h3><ul><li><p><a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/account/login/">Use this tool from Medicare to check your enrollment status</a>.</p></li></ul><h3>How do I complain or appeal a Medicare decision?</h3><ul><li><p>Learn the different ways to <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/claims-appeals/how-to-file-a-complaint-grievance">file a complaint about Medicare. </a></p></li><li><p>You can submit feedback about your Medicare health plan or prescription drug plan. Submit it to Medicare using the<a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/my/medicare-complaint"> online complaint form</a>.</p></li><li><p>Get information on how to <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/claims-appeals/how-do-i-file-an-appeal">file an appeal</a> for a coverage or payment decision. </p></li></ul><h4>How do I report fraud?</h4><ul><li><p>Learn where and how to report <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/basics/reporting-medicare-fraud-and-abuse">suspected Medicare fraud, errors, or abuse</a>.</p></li></ul><h3>Who do I contact for extra help?</h3><p>For questions about billing or other information, <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/account/login/">contact Medicare by phone or mail</a>.</p><h3>Is there anything else I need to know?</h3><ul><li><p><a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/your-medicare-costs/medicare-costs-at-a-glance">Review this chart showing Medicare costs for 2022</a>.</p></li><li><p>If you do not enroll in Medicare Part B when you're first eligible and decide to enroll later, <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-late-enrollment-penalty">you'll pay a penalty for as long as you're enrolled in Part B.</a></p></li><li><p>You do not need to sign up for Medicare each year. But each year, you will have a chance to review your coverage and change plans.</p></li><li><p>Learn more about your plan and benefits by creating a <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/account/create-account/">myMedicare.gov account</a>. </p></li></ul>

Voluntary Termination of Medicare Part B

<ul><li>You can voluntarily terminate your <a href="https://webharvest.gov/congress117th/20221219220114/https://faq.ssa.gov/en-us/Topic/article/KA-02713">Medicare Part B (medical insurance)</a>. It is a serious decision. You must submit <a href="https://webharvest.gov/congress117th/20221219220114/https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS1763.pdf">Form CMS-1763</a> to the <a href="https://webharvest.gov/congress117th/20221219220114/http://www.ssa.gov/">Social Security Administration (SSA)</a>. Visit or call the SSA (<a href="tel:18007721213">1-800-772-1213</a>) to get this form.</li><li>You’ll need to have a personal interview with Social Security before you can terminate your Medicare Part B coverage. To schedule your interview, <a href="https://webharvest.gov/congress117th/20221219220114/https://www.usa.gov/federal-agencies/social-security-administration">call the SSA</a> or your <a href="https://webharvest.gov/congress117th/20221219220114/https://secure.ssa.gov/ICON/main.jsp">local Social Security office</a>.</li></ul>

Medicare Prescription Drug Coverage (Part D)

<p>Part D of Medicare is an insurance coverage plan for prescription medication. Learn about the <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage">costs for Medicare drug coverage</a>.</p><h3>Eligibility</h3><p><a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/drug-coverage-part-d">Prescription drug coverage (Medicare Part D)</a> is available to anyone with Medicare. </p><h3>How to Apply</h3><p>There are two ways to get Medicare drug coverage:</p><ul><li>Add a Medicare Prescription Drug Plan (Part D) to your Medicare-approved insurance policy.</li><li>Get a Medicare Advantage Plan (Part C) such as an HMO or PPO that offers Medicare prescription drug coverage.</li></ul><p><a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/sign-up-change-plans/joining-a-health-or-drug-plan">Learn more about Medicare Part D</a>.</p><h3>When You Can Apply or Change Your Plan</h3><ul><li>You can join or change your drug plan only at <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/sign-up-change-plans/joining-a-health-or-drug-plan">certain times of the year</a> or under <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances-special-enrollment-periods">special circumstances</a>.</li><li>You may have to pay a <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/part-d-late-enrollment-penalty">late enrollment penalty</a>, which is an amount added to your Medicare Part D premium if you decide not to join when you are first eligible. </li></ul><h3>Get Help With Medicare Part D</h3><p>If you need help with Medicare Part D including finding a plan, applying, paying for coverage, or if you have a complaint, visit <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/forms-help-resources">Medicare’s resources section</a>. If you need more assistance paying for your prescriptions under Medicare Part D, <a href="https://webharvest.gov/congress117th/20221219220114/https://www.ssa.gov/medicare/prescriptionhelp/">you may qualify for the Extra Help program</a>.</p><h3>Contact Medicare</h3><p>For help with specific issues, <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/talk-to-someone">contact Medicare</a>.</p>

Replace Your Medicare Card

<p>You can replace your Medicare card in one of the following ways if it was lost, stolen, or destroyed:</p><ul><li>Log into your <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/account/login/">MyMedicare.gov</a> account and request one.</li><li>Request a <a href="https://webharvest.gov/congress117th/20221219220114/https://www.hhs.gov/answers/medicare-and-medicaid/how-do-i-replace-my-medicare-card/index.html">replacement Medicare card</a> online.</li><li>Call or visit your local <a href="https://webharvest.gov/congress117th/20221219220114/https://secure.ssa.gov/ICON/main.jsp">Social Security Administration</a> office.</li></ul>

Medicare Coverage Outside the United States

<p>Medicare coverage outside the United States is limited. Learn about coverage if you <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/coverage/travel">live or are traveling outside the United States</a>.</p><h3><strong>Original Medicare</strong></h3><p>If you have Original Medicare and have a <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap">Medigap policy</a>, it may provide <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/supplements-other-insurance/medigap-travel">coverage for foreign travel emergency health care</a>. Learn more about <a href="https://webharvest.gov/congress117th/20221219220114/https://www.medicare.gov/coverage/travel">Original Medicare outside the United States</a>.</p>

Medicare

Get answers to your questions about Medicare, including how to apply, get a replacement card, and what is Part D for prescription drugs. Also, learn about Medicare coverage when you live abroad.