Helping to solve often difficult riddle of Medicare; Covering; The Bases

I am turning 65 and am not sure where to call for my Medicare. Someone said I must call Social Security and someone else said Medicare.

There are two federal agencies involved in Medicare. Social Security is the agency that enrolls a person into Medicare parts A and B. Part A is hospital insurance and is premium-free for most people.

To receive Medicare Part A premium-free, Social Security reviews a person's work history (or their spouse's work history) to see if enough work quarters are on record. Specifically, Social Security is checking to see if 40 quarters (approximately 10 years) of Federal Insurance Contributions Act taxes have been paid. If the threshold of 40 quarters is met, then Medicare Part A is premium-free.

Social Security also determines the appropriate monthly premium for Medicare Part B. The base Medicare Part B premium (for people turning 65 this year) is $134 per month. Social Security also reviews IRS tax data to determine if a person is subject to an Income Related Monthly Adjustment Amount, or IRMAA.

Medicare Part B costs more for people who are considered higher earners. If a person's modified adjusted gross income is above $85,000 a year (above $170,000 a year for a married couple filing jointly), then Part B will cost more than the base of $134 per month. More information about IRMAA is available by calling Social Security at 1-800-772-1213 or going online at www.ssa.gov/pubs/EN-05-10536.pdf.

The Centers for Medicare and Medicaid Services oversees and administers many federal health programs including Medicare. In simple terms, CMS "runs" Medicare. CMS interprets implements and enforces the laws, rules and regulations that define "Medicare." CMS (or its contractors) process Medicare claims, determining what is or isn't covered. CMS (or its contractors) run the 1-800-MEDICARE phone line with customer service representative who can talk to you about your Medicare coverage.

CMS also runs the website, www.medicare.gov. This website outlines your health benefits under Medicare, including your health options under both Original Medicare or under a Medicare Advantage plan. Both the 1-800-MEDICARE number and the website can help you evaluate your options for Medicare Part D prescription drug coverage.

To recap, you contact Social Security to enroll into Medicare parts A and B. CMS runs the Medicare program and offers online assistance or telephone assistance to better understand your Medicare benefits and to ask specific questions about your Medicare claims and benefits.

Medicare decisions are often complex. If you would like free and unbiased assistance with your Medicare questions, you may also call your local Department of Aging and Disabilities. You may request guidance from specially trained volunteer counselors to help you with your Medicare-related questions.

Please call 410-222-4257 and request to speak with a State Health Insurance Assistance Program counselor.

Amy Rubino is the director of the Senior Health Insurance Assistance Program and the Senior Medicare Patrol for the Anne Arundel County Department of Aging and Disabilities. You may contact either program at 410-222-4257 or ship_program@aacounty.org.

Credit: Amy Rubino - Amy Rubino is the director of the Senior Health Insurance Assistance Program and the Senior Medicare Patrol for the Anne Arundel County Department of Aging and Disabilities. You may contact either program at 410-222-4257 or ship_program@aacounty.org.