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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.


Medicare is health insurance for people age 65 or older, people under age 65 with certain disabilities, and people of any age with End Stage Renal Disease or ALS. Existing or previous health conditions do not matter when it comes to being eligible for Medicare or the amount of premium for optional coverage.

To receive Medicare, you have to sign up unless you are eligible for Medicare because you receive Social Security Disability Insurance (SSDI) benefits for 24 months. If you are eligible for Medicare because of SSDI, you are automatically enrolled in Medicare at the end of the first 24 month period.

There are two types of Medicare: Original Medicare and Medicare Advantage.

  • Original Medicare:
    • Is a fee-for-service (indemnity) type of health insurance provided by the federal government. Indemnity type policies provide freedom of choice about what doctors to see and what treatments to take.
    • Original Medicare is made up of three parts:
      • Part A covers inpatient care in hospitals and similar settings. It also covers a variety of preventive tests. There is no premium for Part A coverage. All Medicare includes Part A
      • Part B covers other medically necessary services such as a doctor's services. Part B is optional. The insured pays a monthly fee for Part B. 
      • Part D covers prescription drugs. This is also optional coverage that the insured pays a monthly premium for.
    • Private insurance companies offer "Medigap" policies that supplement Original Medicare. Medigap policies are standardized for easy comparison. It is difficult to get Medigap coverage if you have a pre-existing health condition unless you sign up during a period when no health insurance questions are asked, such as when you are first eligible for Medicare. These periods are known as "open enrollment periods". (For information about periods when insureds are guaranteed issuance despite a health history, click here offsite link.)
  • Medicare Advantage (sometimes called Medicare Part C).  
    • Medicare Advantage plans are geared to save people money and/or offer more health benefits than Original Medicare.   
    • A variety of types of Medicare Advantage plans are available. Most restrict patients to using particular doctors and hospitals. For a summary of the different types of health insurance policies, click here. The most popular type of Medicare Advantage plan is a managed care type plan (an HMO).
    • Medicare Advantage plans are provided by private companies approved by Medicare, and must include a minimum set of benefits


To go to a web site to help you find doctors who accept Medicare and to compare them, click here offsite link. (If the link does not work, go to offsite link and look for find and compare doctors.)

Yearly choice

  • Each year there is an Open Enrollment period from October 15 through December 7. During that time you can decide which type of Medicare you want for the next calendar year, and what coverage you want if you choose Original Medicare.
  • If you choose Original Medicare and purchase Part D prescription drug coverage, it is wise to review your options each year to be sure you pay the least for the prescriptions you are likely to need. To quote Philip Moeller, an expert on the area: "People tend to stick with the plan they have, despite overwhelming evidence that they would be better off switching."

Finances: If you have difficulty paying Medicare premiums and costs:

  • There is assistance available. 
  • You can also get health care at a Federally-funded health center (also known as HRSA Health Centers) where deductibles and co-insurance may be reduced or waived all together. To locate a HRSA Health Center, click here. offsite link

Of general interest:

  • It is possible to have both Medicare (either Original Medicare or Medicare Advantage) and Medicaid (Medi-cal in California).
  • Medicare premiums are not affected by your past or current health condition.


  • As a general matter, with either Medicare Advantage or Original Medicare, you do not have to worry about submitting bills. However, what you do have to be concerned about is whether the provider files a claim on a timely basis. If not, Medicare won't pay and you will be stuck with the bill. 
  • If you do have to submit a claim and you can't or prefer not to handle a Medicare claim yourself, there are people with expertise available to help. For a list, including what to look for, click here.
  • If your claim is denied, appeal - and keep appealing. Persistence pays off.

For more information, see:

For individual questions about Medicare, consider contacting:


  • Medicare will pay doctors to help patients plan what kind of care they want at the end of life. The discussions can be during an annual wellness visit or during a regular office visit.  The consultation may be repeated.
  • Improvement vs. maintenance: It used to be that Medicare only covered treatment when a patient was improving. Today, Medicare must cover skilled care and therapy when they are necessary to maintain the patient's current condition or prevent or slow further deterioration. (If you are denied coverage and have to spend your own money while appealing, you can ask for reimbusrement as part of your appeal.)
  • Identity theft happens with Medicare just like it happens with credit cards. It is wise to guard your Medicare card and Medicare number. Do not give the number to people who call, no matter how they identify themselves. 
  • If you go into a hospital, check on your status. IWhile this may sound strange, hospitals admit patients on "observation status" as well as in-patient status. Medicare considers "observation status" to be an outpatient status. This means Medicare Part A which covers hospital stays does not cover. Instead, billing will be to Medicare Part B which includes a 20% co-pay. You may also be charged for medications received in the hospital unless they are covered under Part D.  If you are on "observation status" call your doctor and ask to change the designation. If you do receive a bill as an out patient, appeal.

To Learn More

Eligibility For Medicare

Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States. If you aren’t yet 65, you might also qualify for coverage if you have a disability or with End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant).

Following are some simple guidelines.

You can get Part A coverage at age 65 without having to pay premiums if:

  • You already get retirement benefits from Social Security or the Railroad Retirement Board. 
  • You are eligible to get Social Security or Railroad benefits but haven't yet filed for them. 
  • You or your spouse had Medicare-covered government employment.

If you are under 65, you can get Part A without having to pay premiums if you have:

You will be eligible for Medicare when you turn 65 even if you are not eligible for Social Security retirement benefits.

If you pay FICA taxes, you should receive a statement each year which says whether you are eligible based on your work records. If you don’t get it or have questions about eligibility for Medicare Part A or Part B, call Social Security at 800. 772.1213 or visit or call your local Social Security office offsite link. TTY users should call 800-325-0778. You can also get information about buying Part A as well as Part B if you don’t qualify for premium-free Part A.


  • With respect to credits:
    • Credits are earned as follows: A worker makes payments into the Social Security System through F.I.C.A. payroll taxes. Payments become credits. The amount required for one credit varies.
    • Credits are earned at the rate of 4 per year, genearlly one credit for each calendar quarter.
    • You do not have to work a full quarter to earn a credit. It is the dollar amount rather than the length of time worked during a quarter that counts for a credit.
    • if you haven’t worked long tnough to quality – you may qualify on your current or former spouse’s work record- or you may be able to buy into the program. If you continue working until you gain 40 credits, you will no longer have to pay premiums.      
  • Individuals who are not otherwise eligible who are age 65 or older may purchase Medicare coverage by paying a monthly premium.

Enrollment (including changing plans)


You can join, switch, or drop Medicare Advantage or a Medicare drug plan:

  • If you can get Medicare because of your age, the original period for enrollment is a seven month period which starts 3 months before the month you turn 65. It continues for 3 months after the month in which you were born. For example, if your birthday is July 6, you can start applying April 1. The open enrollment continues until October 31. 
  • If you get Medicare due to a disability, the original enrollment period relates to your 25th months after the onset of your disability. Eligibility starts during the 3 months before your 25th month of disability and continues until your 25th month after. You will have another chance to join 3 months before the month you turn 65 to 3 months after the month you turn 65.


  • You can enroll in a Medicare Advantage or Part D Plan in your area with an overall 5 star rating any time during the year. This special enrollment period can only be used once a year. The special enrollment period begins December 8 of the year before the plan is considered to be a 5 star plan and ends November 30 of the year the plan is considered to be a 5 star plan. Enrollments are effective the first of the following month. You must live in the service area covered by the plan.
  • If you didn't sign up for Medicare Part B when you were first eligible because you or your spouse was working and had group health plan coverage through an employer or union based on this current employment, you may be eligible for a Special Enrollment Period. If this applies to you, you can sign up for Medicare Part B any time you are still covered by the employer or union group health plan through your (or your spouse's) current or active employment, or during the eight months following the month the group health plan coverage or the employment ends (whichever is first). Your Medicare Part B coverage will begin:
    • The month you enroll in Medicare Part B if you enroll while you are covered under the group health plan based on current or active employment, or during the first full month after the coverage or employment ends (whichever comes first). You can also delay the start date for Medicare Part B coverage until the first day of any of the following three months; or
    • The month after the month you enroll if you enroll during the remaining 7 months of the Special Enrollment Period.


You can enroll in Medicare by  either:

  • Calling Medicare at 800 Medicare or you can enroll online at offsite link. Look in the "Getting Started" section, or
  • By calling a Medicare Advantage plan directly.

Medicare Rights Center recommends that people enroll by calling Medicare to reduce chances of administrative error.

If you are already in a Medicare Advantage plan,:

  • If you want to move to another Medicare Advantage plan: You do not have to disenroll from the old plan when choosing a new one. In fact, it is preferred that you just enroll in the new plan. The old plan will automatically be advised of your change. This system avoids the potential for any gaps in coverage because the old coverage will not stop before the new one starts. 
  • If you want to move to Original Medicare: enroll in a prescription drug plan.


During October each year, information is published about the coming year for Original Medicare and Medicare Advantage plans.

Original Medicare

You have from October 15 to December 07 to change plans for the coming year.

New coverage begins January 1 of next year. 

Medicare Advantage

You can change plans between October 15 and December 07. Your coverage will begin on the first of next year.

If you are in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare during the period between January 1–February 14. If you switch to Original Medicare during this period, you will have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.

During this period, you cannot do any of the following:

  • Switch from Original Medicare to a Medicare Advantage Plan. 
  • Switch from one Medicare Advantage Plan to another. 
  • Switch from one Medicare Prescription Drug Plan to another. 
  • Join, switch, or drop a Medicare Medical Savings Account Plan. 

In most cases, you must stay enrolled for that calendar year starting the date your coverage begins. However, in certain situations, you may be able to join, switch, or drop a Medicare Advantage Plan at other times. Some of these situations include the following: If you move out of your plan’s service area. If you qualify for Extra Help. Or if you live in an institution (such as a nursing home).

Part D Drug Coverage

You can sign up between October 15 and December 7. Your coverage will begin on January 1, as long as the plan gets your enrollment request by December 7. 

You can sign up anytime, if you qualify for  Extra Help.

In most cases, you must stay enrolled for that calendar year starting the date your coverage begins. However, in certain situations, you may be able to join, switch, or drop Medicare drug plans at other times. Some of these situations include the following:

  • If you move out of your plan’s service area; 
  • if you lose other creditable prescription drug coverage  
  • If you live in an institution (such as a nursing home).  
  • If you want to move to a Medicare Advantage plan with a  5 star rating.

How To Get More Information About Medicare

Questions and Assistance

If you have additional questions, or need assistance:

Concerning Medicare, contact:

Concerning State Health Insurance Assistance Programs (SHIPs): Find the SHIP in your state via: offsite link


Although Medicare is a benefit of the Social Security Administration, Medicare is administered by the Centers for Medicare and Medicaid Services (CMS). CMS publishes many free booklets and brochures about Medicare. See: offsite link.