Medicare provides health insurance coverage to individuals age 65 and older and to certain people with disabilities. APPRISE is a free health insurance counseling program designed to help older Pennsylvanians understand their Medicare coverage. Counselors are specially trained volunteers who can answer your questions about Medicare and provide you with objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medical Assistance and Long-Term Care Insurance.
Listed below is a brief description of the types of health insurance benefits that Medicare provides:
- Medicare Part A - Hospital Insurance
Helps pay for five kinds of services: (1) inpatient hospital care; (2) psychiatric hospital care; (3) medically necessary, skilled nursing facility care following a hospital stay; (4) home health care; and (5) hospice care.
- Medicare Part B - Medical Insurance
Helps pay for: (1) doctor's services; (2) outpatient hospital services; and (3) various medical services and supplies. This is a voluntary program and a monthly premium must be paid.
- Medicare Part D - Prescription Drug Coverage
Before signing up for Medicare Part D, first find out if you are eligible for Pennsylvania’s PACE Plus Medicare.
Medicare Prescription Drug Coverage is provided by private insurance companies throughout Pennsylvania. You choose the plan and pay a monthly premium. Some plans also have a deductible. Like other insurance, if you decide not to enroll in a drug plan when you are first eligible, you may pay a penalty if you choose to join it later, unless you already have prescription insurance coverage which is deemed "credible coverage" by Medicare.
Generally, you are eligible for Medicare if you 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 may also qualify for coverage if you have a disability or have an End-Stage Renal disease (for example, a permanent kidney failure requiring dialysis or transplant).
If you are now receiving Social Security or Railroad Retirement benefits, or are eligible for these benefits, your Medicare card will automatically be sent to you. However, if you are nearing 65, still employed, and do not receive monthly checks, you must apply for the program at your local Social Security Administration office
. If you are employed or covered under a large group employer health insurance contract, contact the local Social Security Administration Office
about coordinating your insurance.
Visit the Medicare website or contact the Social Security Administration Office nearest you for specific information about the benefits and their funding.
Your birth or baptismal certificate recorded before your 5th birthday. Other proof-of-age documents may be substituted only if this is not available.
Local Area Agencies on Aging
Toll-free APPRISE Helpline (1-800-783-7067)
Medicare toll-free number (1-800-MEDICARE)