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Spinal Cord Injury Paralysis Resource Center

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Insurance and 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 old and a citizen or permanent resident of the United States. You might also qualify for coverage if you are a younger person with a disability or with permanent kidney failure requiring dialysis or transplant.

You can get Part A at age 65 without having to pay premiums if you are already receiving retirement benefits from Social Security or the Railroad Retirement Board and you or your spouse had Medicare-covered government employment.

If you are under 65, you can get Part A (hospital insurance) without having to pay premiums if you have received Social Security or Railroad Retirement Board disability benefit for 24 months. Most people get Part A automatically when they turn age 65.

Part B (Medical Insurance) is optional. It helps pay for doctors, services, outpatient hospital care, and some other medical services that Part A does not cover, such as the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.

The Medicare Part B premium is $78.20 per month in 2005. In some cases this amount may be higher if you did not choose Part B when you first became eligible at age 65. The cost of Part B may go up 10 percent for each 12-month period that you could have had Part B but did not sign up for it, except in special cases.

You can sign up for Part B anytime during a 7-month period that begins 3 months before you turn 65. If you choose to have Part B, the premium is usually taken out of your monthly Social Security, Railroad Retirement, or Civil Service Retirement payment. If you do not get any of the above payments, Medicare sends you a bill for your part B premium every 3 months.

If you have questions about your eligibility for Medicare Part A or Part B, or if you want to apply for Medicare, call the Social Security Administration. The toll-free telephone number is: 1-800-772-1213. The TTY-TDD number for the hearing and speech impaired is 1-800-325-0778. You can also get information about buying Part A as well as part B if you do not qualify for premium-free part A.

Source: Social Security Administration/Medicare

A Reeve Foundation Fact Sheet on Medicare Part D (PDF)

A Reeve Foundation Fact Sheet on Medicare, Medicaid and Insurance (PDF)

The Center for Medicare Advocacy, Inc.The Center for Medicare Advocacy, Inc. provides education, advocacy, and legal assistance to help elders and people with disabilities obtain necessary healthcare.

Features information on the State Children's Health Insurance Program (SCHIP), known as Title XXI, which offers health insurance coverage for eligible kids. Also provides information and resources specific to Medicaid and Medicare along with helpful tools to navigate the system.

Insure Kids Now!Insure Kids Now! is a national campaign to link the nation's 10 million uninsured children -- those from birth to age 18 -- to free and low-cost health insurance.

Kaiser Family FoundationFactsheets for consumers on Medicare. Covers prescription drug law, Medicare Advantage program, Medicare and women, etc.

MedicareThis is the official government site for people with Medicare.

MedicaidMedicaid is a federally supported healthcare program administered on the state level.

The Medicare Rights CenterThe Medicare Rights Center (MRC) is a not-for-profit organization working to ensure that older adults and people with disabilities get affordable health care.

Tri-State AdvocacyPrivately funded non-profit for spinal cord and burn injured survivors and amputees. Helps families on specific provisions of their health insurance policy. Services are free.

Quality of Life Grants DatabaseFind resources within the PRC Quality of Life Grants Database. Search by Zip Code, State or an Entire Category.

Library Books and VideosFind resources within the PRC library catalog.

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The information provided in the Paralysis Resource Center was supported by Grant/Cooperative Agreement Number 1U59DD000338 from the Centers for Disease Control and Prevention (CDC). The contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC.