California Health Advocates
We provide accurate, unbiased information about Medicare benefits and long-term care for Californians. Learn how Medicare works, ways to supplement your coverage, about low-income programs, prescription drugs and your long-term care options.
Disability Planner: Medicare Coverage If You’re Disabled
Everyone with Medicare also has access to prescription drug coverage (Part D) that helps pay for medications doctors prescribe for treatment. For more information on the enrollment periods for Part D, we recommend you read Medicare’s "How to get drug coverage" page.
Benefits for People with Disabilities
The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.
Health coverage options for people who get Social Security Disability Insurance (SSDI)
One exception: If you enrolled in a Marketplace plan before getting Medicare, you can keep your Marketplace plan as supplemental insurance when you enroll in Medicare. But if you do this, you’ll lose any premium tax credits and other savings for your Marketplace plan.
Medicare Coverage if You’re Disabled
If you have amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), you will automatically be enrolled in Medicare Part A (hospital insurance) in the first month that you begin receiving Social Security disability benefits. You will automatically be enrolled in Medicare Part B (medical insurance) if you live within the 50 United States or District of Columbia. You will have the option to refuse the automatic enrollment in Medicare Part B if you already have medical insurance. If you need prescription drug insurance, you will have to enroll in a Medicare Part D prescription drug plan separately.
Original Medicare (Part A and B) Eligibility and Enrollment
To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child. To receive premium-free Part A, the worker must have a specified number of quarters of coverage (QCs) and file an application for Social Security or Railroad Retirement Board (RRB) benefits. The exact number of QCs required is dependent on whether the person is filing for Part A on the basis of age, disability, or End Stage Renal Disease (ESRD). QCs are earned through payment of payroll taxes under the Federal Insurance Contributions Act (FICA) during the person’s working years. Most individuals pay the full FICA tax so the QCs they earn can be used to meet the requirements for both monthly Social Security benefits and premium-free Part A.
Medscape: Medscape Access
Medicare Information, Help, and Plan Enrollment
Humana is a Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. [Benefits, premiums and/or member cost-share] may change on January 1 of each year. The [Formulary, pharmacy network, and/or provider network] may change at any time. You will receive notice when necessary.
More Medicare Information
If you live in Puerto Rico you will not receive Medicare Medical Insurance (Medicare Part B) automatically. You will need to sign up for it during your initial enrollment period or you will pay a penalty. To sign up, please call our toll-free number at 1-800-772-1213 (TTY 1-800-325-0778). You also may contact your local Social Security office. You can find your local Social Security office by using our Office Locator.
2017 Medicare Part D Prescription Drug Plans: Overview by State
Choose your State from the list below for an overview of the Medicare Part D Prescription Drug Plans available in 2017. Select your state below or choose from one of these links to other tools available to review 2017 Medicare Part D Plans:
Tufts Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Tufts Health Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Tufts Medicare Preferred Supplement Plan Comparison
If you compare Medigap plans, you’ll see that Tufts Medicare Preferred Supplement plans offer the same coverage as other well-known plans in Massachusetts. Although benefits may not vary from plan to plan, service and member extras do. As a Tufts Medicare Preferred Supplement member, you’ll have a team of friendly, knowledgeable service representatives who support Medicare members exclusively. It’s easy to get to know us … easy to enroll in our plans … and you’re treated with courtesy and respect. Plus, with Healthy Living Essentials you can stay healthy and save money.
Home Health Agency (HHA) Center
The Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1648-F) that updates the Medicare Home Health Prospective Payment System (HH PPS) rates and wage index for calendar year (CY) 2017. In the CY 2017 final rule, CMS implements the fourth and final year of the four year phase-in of the rebasing adjustments to the HH PPS payment rates as required by the Affordable Care Act. In addition, CMS will decrease the national, standardized 60-day episode payment amount by 0.97 percent in CY 2017 to account for nominal case-mix growth between CY 2012 and CY 2014, which was not accounted for in the rebasing adjustments finalized in the CY 2014 HH PPS final rule. CMS is also changing the methodology used to calculate outlier payments to a per-unit approach. The CY 2017 final rule will result in a 0.7 percent decrease (-$130 million) in payments to HHAs.
Medicare Eligibility Requirements
By law, you’re allowed to sign up for any Medigap policy in your state as long as you enroll during the initial window, even if you have medical issues that would otherwise prevent you from getting covered. An insurer has to charge you the same premium rate as a healthy person, too, so enrolling during this initial period is essential if you need the extra coverage. Your guarantees under the initial enrollment window expire once that 6-month eligibility period ends. Outside of the initial eligibility window, you may not find Medigap coverage at all. And if you do, it will probably cost a lot more.