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The Health Care Financing Administration (HCFA) administers Medicare, the nation's largest health insurance program, which covers 39 million Americans.

Medicare provides health insurance to people age 65 and over and those who have permanent kidney failure and certain people with disabilities.

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Who's Eligible 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 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 chronic kidney disease.

Here are some simple guidelines. 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.
• You are eligible to receive Social Security or Railroad benefits but have not 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 received Social Security or Railroad Retirement Board disability benefits for 24 months.
• You are a kidney dialysis or kidney transplant patient.

While you do not have to pay a premium for Part A if you meet one of those conditions, you must pay for Part B if you want it. The Part B monthly premium in 1998 is $43.80. It is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check.

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.

Enrollment

Enrollment in Medicare is handled in two ways: either you are enrolled automatically or you have to apply. Here's how it works.

Automatic Enrollment

If you are not yet 65 and already getting Social Security or Railroad Retirement benefits, you do not have to apply for Medicare. You are enrolled automatically in both Part A and Part B and your Medicare card is mailed to you about 3 months before your 65th birthday. If you do not want Part B, follow the instructions that come with the card.

If you are disabled, you will be automatically enrolled in both Part A and Part B of Medicare beginning in your 25th month of disability. Your card will be mailed to you about 3 months before you are entitled to Medicare.

Applying for Medicare

You need to apply for Medicare if you are not receiving Social Security or Railroad Retirement Benefits three months before you turn 65, or if you require regular dialysis or kidney transplant. That's the beginning of your 7-month initial enrollment period. By applying early, you'll avoid a possible delay in the start of your Part B coverage. You apply by contacting any Social Security Administration office or, if you or your spouse worked for the railroad, the Railroad Retirement Board.

If you do not enroll during this 7-month period, you'll have to wait to enroll until the next general enrollment period. General enrollment periods are held January 1 to March 31 of each year, and Part B coverage starts the following July.

Don't put off enrolling. If you wait 12 or more months to sign up, your premiums generally will be higher. Part B premiums go up 10 percent for each 12 months that you could have enrolled but did not. The increase in the Part A premium (if you have to pay a premium) is 10 percent no matter how late you enroll for coverage.

Under certain circumstances, however, you can delay your Part B enrollment without having to pay higher premiums. If you are age 65 or over and have group health insurance based on your own or your spouse's current employment, or if you are disabled and have group health insurance based on your current employment or the current employment of any family member, you have a choice:

7 You may enroll in Part B at any time while you are covered by the group health plan; or,

7 You can enroll in Part B during the 8-month enrollment period that begins the month employment ends or the month you are no longer covered under the employer plan, whichever comes first.

If you enroll in Part B while covered by an employer plan or during the first full month when not covered by that plan, your coverage begins the first day of the month you enroll. You also have the option of delaying coverage until the first day of the following 3 months. If you enroll during any of the 7 remaining months of the special enrollment period, your coverage begins the month after you enroll.

If you do not enroll by the end of the 8-month period, you'll have to wait until the next general enrollment period, which begins January 1 of the next year.

Even if you continue to work after you turn 65, you should sign up for Part A of Medicare. Part A may help pay some of the costs not covered by the employer plan. It may not, however, be advisable to sign up for Part B if you have health insurance through your employer. You would have to pay the monthly Part B premium, and the Part B benefits may be of limited value to you as long as the employer plan was the primary payer of your medical bills. Moreover, you would trigger your 6-month Medigap open enrollment period (see Medigap Insurance).

Medigap Insurance

Though Medicare covers many health care costs, you will still have to pay Medicare's coinsurance and deductibles. There are also many medical services that Medicare does not cover.

You may want to buy a Medicare supplemental insurance (Medigap) policy. Medigap is private insurance that is designed to help pay your Medicare cost-sharing amounts. There are 10 standard Medigap policies, and each offers a different combination of benefits.

The best time to buy a policy is during your Medigap open enrollment period. For a period of 6 months from the date you are first enrolled in Medicare Part B and are age 65 or older, you have a right to buy the Medigap policy of your choice. That is your open enrollment period.

You cannot be turned down or charged higher premiums because of poor health if you buy a policy during this period. Once your Medigap open enrollment period ends, you may not be able to buy the policy of your choice. You may have to accept whatever Medigap policy an insurance company is willing to sell you.

If you have Medicare Part B but are not yet 65, your 6-month Medigap open enrollment period begins when you turn 65. However, several states (Connecticut, Maine, Massachusetts, Minnesota, New Jersey, New York, Oklahoma, Oregon, Pennsylvania, Virginia, Washington, and Wisconsin) require at least a limited Medigap open enrollment period for Medicare beneficiaries under 65.

Your state health insurance assistance program can answer questions about Medicare and other health insurance. The services are free. You can get help in deciding whether you need more insurance and, if so, what kind and how much to buy. A state-by-state listing of assistance program telephone numbers is located in the Who to Contact section of this site. Free copies of the Guide to Health Insurance for People with Medicare are also available from the assistance office.

Your state assistance program can also provide you with information about Medicare SELECT, another type of Medicare supplemental health insurance sold by insurance companies and HMOs throughout most of the country. Medicare SELECT is the same as standard Medigap insurance in nearly all respects. The only difference between Medicare SELECT and standard Medigap insurance is that each insurer has specific hospitals, and in some cases specific doctors, that you must use, except in an emergency, in order to be eligible for full benefits. Medicare SELECT policies generally have lower premiums than other Medigap policies because of this requirement. Medicare SELECT is explained in more detail in the Guide to Health Insurance for People With Medicare.

Suspected violations of the laws governing the marketing and sales of Medigap and other types of insurance policies should generally be reported to your state insurance department. The phone numbers for your state's insurance department is in the Who to Contact section of this site. If you believe you have been a victim of Medigap fraud, you can also call the federal toll-free number for registering such complaints. The number is 1-800-638-6833, or TTY/TDD 1-800-820-1202 for the hearing or speech impaired.

Medicare Simplifies Beneficiary Notices

You may have noticed a change in your Medicare benefits statements. Recently HCFA redesigned the Part A and Part B notices and created the new Medicare Summary Notice (MSN). The Medicare Summary Notice is an easy-to-read, monthly statement that clearly lists your health insurance claims information. It replaces the Explanation of Your Medicare Part B Benefits (EOMB), the Medicare Benefits Notice (Part A) and benefit denial letters.

To design the Medicare Summary Notice, HCFA solicited feedback from contractors, beneficiary groups and provider groups. HCFA then hired a research contractor to conduct beneficiary focus groups and make sure beneficiaries liked the new notice. HCFA then tested the notice at several contractors and, after making some changes, began to start using the new notice across the United States.

At this time, there are still some Medicare contractors that are not issuing the new MSN. The intermediaries that are not issuing the MSN yet are: Alabama Blue Cross, Mutual of Omaha, Rhode Island Blue Cross, New Hampshire-Vermont Health Services, New Jersey Blue Cross, Washington/Alaska Blue Cross, North Carolina Blue Cross and Associated Hospital Service of Maine. The carriers that are not yet issuing the MSN are: North Dakota Blue Shield, Xact/Highmark, IASD/Wellmark, Western New York Blue Shield, National Heritage Insurance Company, United HealthCare and Rhode Island Blue Shield. These contractors will begin issuing the MSN at a future date. Until they begin issuing the MSN, these contractors will continue to send the current notices.

It is important to read your Medicare notices carefully. Make sure you received the services, medical equipment or supplies for which Medicare was billed. If you have any questions, contact the carrier or intermediary listed on the front of the notice. If you disagree with a claims decision, you have the right to file an appeal. Follow the instructions on the notice to file an appeal.

View an example of the new, simplified MSN Part A (101kb)
View an example of the new, simplified MSN Part B (107kb)

The Inpatient and outpatient notices have been replaced with a newly designed Medicare Summary Notice (MSN). Remember that the MSN is not a bill. DO NOT send money to Medicare or to the providers of service until you receive a bill.

1. The Date the MSN was sent.
2. Refer to the Customer Service Information box if you have questions about your MSN. For all inquiries, include your Medicare number, the date of the notice, and the specific date of service you have questions about.
3. Your Medicare Number should match the number on your Medicare card.
4. If your Name and Address are incorrect on your MSN, please contact both the Medicare intermediary shown on your MSN and the Social Security Administration immediately.
5. Read the Help Stop Fraud message for information on ways to protect yourself and Medicare against fraud and abuse.
6. Part A Hospital Insurance - Inpatient Claims or Part B Medical Insurance - Outpatient Claims. The Inpatient claims (for hospitals and skilled nursing facilities) and Outpatient claims are listed separately.
7. Dates of Service shows when services were provided. You may use these dates to compare with the dates shown on your hospital bill.
8. Each claim is assigned a Claim Number, which you may be asked to provide when calling regarding your MSN.
9. Benefit Days Used shows the number of days used in the benefit period. See the back of your MSN for an explanation of benefit periods.

   Note: For Part B Medical Insurance - Outpatient Facility Claims (not shown here), the column will be titled Services Provided and will give a brief description of the service or supply provided.

10. Non-Covered Charges shows the charges for services denied or excluded by the Medicare program for which you may be billed.
11. The amount applied to your Deductible and Coinsurance.
12. You May Be Billed. This is the total amount the provider is allowed to bill you. It combines the deductible, the coinsurance and any non-covered charges. If you have supplemental insurance, it may pay all or part of this amount.
13. See Notes Section. If a letter appears in this column, refer to Notes Section. Please see item 15 in this pamphlet.
14. Provider's Name and Address shows the name of the facility where you received services. The referring doctor's name will also be shown. The address shown is the billing address which may be different from where you receive the service(s).

15. The Notes Section gives more detailed information about your claim.
16. The Deductible Information section shows how much of your Part A and/or Part B deductible has been met.
17. The General Information section provides important Medicare news and information.
18. Appeals Information, such as how and when to request an appeal, is shown here. See the back of your MSN for more information and how to get help with the appeal requests.

    Note: Medicare & You provides more information about coverage and other services. For a free copy, call the Medicare contractor listed in the Customer Service box on your MSN.

Copy of Initial Enrollment Package

Letter from the Administrator Your Medicare Card

Introductory Medicare Brochure SSI Brochure

Welcome to Medicare! You have been enrolled automatically in Part A and Part B of the Medicare program because you are a Social Security beneficiary. Part A helps pay for hospital expenses and Part B helps pay for medical expenses, such as doctor visits. This package will help you learn about the Medicare program. It contains your red, white, and blue Medicare card. Your Medicare card shows that you have hospital insurance (Part A) and medical insurance (Part B). Your card also shows the dates your coverage begins. Your Part A is free. There is a monthly premium for your Part B medical insurance. In 1998, Part B costs you $43.80 each month. If your income is low, your state may pay your Part B monthly premium. Read the section Assistance for Low-Income Medicare Beneficiaries@ in the enclosed booklet.

You have three important decisions to make:

1) Do you want to keep Medicare Part B?

2) If you keep Medicare Part B, how do you want to receive your Medicare-covered services?

3) Do you need supplemental insurance to pay for services and products that Medicare does not cover?

Before you make a decision, you should read the information about Part B in the enclosed booklet, What You Need to Know about Medicare and Other Health Insurance. You must keep Part B if you want to be able to join any of the Medicare managed care plans (such as HMOs), Medicare medical savings accounts, or other Medicare health insurance options. If you do not keep Part B, you will only be eligible to receive Medicare hospital coverage.

If you are turning 65 or are older, you can delay taking your Part B medical insurance if: (1) you or your spouse (of any age) continue to work and (2) you are covered under a group health plan from that current employment.

If you are under age 65 and disabled, you can delay your Part B if (1) you, or any member of your family is currently working, and (2) you have group health plan coverage from that current employment.

You can find out how your group health plan works together with Medicare by contacting your employer or health benefits representative.

IMPORTANT: If you do not have group health plan coverage based on current employment and you delay taking Part B, your monthly premium may be higher. Your premium will increase by 10 percent for each 12 months that you could have had Part B, but did not take it. For example, if you delayed your Part B for 12 months at the current rate, you may have to pay $48.20 each month for Part B, instead of $43.80. If you do not keep Part B now, you will only have a chance to sign up for Part B once a year -- between January 1 and March 31. Your Part B insurance will start the following July. If you choose to delay taking Part B because you currently have group health plan coverage, you may be able to avoid paying this higher premium by signing up for Part B while you have this coverage or within eight months after the employment ends or the group health coverage ends, whichever comes first.

If you want to keep Part B, cut out the enclosed card and keep it with you. No further action is necessary. Your premium will begin to be deducted from your Social Security payment the month your Part B starts. If you do not get monthly Social Security benefits, you will receive a bill every three months for your Part B. Do not send any money now.

If you do not want to keep Part B, sign the enclosed form and check the block after AI do not want medical insurance.@ Return the entire form in the enclosed envelope. Do this before the date shown on the card so you will not owe a monthly premium. We will send you a new card that shows you have Part A only.

2) DECISION: How do you want to receive your services?

3) DECISION: Do you need supplemental insurance?

The enclosed booklet provides some information to help you answer these two questions. It gives you more details about Part B, supplemental insurance, and Medicare health insurance options, such as managed care. It also lists additional resources to help you get the information that you need.

If you have any questions or need more information, you can call Social Security at 1-800-772-1213.

Medicare

Medicare is a federal health insurance program for people age 65 and older, people of any age with permanent kidney failure, and certain disabled people under age 65. Medicare is managed by the Health Care Financing Administration, which is part of the Department of Health and Human Services. This pamphlet summarizes Medicare covered services. You will also receive Medicare & You, a publication which provides more detailed information. If you have not received your copy in the mail, you will get it soon.

Medicare Has More to Offer

Medicare allows you to choose the way you receive your benefits. You have been enrolled automatically in the Original Medicare Plan, which is the traditional payment-per-service arrangement. If you want to stay with the Original Medicare Plan, you don't have to do anything. The basic benefits of this plan are described below.

Starting in 1999, Medicare offers more ways to receive your benefits through other health plan choices. Choices that may be available in your area include Medicare Managed Care Plans, such as Health Maintenance Organizations, Preferred Provider Organizations, or Provider Sponsored Organizations. In addition, Private Fee-For-Service Plans and Medicare Medical Savings Account Plans may be available in your area. One of the new health plan choices might be right for you. The choice is yours. No matter what you decide, you are still in the Medicare program.

Your copy of Medicare & You will explain the Original Medicare Plan and other Medicare health plans in detail. It also will explain how to enroll in other health plan options, if you are interested. If you don't have a computer, your local public library or senior center may be able to help you find this information.

All Medicare health plans must provide at least the basic Medicare covered services.

Medicare Covered Services

Hospital Insurance (Part A)

Medicare hospital insurance helps pay for necessary medical care and services furnished by Medicare-certified hospitals, skilled nursing facilities, home health agencies, and hospices.

The number of days that Medicare covers care in hospitals and skilled nursing facilities is measured in benefit periods. A benefit period begins on the first day you receive services as a patient in a hospital or skilled nursing facility and ends after you have been out of the hospital or skilled nursing facility and have not received skilled care in any other facility for 60 days in a row. There is no limit to the number of benefit periods you can have.

Inpatient Hospital Care

Medicare Part A helps pay for up to 90 days of inpatient hospital care in each benefit period. Covered services include your semi-private room and meals, general nursing services, operating and recovery room costs, intensive care, drugs, laboratory tests, X-rays, and all other necessary medical services and supplies.

Skilled Nursing Facility Care

You may need inpatient skilled nursing or rehabilitation services after a hospital stay. If you meet certain conditions, Part A helps pay for up to 100 days in a participating skilled nursing facility in each benefit period. Medicare pays all approved charges for the first 20 days; you pay a coinsurance amount for days 21 through 100. Covered services include your semi-private room and meals, skilled nursing services, rehabilitation services, drugs, and medical supplies.

Home Health Care

If you meet certain conditions, Medicare pays the full approved cost of covered home health care services. This includes part-time or intermittent skilled nursing services prescribed by a physician for treatment or rehabilitation of homebound patients. The only amount you pay for home health care is a 20 percent coinsurance charge for medical equipment such as a wheelchair or walker.

Hospice Care

Medicare helps pay for hospice care for terminally ill beneficiaries who select the hospice care benefit. There are no deductibles, but you pay limited costs for drugs and inpatient respite care.

Medical Insurance (Part B)

Medicare Part B helps pay for doctor=s services, outpatient hospital services (including emergency room visits), ambulance transportation, diagnostic tests, laboratory services, some preventive care like mammography and Pap smear screening, outpatient therapy services, durable medical equipment and supplies, and a variety of other health services. Part B also pays for home health care services for which Part A does not pay.

Medicare Part B pays 80 percent of approved charges for most covered services. You are responsible for paying a $100 deductible per calendar year and the remaining 20 percent of the Medicare approved charge. You will have to pay limited additional charges if the doctor who cares for you does not accept assignment. This means the doctor does not agree to accept the Medicare approved charge for services.

Services Medicare Does Not Cover

Medicare Part A does not pay for convenience items such as telephones and televisions provided by hospitals or skilled nursing facilities, private rooms (unless medically necessary), or private duty nurses.

The only type of nursing home care Medicare pays for is skilled nursing facility care for rehabilitation, such as recovery time after a hospital discharge. Medicare does not pay if you need only custodial services (help with daily living activities like bathing, eating or getting dressed).

Medicare Part B usually does not pay for most prescription drugs, routine physical examinations, or services not related to treatment of illness or injury. Part B does not pay for dental care or dentures, cosmetic surgery, routine foot care, hearing aids, eye examinations, or eyeglasses.

Except for certain limited cases in Canada and Mexico, Medicare does not pay for treatment outside the United States.

The Original Medicare Plan

This is the traditional payment-per-service arrangement. You have been enrolled automatically in this option. This plan includes all Medicare covered services listed above.

Carriers and Fiscal Intermediaries

Private insurance organizations called Medicare carriers and fiscal intermediaries handle claims under the Original Medicare Plan. Carriers handle medical insurance (Part B) claims. Fiscal intermediaries handle all hospital insurance (Part A) claims. Medicare & You gives more information about how to contact your carrier or fiscal intermediary. The Social Security Administration does not handle claims for Medicare payment.

The Original Medicare Plan with a Supplemental Policy

Many private insurance companies sell Medicare Supplemental Insurance Policies (Medigap or Medicare SELECT) to help fill the coverage gaps@ in the Original Medicare Plan. If you remain in the Original Medicare Plan, you may want to consider buying one of these 10 standard policies for extra benefits. These policies help pay Medicare=s coinsurance amounts and deductibles, and other out-of-pocket costs for health care.

The federal government does not sell these types of policies. You should read the publication called Guide to Health Insurance for People With Medicare before you buy a supplemental policy. For a free copy, call the Medicare hotline at 1-800-638-6833. Your state insurance department also has information available to help you.

Do not delay. When you first enroll in Part B at age 65 or older, you have a 6-month Medigap open enrollment period. During that time your health status cannot be used as a reason either to refuse you a policy or to charge you more than all other open enrollment applicants. (The insurer may make you wait up to 6 months for coverage of a pre-existing condition.) If you try to enroll later, you may be denied a policy or charged a higher rate.

At age 65, Medigap open enrollment is available to beneficiaries who are enrolled in Part B. If you are under age 65, contact your state insurance department for information about open enrollment.

Other Medicare Health Plan Choices

In addition to the plans explained above, you may have other Medicare health plan choices available to you. To be eligible for these other health plan choices, you must:

• Have both Part A (hospital insurance) and Part B (medical insurance).
• Continue to pay the monthly Part B premium.
• Live in the plan's service area (the counties in which the plan is offered).
• Not have permanent kidney failure (End-Stage Renal Disease).

The following types of plans may be options for you.

Medicare Managed Care Plans

You may choose to get your Medicare coverage through a managed care plan. Medicare Managed Care Plans may include Health Maintenance Organizations (HMOs), HMOs with a Point-of-Service option (POS), Provider Sponsored Organizations (PSOs), and Preferred Provider Organizations (PPOs). These types of plans involve a specific group of doctors, hospitals and other providers who provide your care as a member of the plan.

Medicare Managed Care Plans provide all services covered by both Part A and Part B. Most offer a variety of additional benefits, like preventive care, prescription drugs, dental care, hearing aids, eyeglasses and other items not covered by the Original Medicare Plan. Costs for these extra benefits vary among plans.

Other Choices

In addition to the Original Medicare Plan and Medicare Managed Care Plans, other Medicare health plan choices may be available in your area. These include Private Fee-for-Service Plans, Medicare Medical Savings Account (MSA) Plans, and Religious Fraternal Benefit Plans. These plans provide all services covered by both Part A and Part B. Some offer a variety of additional benefits.

Your copy of Medicare & You will explain all of these health plan choices. For information about which ones are available in your area, look on the Internet at www.medicare.gov.

Other Insurance Sometimes Pays Before Medicare

Some people who have Medicare have other insurance (not including Medigap policies) that must pay before Medicare pays its share of your bill. Your other insurance pays first if:

• (a) You are 65 or older; (b) you or your spouse are currently working at an employer with 20 or more employees; and (c) you have group health insurance based on that employment.
• (a) You are under age 65 and are disabled; (b) you or any member of your family is currently working at an employer with 100 or more employees; and (c) you have group health insurance based on that employment.
• You have Medicare because of permanent kidney failure.
• You have an illness or injury that is covered under workers' compensation, the federal black lung program, no-fault insurance, or any liability insurance.

If you match any of these descriptions and you have other insurance along with Medicare, your other insurance will often be the first payer on your health claims. Tell your doctor, hospital, and all other providers of services about your other insurance. Your claims can then be sent to the right insurer first.

Assistance for Low-Income Beneficiaries

If you have a low income and limited resources, your State may pay your Medicare costs, including premiums, deductibles, and coinsurance. To qualify:

• You must be entitled to Medicare hospital insurance (Part A).
• Your annual income level must be at or below the national poverty guidelines.
• and You cannot have resources such as bank accounts or stocks and bonds worth more than $4,000 for one person or $6,000 for a couple (your home and first car don't count).

If your income is just above the poverty guidelines, you may qualify for help with paying your Part B premiums. If you think you qualify, contact your state or local welfare, social service, or Medicaid agency. The contact number is available on the Internet at www.medicare.gov. Ask about the Qualified Medicare Beneficiary (QMB) program, the Medicare Buy-In program, the Specified Low-Income Medicare Beneficiary (SLMB) program, or the Qualifying Individual (QI) program.

If you have young children in your care, you also should ask about your State's Child Health Program to help pay their health care costs.

For More Information

Up-to-date information about Medicare is available on the Internet at the web site www.medicare.gov. If you don't have a computer, your local public library or senior center may be able to help you find this information.

If you have questions about how to enroll in Medicare, call Social Security's toll-free number, 1-800-772-1213, any business day from 7:00 a.m. to 7:00 p.m. The lines are busiest early in the week and early in the month, so it is best to call at other times. People who are deaf or hard of hearing may call a toll-free TTY@ number, 1-800-325-0778, between 7:00 a.m. and 7:00 p.m. on business days. When you call, have your Social Security number handy.

These calls are all treated confidentially. Some calls may be monitored by a second customer representative to make sure you are receiving accurate information and courteous service.

If you have any questions about what Medicare covers, call the Medicare carrier that processes Medicare claims in your area. The name and number are listed in Medicare & You.

If you want to order free publications, like the Guide to Health Insurance for People With Medicare, call the Medicare hotline at 1-800-638-6833. Audio-tapes in English and Spanish, and Spanish copies of Medicare & You are also available by calling this number.

If you believe you have been discriminated against because of your race, color, sex, national origin, disability or age, call the DHHS Office for Civil Rights at 1-800-368-1019 or 1-800-537-7697 (TTY/TDD).

Health Care Financing Administration

Publication No. 95139

ICN No. 004346

September 1998 (Destroy prior editions)

Your Medicare Card

Once enrolled, you'll receive a Medicare card imprinted with your name and Medicare claim number. It shows what coverage you have (Part A, Part B, or both) and the date your coverage started.

Show your card whenever you get medical care. This will assure that a claim for payment is sent to Medicare. Make sure to use your exact name and claim number. If you are married, your spouse will have his or her own card and claim number. Never let anyone else use your Medicare card, and keep the number as safe as you would a credit card number. Take your card with you when you travel, and have it handy when you call about a Medicare claim. If you lose your card, contact the Social Security Administration right away.

SOCIAL SECURITY: YOU MAY BE ABLE TO GET SSI

What is SSI?

SSI stands for Supplemental Security Income. It's a program run by Social Security. It pays monthly checks to the elderly, the blind, and people with disabilities who don't own many things or have much income.

If you get SSI, you usually get food stamps and Medicaid, too. Medicaid helps pay doctor and hospital bills.

To get SSI, you must be elderly or blind or have a disability.

- Elderly means you are 65 or older.

- Blind means you are either totally blind or have very poor eyesight. Children, as well as adults, can get benefits because of blindness.

- A disability means you have a physical or mental problem that is expected to last at least a year or result in death. Children, as well as adults, can get benefits because of disability.

How Much Can You Get From SSI?

The basic monthly SSI check is the same in all states. It is:

- $470 for one person.

- $705 for a couple.

Not everyone gets this exact amount, however. You may get more if you live in a state that adds to the SSI check. Or you may get less if you or your family have other money coming in each month.

Things You Own and Income You Have

To get SSI, the things you own and income you have must be below certain amounts.

Things You Own:

We don't count everything you own when deciding if you can get SSI.

For example, we don't count your home and some of your personal belongings. Usually, we don't count your car. We do count cash, bank accounts, stocks, and bonds.

You may be able to get SSI if the things we count are no more than:

- $2,000 for one person

- $3,000 for a couple

Income You Have:

Income you have is the money you have coming in, such as earnings, Social Security checks, and pensions. Non-cash items you receive such as food, clothing, or shelter also count as income.

The amount of income you can have each month and still get SSI depends on where you live. In some states you can have more income than in others.

If you don't work, you may be able to get SSI if your monthly income is less than:

- $490 for one person

- $725 for a couple

If you work, you can have more income each month. If all of your income is from working, you may be able to get SSI if you make less than:

- $1,025 a month for one person

- $1,495 a month for a couple

However, if you're applying for SSI disability benefits and are earning more than $500 a month, you probably won't be eligible for benefits.

Remember: We don't count all your income so you may be able to get SSI even if you have more income, especially if you live in a state that adds money to the SSI checks.

Where You Live

To get SSI checks, you must live in the U.S. as a U.S. citizen or other legal resident. Residents of the Northern Mariana Islands also qualify.

How To Sign Up For SSI?

Just call our toll-free number, 1-800-772-1213, to set up an appointment with a Social Security representative who will help you sign up. You can speak to a service representative between the hours of 7:00 a.m. and 7:00 p.m. on business days. People who are deaf or hard of hearing may call our toll-free TTY@ number, 1-800-325-0778, between 7:00 a.m. and 7:00 p.m. on business days.

The Social Security Administration treats all calls confidentially -- whether they're made to our toll-free numbers or to one of our local offices. We also want to ensure that you receive accurate and courteous service. That is why we have a second Social Security representative monitor some incoming and outgoing telephone calls.

SSA Publication No. 05-11069

January 1996

ICN 480390

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