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What is Medicare? 

 

Medicare is a federal health insurance program for the following:

  • Participants age 65 or older
  • Participants under age 65 with certain disabilities
  • Participants of any age with End-Stage Renal Disease (ESRD)

Medicare has the following parts to help cover specific services:

  • Medicare Part A (Hospital Insurance): Part A coverage is a premium-free program for participants with enough earned credits based on their own work history or that of a spouse at least 62 years of age (when applicable) as determined by the Social Security Administration (SSA).
  • Medicare Part B (Outpatient and Medical Insurance): Part B coverage requires a monthly premium contribution. With limited exception, enrollment is required for members who are retired or who have lost Current Employment Status and are eligible for Medicare.
  • Medicare Part D (Prescription Drug Insurance): Part D coverage is not required for plan participants enrolled in any of the state programs (i.e., CIP, TRIP, LGHP or State). Medicare Part D coverage requires a monthly premium, unless the participant qualifies for extra-help assistance.

In order to apply for Medicare benefits, plan participants are instructed to contact their local SSA office or call 1-800-772-1213. Plan participants may also sign up for Medicare Part A via the SSA website at www.socialsecurity.gov.

To ensure that benefits are coordinated appropriately and to prevent financial liabilities with healthcare claims, plan participants must notify the State of Illinois CMS Medicare COB Unit when they become eligible for Medicare. The Medicare COB Unit can be reached by calling 1-800-442-1300 or (217) 782-7007.