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C E N T E R S F O R M E D I C A R E & M E D I C A I D S E R V I C E S &You ★ ★ Medicare 2008 ★ This is the official government handbook with important information about the following: ★ 2008 costs ★ What’s covered ★ Preventive services ★ Health plans ★ Prescription drug plans ★ Your rights and appeals Welcome to Medicare & You 2008 A healthy life is a better life. Medicare strives to make sure you can get the health care and prescription coverage you need and the quality of care you
  CENTERS FOR MEDICARE & MEDICAID SERVICES & Medicare  You   2008 This is the official government handbook withimportant information about the following: ★ 2008 costs ★ What’s covered ★ Preventive services ★ Health plans ★ Prescription drug plans ★ Your rights and appeals ★     ★     ★    Welcome to Medicare & You 2008 A healthy life is a better life. Medicare strives to make sure you can get the healthcare and prescription coverage you need and the quality of care you deserve.With more Medicare choices than ever, it’s important that you look at your coverageevery year. Plan costs and benefits change, and so can your health. The coverage thatworked for you this year might still meet your needs in 2008. Or, there might be a better option. This handbook has information on your Medicare health and prescriptiondrug plan choices, tips on what to consider when comparing plans, and resources whereyou can get detailed information and personalized help.The information in this handbook is good from January 1, 2008, through December 31,2008. You will get a new handbook every fall to help you compare plans and learnabout new benefits.Use the information in this handbook to make the most of your Medicare benefits.ã Get the Medicare-covered preventive services you need, like cancer screenings(mammogram, colorectal, prostate), cardiovascular screenings, and yearly flushots. These tests and services are critical to your overall health and can help you prevent diseases or detect them early on, when treatment works best.ã Visitwww.medicare.gov onthe web to help you compare the quality of the healthcare providers in your area, like health plans, hospitals, and home health careagencies. To promote high-quality care at a lower cost, Medicare works closelywith health care providers and Congress to develop reporting and paymentsystems that support and reward quality.As always, Medicare is here for you anytime, day or night. You can visitwww.medicare.gov onthe web or call 1-800-MEDICARE (1-800-633-4227).TTY users should call 1-877-486-2048.Yours in good health, Michael O. LeavittSecretaryDepartment of Health andHuman ServicesKerry N. WeemsActing Administrator Centers for Medicare &Medicaid Services  ★ Table of Contents List of Topics/Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1–4Medicare Basics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5–8 What’s New and Important in 2008?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5What Is Medicare?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Your Medicare Plan Choices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7“To Do” List for People New to Medicare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Section 1: Medicare’s Covered Services (Part A and Part B) . . . 9–28 Medicare Part A(Hospital Insurance) and What it Covers. . . . . . . . . . . . . . . . . . . . 10–13Medicare Part B (Medical Insurance) and What it Covers. . . . . . . . . . . . . . . . . . . . 14–25What’s NOT Covered by Part Aand Part B?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26How Medicare’s Information About Quality Can Help You. . . . . . . . . . . . . . . . . . . . . . 27 Section 2:Your Plan Choices. . . . . . . . . . . . . . . . . . . . . . . . . 29–74 Decide How to Get Your Medicare Benefits. . . . . . . . . . . . . . . . . . . . . . . . . . 30 Your Plan Choices Chart. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Things to Consider When Choosing or Changing Your Coverage. . . . . . . . . . . . . . . . . 32 Original Medicare Plan.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33–37 How Does the Original Medicare Plan Work?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33–34Your Out-of-Pocket Costs in the Original Medicare Plan Depend On. . . . . . . . . . . . . . 34Your Out-of-Pocket Costs and Assignment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35What Is a Private Contract?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36Adding Medicare Prescription Drug Coverage (Part D). . . . . . . . . . . . . . . . . . . . . . . . . 37 Medicare Advantage Plans (Part C).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38–49 How Do Medicare Advantage Plans Work?. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . 38–46Your Out-of-Pocket Costs in a Medicare Advantage Plan. . . . . . . . . . . . . . . . . . . . . . . . 47When Can You Join, Switch, or Drop a Medicare Advantage Plan?. . . . . . . . . . . . . . . . 48What Happens if Your Medicare Advantage Plan Leaves the Medicare Program?.. . . . 48How Do You Join or Switch a Medicare Advantage Plan?. . . . . . . . . . . . . . . . . . . . . . . 49 Other Medicare Health Plans.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50–51 The information in this handbook was correct when it was printed. Changes may occur after  printing. Visitwww.medicare.gov onthe web or call 1-800-MEDICARE (1-800-633-4227) toget the most current information. TTY users should call 1-877-486-2048.“Medicare & You” explains the Medicare Program. It isn’t a legal document. OfficialMedicare Program legal guidance are contained in the relevant statutes, regulations, andrulings.  ★ Table of Contents Section 2: Your Plan Choices (continued) Medicare Prescription Drug Coverage (Part D). . . . . . . . . . . . . . . . . . . . . . . 52–66 How Do Medicare Drug Plans Work?.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53Things to Consider When You Compare Plans.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54How to Compare Medicare Drug Plans.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55How Much Does Medicare Drug Coverage Cost? . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . 55–56When Can You Join, Switch, or Drop a Medicare Drug Plan?. . . . . . . . . . . . . . . . . . . . . . . . 57What Is the Part D Late-Enrollment Penalty?.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58Other Prescription Drug Coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59–61Important Drug Coverage Rules . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62–65Ways to Pay Your Medicare Drug Plan Premium.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Other Government Insurance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67–68Other Private Insurance (Employer, Union, COBRA, Long-Term Care). . . . . 69–74 How Your Bills Get Paid if You Have Other Health Insurance. . . . . . . . . . . . . . . . . . . . . . . 71Medigap (Medicare Supplement Insurance) Policies .. . . . . . . . . . . . . . . . . . . . . . . . . . . 72–74 Section 3:Getting the Help You Need. . . . . . . . . . . . . . . . . . . 75–108 Help for People with Limited Income and Resources. . . . . . . . . . . . . . . . . . 76–82 Extra Help Paying for Medicare Prescription Drug Coverage. . . . . . . . . . . . . . . . . . . . . 76–78State Pharmacy Assistance Programs (SPAPs). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79Medicaid.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79Medicare Savings Programs (Help from Medicaid to Pay Medicare Premiums). . . . . . . . . 80Supplemental Security Income (SSI) Benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81Programs of All-Inclusive Care for the Elderly (PACE).. . . . . . . . . . . . . . . . . . . . . . . . . . . . 82Programs for People Who Live in the U.S. Territories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Your Medicare Rights. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83–94 What Is an Appeal and How to File?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83–88How Medicare Uses Your Personal Information.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89–90Protect Yourself From Identity Theft and Fraud. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91–93The Medicare Beneficiary Ombudsman Works for You. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Where to Get More Information (Phone, Web, Publications).. . . . . . . . . . 95–102Definitions of Words in Blue . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . 103–107What Preventive Services Do You Need?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1082008 Medicare Costs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110–113Quiz—Get the Most Value From Medicare. . . . . . . . . . . . . 114–Inside back cover If your household got more than one copy of “Medicare & You,” you can call 1-800-MEDICARE(1-800-633-4227) and tell a customer service representative if you would like to get only onecopy in the future. TTY users should call 1-877-486-2048.
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