Pennsylvania Medicare

The Center for Medicare and Medicaid Services (CMS) has contracted Highmark Medicare Services to provide Medicare to those residing in Pennsylvania. You may take advantage of the Medicare plans if you are sixty five years of age or older, or if you are disabled. Highmark offers services for both Medicare Part A and Part B plans.

The focus of Medicare Part A is to provide coverage for hospitals and facilities. Pennsylvania Medicare aims to assist people who need medical services that are obtained in nursing facilities, health clinics and other health centers. Medicare Part B on the other hand, provides coverage benefits to those who utilize services provided by a doctor or medical supplier. In order for each beneficiary to take full advantage of their insurance, it is important that you choose a facility or a doctor that closely follows the national Medicare guidelines.

Every Medicare beneficiary is provided with a Medicare card. This card is to verify that you are in fact covered through Medicare. Some enrollees will have to meet a yearly deductible or pay a monthly premium in order to attain coverage. The beneficiary and/or the beneficiary’s household income, is the primary determinate in how much the monthly premium costs. Pennsylvania does offer supplementary insurance coverage, which may lower out of pocket expenses.

If you are in need of prescription coverage, several insurance companies in Pennsylvania provide the Medicare Part D Prescription Drug Benefit Program. The intent of this benefit program is to lower the cost of prescriptions needed by those enrolled in Medicare. When you enroll in this policy it is important to make sure the insurance company you are working with is licensed to distribute Medicare Part D plans. This along with any other Medicare questions may be addressed through the Pennsylvania Insurance Department.

^*You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:

• 1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week;

  OR

• The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call, 1-800-325-0778; or Your State Medicaid Office.