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Knowing Which Federal Agency Will Answer Your Medicare Question

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The bureaucratic division between Social Security and Medicare, which consumers often find confusing, has its roots in history. When Medicare began in 1966, the whole program was run by the Social Security Administration (SSA). Later, the federal government created a separate agency now known as the Centers for Medicare & Medicaid Services (CMS). Today, SSA still administers some functions of Medicare, such as enrollment, whereas CMS runs others, such as coverage policies.

Contact the Social Security Administration for help and information on the following:

  • Discussing eligibility for Medicare

  • Enrolling in Medicare Part A (hospital insurance) and Part B (doctors' visits and other outpatient services)

  • Disenrolling from Part B

  • Applying for the low-cost Extra Help benefit under the Medicare Part D prescription drug program if your income is low

  • Paying a higher Part B premium if your modified adjusted gross income is over a certain level

  • Obtaining a replacement Medicare card

  • Reporting a change of address

  • Asking any questions relating to Social Security retirement and survivor benefits, disability insurance (SSDI), and Social Supplementary Income (SSI)

Here are SSA contacts:

  • Phone: 800-772-1213

  • TTY phone: 800-325-0778

  • Website: www.ssa.gov. Click on the "Benefits" tab at the top of the home page and from the drop down, choose Medicare. The website includes general information, frequently asked questions, and online application forms for certain benefits, such as Extra Help for assistance paying for prescription drug costs. You can read the site in 15 languages as well as English. (Note: Some web browsers don't support this site. If you have difficulty reading it, switch to a common browser such as Internet Explorer, Mozilla, Firefox, or Safari.)

Contact the Centers for Medicare & Medicaid Services for help and information on the following:

  • Addressing medical services that Medicare covers

  • Choosing a Medicare Part D drug plan

  • Choosing a Medicare Advantage (Part C) health plan

  • Choosing private Medicare supplemental insurance (Medigap)

  • Finding a provider (physician, hospital, and so on) that accepts Medicare patients in your area

  • Finding a Medicare-approved medical equipment supplier in your area

  • Comparing the quality of hospitals, nursing homes, and home health agencies

  • Asking questions about Part D's Extra Help program if you qualified for it automatically and didn't have to apply

  • Discussing questions about billing for Medicare services

  • Appealing a coverage or payment decision you don't agree with

  • Getting help to pay Part B premiums through a Medicare Savings Program if your income is low

  • Reporting fraud

Here are CMS contacts:

  • Phone: 800-633-4227

  • TTY phone: 877-486-2048

  • Website: www.medicare.gov. The website provides information on all Medicare matters in English and Spanish. It also includes useful online tools for comparing Medicare's private health and prescription drug plans. For details on many specific topics (for example, home health care, choosing a Medigap policy, how Medicare's private health plans work, and so on), check out the "Publications" link on the home page.

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