Benefits with County of San Diego

Social Security (Part 6): Supplemental Security Income and Medicare

Supplemental Security Income (SSI)

If you get Social Security benefits, but have limited income and resources (things you own), SSI may be able to help. SSI is financed from general revenues, not Social Security taxes.

SSI makes monthly payments to people who are ages 65 or older or who are blind or disabled. The Social Security Administration (SSA) does not count some of your income and some of your resources when they decide whether you are eligible for SSI. Your house and your car, for example, usually are not counted as resources. Call (800) 772-1213 for more information or to apply for SSI.

Medicare

Medicare is this country's basic health insurance program for people age 65 or older and many people with disabilities.

You should not confuse Medicare and Medicaid. Medicaid is a health care program for people with low income and limited resources. It is usually run by state welfare or social services agencies. Some people qualify for one or the other, while some people qualify for both Medicare and Medicaid.

Medicare has four parts:

1. Hospital insurance (Part A) helps pay for inpatient hospital care and certain follow-up services.
2. Medical insurance (Part B) helps pay for doctors' services, outpatient hospital care, and other medical services.
3. Medicare Advantage plans (Part C) are available in many areas. People with Medicare Parts A and B can choose to receive all of their health care services through a provider organization under Part C.
4. Prescription drug coverage (Part D) helps pay for medications doctors prescribe for medical treatment.

Who is eligible for hospital insurance (Part A)?

Most people get hospital insurance when they turn 65. You qualify for it automatically if you are eligible for Social Security or Railroad Retirement benefits. Or you may qualify based on a spouse's (including a divorced spouse's) work. Others qualify because they are government employees not covered by Social Security who paid the Medicare tax.

If you get Social Security disability benefits for 24 months, you will qualify for hospital insurance. If you get Social Security disability benefits because you have amyotrophic lateral sclerosis (Lou Gehrig's disease), you do not have to wait 24 months to qualify.

Also, people who have permanent kidney failure that requires maintenance dialysis or a kidney replacement qualify for hospital insurance if they have worked long enough or if they are the spouse or child of a worker who qualifies.

Who can get medical insurance (Part B)?

Almost anyone who is eligible for hospital insurance can sign up for medical insurance. Part B is an optional program. It is not free. In 2010, the standard monthly premium is $110.50. Some people with higher incomes pay higher premiums.

Who can get Medicare Advantage plans (Part C)?

Anyone who has Medicare Part A and Part B can join a Medicare Advantage plan. Medicare Advantage plans include

• Medicare managed care plans
• Medicare preferred provider organization (PPO) plans
• Medicare private fee-for-service plans
• Medicare specialty plans

You might have to pay a monthly premium because of the extra benefits the Medicare Advantage plan offers.

Who can get Medicare prescription drug coverage (Part D)?

Anyone who has Medicare Medicare hospital insurance (Part A) or medical insurance (Part B) or a Medicare Advantage plan (Part C) is eligible for prescription drug coverage (Part D).

Help With Medicare Expenses for People With Low Income

If you have a low income and few resources, your state may pay your Medicare premiums and, in some cases, other out-of-pocket medical expenses, such as deductibles and coinsurance.

Only your state can decide whether you qualify for help under this program. If you think you qualify, contact your state or local medical assistance (Medicaid) agency, social services, or welfare office.

You can go online to get more information about this program from the Centers for Medicare and Medicaid Services (CMS) by visiting http://www.medicare.gov/.

Extra Help With Medicare Prescription Costs

If you have limited income and resources, you may qualify for extra help to pay for your prescription drugs under Medicare Part D. Social Security's role is to help you understand how you may qualify and to process your application for extra help. To see if you qualify or to apply, call Social Security's toll-free number, (800) 772-1213, or visit the Web site at http://www.socialsecurity.gov/.