How to Use Medicare.gov – NerdWallet


Medicare.gov is the official website for Medicare, the U.S. government health care program for seniors and those with certain disabilities. The site is especially helpful for comparing various plans, finding providers, getting claims paperwork and learning about costs and policies. Here’s how you can use it.

Nerd tip: If you want to enroll in Original Medicare, which includes Part A (hospital insurance) and Part B (doctor’s appointments and preventive care), you can’t do it directly through Medicare.gov — you have to go through Social Security.

Determine your Medicare eligibility

If you’re just getting started with Medicare, checking out Medicare.gov’s eligibility calculator is a good first step. There, you can figure out whether you qualify for Medicare and when you can sign up. If your initial enrollment period — the period that starts before your 65th birthday — has already elapsed, you can also get information about the next general enrollment period.

The site’s premium calculator is another tool worth checking out. You can use this to calculate the premiums you’d pay on Part B, since those can vary based on income and penalties applied for late enrollment. The results will also tell you if you’re eligible for premium-free Part A — as it the case for most people — or if you need to purchase it.

Make a MyMedicare.gov account

You’re not required to make an online profile through Medicare.gov to use Medicare services, but doing so can be helpful. A MyMedicare.gov account allows you to make a list of your favorite health care providers, view claims and deductible statuses and print official copies of your Medicare card if it gets lost, among other things.

To make an account, you’ll need to click the “Log In/Create Account” button on the homepage, and provide the following information:

  • Medicare number (this is the number on your red, white and blue government-issued Medicare card)

  • Part A coverage start date (or Part B start date, if you don’t have Part A)

Sign up for Medicare Advantage or drug plans

You can also compare and sign up for Medicare Advantage plans and Part D plans (which cover prescription drugs) on Medicare.gov. The site’s tool for this includes Medicare ratings for each plan based on quality, and information about costs, deductibles and limits.

Not all types of plans are listed, though. While you can view price ranges for Medigap plans — which provide supplemental coverage to Original Medicare — on the site, you can’t enroll through Medicare.gov for those. You’ll have to contact those insurers directly.

Find Medicare providers

  • Inpatient rehabilitation facilities.

  • Long-term care hospitals.

For those with Original Medicare or Original Medicare with Medigap, this is a handy way to find care near you or size up your options. If you have Medicare Advantage, turn to your insurer for information about providers before booking any appointments; with these plans, you generally need to get care within a certain network.

Get paperwork for claims or appeals

You generally won’t have to file claims to get expenses covered with Original Medicare — providers are required to do that. And if you have a Medicare Advantage plan, there’s no need to file claims; Medicare pays those private insurers directly.

But in some cases, providers might not file claims until very late. And if they file more than 12 months after services were provided, Medicare can’t pay. (You can check the status of claims by logging onto your MyMedicare.gov account.) You might want to file a claim if this deadline is approaching — for example, if it’s 11 months after you received services and a claim has yet to be filed. While you can’t actually file the claim online, you can find the forms you need to print out on Medicare.gov.

The website also provides paperwork and instructions for filing appeals, which you can file when Medicare or your plan denies coverage for a certain service, item or drug and you disagree with the decision. The process for this varies based on what kind of coverage you have. If the appeal is successful, the decision will be overturned.



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