MedicareSupplement

Summary of Benefits | Prescription Drug Plan Comparison | Medicare Advantage Plan Comparison | Medicare Supplement Plans outlines A-J | Medicare Supplement FAQ's | Medicare Supplement Rates | Medicare Prescription Drug Plan - Part D

F.A.Q.

Summary of Questions

Up to date Information compiled at Thacker Agency.Com for your convenience from the Official Medicare.Gov website

1.What are the Medicare premiums and coinsurance rates for 2005?
2. Information from Medtronic on a possible battery issue with some ICDs and CRT-Ds
3. Are all people with Medicare eligible to get the "Welcome to Medicare" physical
4. How much does the "Welcome to Medicare" physical exam cost?
5. What cancer screening does Medicare currently cover?
6. What services are included in the "Welcome to Medicare" physical exam?
7. What is the new diabetes screening?
8. What are the new cardiovascular screenings?
9. How often does Medicare cover the new cardiovascular screenings?
10. How often is the new diabetes screening covered by Medicare?
11. How are the new Medicare drug plans that are starting in 2006 different from the
12. What happens to my Medicare-approved drug discount card when I sign up for a Med
13. Can I still use any credits left on my Medicare-approved drug discount card afte
14. If I qualify, can I still get $600 credit on my Medicare-approved drug discount
15. What is the new Together Rx Access Card program and who can get one?
16. What are Medicare prescription drug plans?
17. Information about the Flu Medicines Demonstration
18. When can I join a Medicare prescription drug plan?
19. When will I get more information about choosing a Medicare Prescription Drug Pla
20. What if I have prescription drug coverage from an employer or union?
21. What if I already have prescription drug coverage from a Medigap (Supplemental I
22. Do Medicare prescription drug plans work with all types of Medicare health plans
23. Does the Medicare-approved drug discount card program vary if I live in Puerto R
24. How do I get a new Medicare card if my card is lost, stolen, or damaged?
25. How can I get my name and address changed?
26. I've heard that I might be able to get a $600 credit to help pay for my prescrip
27. If I get a flu shot from a doctor or provider who doesn't bill Medicare, what sh
28. I think my doctor or provider charged too much for my flu shot. What should I d
29. Where can I get a flu shot?
30. What does it mean that the sponsor provides discounts on the top 100 drugs and t
31. How much will Medicare pay (For the Flu shot)?
32. Who should get a flu shot this season?
33. What can I do if my regular doctor or provider doesn't have flu shots available?
34. If I can't get the flu shot, can I take FluMist instead?
35. What other steps can I take to prevent the flu?
36. Is there going to be a shortage of flu vaccines for this flu season?
37. Why is there a shortage of the flu shot for this season?
38. What can I do if my Medicare Advantage Plan doesn't have flu shots available?
39. Will getting a flu shot help keep me from getting sick?
40. What is the Medicare Replacement Drug Demonstration?
41. Why doesn't my Medicare-approved drug discount card provide discounts on every d
42. Why is Vioxx no longer on your drug list?
43. How do I go about choosing a Medicare-approved drug discount card?
44. I am on Medicaid spenddown. Am I eligible for a Medicare-approved drug discount
45. What can I do if I am denied the $600 credit that goes along with the Medicare-a
46. What can I do if I am denied enrollment into a Medicare-approved drug discount c
47. When will enrollment in a Medicare-approved drug discount card become effective?
48. When can I change Medicare-approved drug discount cards?
49. How do I use the $600 credit from Medicare to help pay for prescriptions?
50. Can I get the $600 credit without getting a Medicare-approved drug discount card
51. How do I get a Medicare-approved drug discount card and the $600 credit if I liv
52. How do I find out if the pharmacy that provides my drugs has contracted with one
53. For which drugs can the $600 be applied?
54. Can I choose whichever Medicare-approved drug discount card I want even though I
55. If I choose a Medicare-approved drug discount card, do I have to use the pharmac
56. Can I get a discount and the $600 credit?
57. What if I have a Medicare-approved drug discount card already, but it isn't one
58. Can I use my card at an assisted living facility?
59. If I live in a nursing home, can I get a Medicare-approved drug discount card an
60. Why are there three special drug discount cards for people who live in nursing h
61. What if I have one of the three special Medicare-approved drug discount cards fo
62. How do I know how much of the $600 credit I have left?
63. How can I find out the prices of different prescription drugs at my nursing home
64. Can I use the $600 credit while Medicare is paying for my stay in the nursing ho
65. What if I have one of the special drug discount cards for nursing homes and my n
66. Will the availability of the $600 credit or discount prices prevent or delay an
67. How much will I save on my medicines if I join a Medicare-approved drug discount
68. When does Medicare begin paying for my prescription drug costs? How does it wor
69. Who can get a Medicare-approved drug discount card?
70. My income is very limited. It will be hard for me to pay the premiums and deduct
71. What is Medicare Advantage and how does it work with Medicare + Choice plans?
72. I have a Medigap plan that covers prescription drugs. Can I keep that plan and
73. I already have a prescription drug discount card, but it's not Medicare-approved
74. I am in a Medicare managed care plan. Can I get a Medicare-approved drug discou
75. I am disabled and have Medicare and Medicaid. Can I get a Medicare-approved dru
76. I have Medicare and a Medigap policy. Can I get a Medicare-approved drug discou
77. Does the cost go up if I enroll in a Medicare-approved drug discount card after
78. Do I have to join a Medicare-approved drug discount card?
79. Where can I go for the latest, official information about changes in Medicare?
80. Are people with Medicare going to have to pay different premiums for Part B in t
81. I have a Medigap plan that covers prescription drugs. Can I keep that plan and
82. Does the new law make any changes to Medigap supplement policies?
83. Does the new law change the coverage I have for therapy services?
84. Does the new law add any preventive benefits that will help me stay healthy?
85. Will the new law change what Medicare pays my doctors?
86. I don't live near a big city, and sometimes it's hard to get health care. Does
87. How will Medigap plans change with the 2003 Medicare Modernization Act?
88. Will I get Medicare at age 65 if I'm not yet eligible for Social Security?
89. What types of services are covered under Medicare?
90. Who is eligible for Medicare?
91. When should I get my flu shot?
92. How do I enroll in Medicare?
93. What is the new Electronic Medicare Summary Notice (E-MSN)?
94. How do I find a Medicare-approved home health agency?
95. Does Medicare pay for prescription drugs?
96. Can I delay Medicare Part B enrollment without paying higher premiums?
97. Are my spouse and dependent children eligible to get Medicare coverage?
98. What if I'm over 65 and didn't enroll in Part B during my Initial Enrollment Per
99. Important information you need to know regarding Medicare prescription drug and
100. I have more than one insurance. How do I know who pays first?
101. I want to add Part B to my Medicare. When can I do that?
102. Whom do I contact when there is a change in my other health insurance?
103. I have employer group health insurance. Can I drop Part B and add it later?
104. What is Medicare Easy Pay and how do I sign up?
105. Should I sign up for Medicare Part B if I am (or my spouse is) still working?
106. What is the current Medicare coverage for LTC, nursing home care, and SNF care?
107. Why is Social Security still taking money each month for Part B when I joined a
108. Should I sign up for Medicare Part B?
109. I can't afford my Medicare premiums. What can I do?
110. What is a Medicare deductible?
111. What is Medicaid and who does it cover?
112. What is Medicare?
113. What medical supplies and equipment does Medicare Part B cover?
114. Does Medicare cover dental services?
115. What is a Medicare Advantage plan?
116. Should I sign up for Medicare Part A and B if I am still working?
117. How do I get help with my health care costs?
118. Does Medicare cover glaucoma screening?
119. If I retire at age 62 will I be eligible for Medicare at that time?
120. Is the Medicare Part B deductible something new?
121. Who is eligible to get Medicare covered home health care and what services are c
122. How do I submit a Medicare claim (bill)?
123. What diabetic supplies and services does Medicare cover?
124. Do you get Medicare if you are getting Social Security disability benefits?
125. Does Medicare cover chiropractic services?
126. How do I find out more about TRICARE for Life for military retirees?
127. Will Medicare pay for my flu shot every year?
128. Will the Original Medicare Plan offer to pay for my prescription drugs?
129. Does the Original Medicare Plan pay for care in a nursing home?
130. Guide for entering the quantity for non-oral and liquid medications.
131. Why doesn't Medicare pay for dental care, hearing aids, and eyeglasses?
132. Is Medicare saying that all Medicare beneficiaries should be tested for anthrax?
133. Does Medicare cover me when I travel outside of the United States?
134. When does Medicare cover ambulance trips?
135. Is the E-MSN available in my state?
136. Why isn't the drug I'm taking listed in your Drug Assistance Program tool?
137. What if I do not have Medicare Part A -- should I sign up for Medicare Part B?
138. Does a spouse, age 62, receive Medicare when his/her aged 65 husband/wife does?
139. Will my non-working spouse, who turns 65 before me, get Medicare at age 65?
140. I am a retired Federal employee with FEHBP. Do I need to enroll in Part B?
141. What is included in the Durable Medical Equipment category?
142. I received a notice (bill) for my Medicare premiums. Why?
143. I am disabled and have Medicare Part A only. Can I get Part B when I turn 65?
144. Which oral anti cancer drugs are covered under the Original Medicare plan?
145. Can I get the flu even if I get the flu vaccine this year?
146. Why should I get a flu shot?
147. Why do I need to get a flu shot every year?
148. Are Medicare-approved drug discount cards available now? Someone contacted me t
149. How Does Medicare Decide if a Service is Covered?
150. Do I have to pay for Medicare Part A (Hospital Insurance)?
151. Will my secondary insurance cover my deductible and/or 20% coinsurance?
152. Should I notify Medicare when my spouse and I are no longer working?
153. How do I file a claim with my secondary insurance after Medicare processes....
154. Why am I getting notices asking if Medicare is my primary insurance?
155. What is "assignment" in the Original Medicare Plan and why is it important?
156. How can Medicaid help people with low incomes?
157. Why aren't all of my Medicare claims forwarded to my secondary insurer?
158. I live outside the U.S. I do not have Part B. If I get Part B, will I pay more?
159. I am retired and on Medicare. If I go back to work, will it affect my Medicare?
160. Does Medicare pay for an ambulance trip from one hospital to another?
161. Should my doctor submit claims to Medicare if it is my secondary insurance?
162. What supplies require a certificate of medical necessity (CMN)?
163. Are there any programs for medications you can buy without a prescription?
164. Who is eligible to get benefits under TRICARE for Life (TFL)?
165. How do I find out if I have Medicare Part A and B?
166. Will Medicare pay for an ambulance once a patient has been to the ER?
167. Does the Original Medicare Plan cover mental health care?
168. How do Medicare Advantage plans work?
169. Will Medicare pay for ambulance services from home to the doctor's office?
170. What is Durable Medical Equipment (DME)?
171. Where can I find Medicare provider enrollment information?
172. What is a Certificate of Medical Necessity?
173. Please explain how the Medicare Part B deductible is applied?
174. Who can help me if I have questions about my doctor bills and claims?
175. What is a benefit period and how does the Medicare Part A deductible work?
176. Who can help me if I have questions about health plans and long term care?
177. When can I get Medicare if I am under age 65 and have Lou Gehrig's disease?
178. What is an Advance Beneficiary Notice (ABN)?
179. What is a DMERC?
180. Why did I receive an EOB from my secondary insurance and nothing from Medicare?
181. Why aren't all Medicare participating healthcare professionals included...?
182. Where can I find a list of all physicians that participate in Medicare?
183. Will Medicare pay for ambulance service to go to the doctor's office?
184. Can I pay for a service myself, even if Medicare covers it?
185. Where can I find a list of all physicians that participate in Medicare?
186. Why doesn't Nursing Home Compare contain the most recent inspection results?
187. I now have TRICARE for Life, do I need to keep my other supplemental insurance?
188. How do I report the death of a beneficiary?
189. What should I consider when locating a nursing home?
190. Does Medicare cover treatment for macular degeneration?
191. Who are Long Term Care Ombudsmen?
192. What will Medicare cover for bone mass measurement?
193. How do I leave a Medicare Advantage plan?
194. I disagree with Medicare not paying for the ambulance. What should I do?
195. Medicare is forwarding my claims to two secondary insurance plans...
196. Why did I get a Medicare Summary Notice? What is it for if it is not a bill?
197. Do I need a prescription to get a supply?
198. I am a U.S. citizen living outside the country. How do I apply for Medicare?
199. Why didn't Medicare pay for my bone mass measurement?
200. I received a bill for my Medicare premiums. Where do I send my payment?
201. How can I receive additional assistance or more information about my options?
202. What do I do if Medicare is not paying for an item or service that I feel should
203. If my doctor submits a claim too late and it is denied, am I still responsible?
204. How can I arrange to have my parent's Medicare statements mailed to me??
205. I dropped a Medigap policy to join this Medicare Advantage plan for the first ti
206. Will Medicare pay for cardiac rehabilitation if I have a valve replacement?
207. What does $0 mean under Non-Covered Charges of my MSN?
208. I understand that there are new benefits available to Uniformed Services retiree
209. What is included in the Prosthetic and Orthotic category?
210. What if I refuse to sign an ABN but I want the service or item anyway?
211. What is a Supply?
212. Who must follow the Health Insurance Portability and Accountability Act of 1996
213. What about nursing home availability?
214. Where can I get help with my home health care questions?
215. How do I get on or off the automatic crossover file and how long will it take?
216. What is Medicare's policy regarding screening mammograms?
217. I received an ABN that was not on the standard gov't form. Is it legitimate?
218. Who do I contact if I suspect an act of fraud?
219. I disagree with a claims decision; how do I request an appeal?
220. What kinds of services can I receive from a dietician or nutritionist?
221. How do I pay for Supplies?
222. Are there any other steps a person with Medicare can take to try to get a Local
223. When I am liable for payment because I signed an ABN, how much can I be charged?
224. Medicare paid for the services I received after an accident, and then I received
225. What is a "capped" item?
226. How do I get my information corrected in Medicare.gov's Participating Physician Directory?
227. Is accreditation the same thing as Medicare or Medicaid certification?
228. What is assignment and why is it important when choosing a power wheelchair or s
229. What does the Health Insurance Portability and Accountability Act of 1996 (HIPAA
230. How do I order multiple copies of Medicare publications?
231. Patient Survival: What affects patient survival?
232. Am I protected from having to pay if I did not receive an ABN?
233. How does receiving an Advance Beneficiary Notice (ABN) help me?
234. Why aren't all Medicare participating healthcare professionals included in the P
235. What does Medicare pay for a power wheelchair or scooter?
236. I am a Federal employee. How do I enroll in Medicare?
237. Does my doctor have to tell me beforehand if he/she does not accept assignment?
238. If I receive an Advance Beneficiary Notice (ABN), what are my options?
239. Does Medicare cover my costs if I am in a clinical trial?
240. Can I choose any home health agency if I am in a Medicare Advantage Plan?
241. What is Medicare.gov?
242. How can I get a copy of my personal health information?
243. What is the Participating Physician Directory?
244. I live outside of the U.S., how do I contact the Social Security Administration
245. Can I legally get prescription drugs from Canada?
246. What should I do if I get the flu?
247. What determines which home health agencies will be included in the search result
248. Can I rent a power wheelchair or scooter and then buy it?
249. Patient Survival: How rates are calculated?
250. Can I rent a supply then purchase it?
251. Does Medicare cover power wheelchair and scooter accessories?
252. Where does the information in the Participating Physician Directory originate?
253. What is a �Private Contract�?
254. I paid my doctor more than I owe, how do I get my money back?
255. Where can I get information about the availability of mediation as an option to
256. What do I pay for a power wheelchair or scooter?
257. Does the Medicare-approved drug discount card program vary if I live in the U.S.
258. What is the Notice of Medicare Privacy Practices?
259. Will Medicare pay for my Pneumococcal shot?
260. What should I do if my doctor orders a test and the supplier gives me an ABN?
261. Is a power wheelchair or scooter supplier supposed to waive my coinsurance or Pa
262. What is a participating physician?
263. If I receive an ABN, does that mean I should not accept the service or item?
264. Who pays for repairs and general maintenance of my power wheelchair or scooter?
265. How do I get added to the Participating Physician Directory?
266. How do I get my information corrected in your Participating Physician Directory?
267. What can I do so that my spouse and I only receive one copy of the Handbook?
268. Do ABNs mean that less and less is being covered by Medicare?
269. How can I file a complaint with the Secretary of Health and Human Services?
270. Where can I find a list of participating suppliers in my area?
271. Anemia: What is Epogen®?
272. Patient Survival: expected patient survival?
273. How do I become a participating physician?
274. How is the privacy of my medical records protected?
275. What information must be included in an ABN for a Part B service or item?
276. Dialysis Adequacy: Guidelines.
277. On an ABN what does I will be �personally & fully responsible" for payment mean?
278. Are Health Care Providers required to file with Medicare?
279. Do you have tips for how to best view this site?
280. In Home Health Compare, what is risk adjustment?
281. Why are my bills for outpatient services higher than they were before Aug 2000?
282. What are Health Savings Accounts (HSAs)?
283. Patient Survival: As Expected?
284. How can I get my personal health information held by Medicare corrected if I thi
285. Dialysis Adequacy: Importance of URR of 65 or more.
286. Can I rent a power wheelchair or scooter?
287. How can I get a listing of those who have received my personal health informatio
288. Why did Medicare pay for interpreting a test while I was in the hospital?
289. How does Medicare use my personal information?
290. How can I get a paper copy of the Notice of Medicare Privacy Practices?
291. How often is the Participating Physician Directory updated?
292. Dialysis Adequacy: What is Urea?
293. I think my health care provider may have violated my privacy rights. How can I
294. Anemia: Kidney disease and low blood count.
295. Patient Survival: Worse than expected?
296. Anemia: What is anemia?
297. Dialysis Adequacy: How often should I be tested?
298. What rule or policy provides the process for appealing Local Coverage Decisions
299. How often is the data on Home Health Compare updated?
300. How do you collect health plan quality information?
301. Dialysis Adequacy: Other ways to measure?
302. How does Medicare protect my personal information?
303. What if I want to change home health agencies?
304. Who will hear the Local Coverage Decision (LCD) and National Coverage Decision (
305. What is the Screen Reader Version?
306. I am getting Medicaid or State Children's Health Insurance Program benefits. Ho
307. How can I ask Medicare to limit how my personal health information is used or gi
308. What are the timeframes for filing an Local Coverage Decision (LCD) Appeal?
309. Where do I go to file a complaint about a physician?
310. How was the satisfaction information collected?
311. Can a person with Medicare request a formal review of an Local Coverage Decision
312. Anemia: What is K/DOQI?
313. Dialysis Adequacy: What is URR?
314. Patient Survival: Better than Expected?
315. Anemia: What is hemoglobin?
316. Anemia: What is hematocrit?
317. Dialysis Adequacy: How are results affected?
318. I think Medicare may have violated my privacy rights. How can I file a complain
319. Why does Medicare need my personal health information?
320. Do you collect quality information for the Original Medicare Plan?
321. How do I update the demographic information for my agency on Home Health Compare
322. Does the Medicare-approved drug discount card program vary if I live in American
323. I am enrolled in a Medicare Advantage plan. How does this affect my privacy rig
324. Does the Medicare-approved drug discount card program vary if I live in Commonwe
325. Can more than one person file a complaint?
326. Can I use any Medicare-approved drug discount card and the $600 credit if I'm an
327. Anemia: What is a hormone?
328. Anemia: calculated hematocrit/hemoglobin.
329. I am a physician planning to relocate outside the US for a few years. How do I
330. Does the Medicare-approved drug discount card program vary if I live in Guam?
331. How can I report fraud, waste, and abuse to the Inspector General's Hotline abou
332. Why are preventive services important?
333. What is an I/T/U pharmacy?
334. When should I call the Inspector General's Hotline on waste, fraud, and abuse?
335. Why should I get a special Medicare-approved drug discount card to use at an I/T
336. What information do I need to provide when submitting a complaint to the Office
337. What happens when I report fraud to the Inspector General's Hotline?
338. Do I have to identify myself if I report fraud to the Inspector General?
339. My Medicare Summary Notice shows a charge for a service that I did not receive.
340. If I am an American Indian or Alaska native, will my special Medicare-approved d
341. What is the mission of the Office of the Inspector General Hotline ?
342. How do I report identity theft?
343. How do I report disability fraud?
344. What if I am an American Indian or Alaska native and have a Medicare-approved dr
345. Is there any help for American Indians or Alaska natives to fill out the enrollm
346. What if I am an American Indian or Alaska native and my I/T/U clinic doesn't hav
347. What if I am an American Indian or Alaska native and my I/T/U pharmacy doesn't c

1. What are the Medicare premiums and coinsurance rates for 2005?

The following is a listing of the Medicare premium, deductible, and coinsurance rates that will be in effect in 2005:

Medicare Premiums for 2005:

Part A: (Hospital Insurance) Premium

• Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
• The Part A premium is $206.00 for people having 30-39 quarters of Medicare-covered employment.
• The Part A premium is $375.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.

Part B: (Medical Insurance) Premium

$78.20 per month.

Medicare Deductible and Coinsurance Amounts for 2005:

Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2005 = $912) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.

For each benefit period you pay:

• A total of $912 for a hospital stay of 1-60 days.
• $228 per day for days 61-90 of a hospital stay.
• $456 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
• All costs for each day beyond 150 days

Skilled Nursing Facility Coinsurance

• $114.00 per day for days 21 through 100 each benefit period.

Part B: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)

• $110.00 per year. ( Note : You pay 20% of the Medicare-approved amount for services after you meet the $110.00 deductible.)

Additional information about the Medicare premiums, deductibles, and coinsurance rates for 2005 is available in the September 3, 2004 Health and Human Services press release titled "HHS Announces Medicare Premium, Deductibles for 2005" on the www.hhs.gov website.

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2. Information from Medtronic on a possible battery issue with some implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-Ds) manufactured between April 2001 and December 2003.

On February 10, 2005, Medtronic, the manufacturer of implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-Ds), began notifying physicians about a problem that may affect the battery in some of the company's implantable devices. There have been no reports of patient injury or death related to this issue. This problem has been identified in a very small number of ICD and CRT-D devices with batteries manufactured between April 2001 and December 2003.

Devices manufactured during this time period include the following models:

Model 7230 Marquis� VR

Model 7274 Marquis� DR

Model 7232 Maximo� VR

Model 7278 Maximo� DR

Model 7277 InSync Marquis�

Model 7289 InSync II Marquis�

Model 7279 InSync III Marquis�

Model 7285 InSync III Protect� (no devices implanted in the United States)

This potential issue does not affect individuals with other models of Medtronic devices or these devices with batteries manufactured after December 2003. If your device is not included in this list, your device is not affected by this situation.

If you believe you may have one of Medtronic's devices, please call your doctor who follows the performance of your device. Your doctor is in the best position to assess your care needs.

If you have other questions or concerns, please call the Medtronic patient toll-free line at 1-888-775-2702.

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3. Are all people with Medicare eligible to get the �Welcome to Medicare� physical exam?

No. In order to be eligible to get the �Welcome to Medicare� physical exam, your Medicare Part B coverage must have been effective on or after January 1, 2005. Also, you must get the �Welcome to Medicare� physical exam within the first six months you have Part B coverage.

Additional information can be found in Medicare.gov's publication titled, Guide to Medicare's Preventive Services .

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4. How much does the �Welcome to Medicare� physical exam cost?

You pay 20% of the Medicare-approved amount after you meet the yearly Part B deductible ($110 for 2005). Since this may be your first Medicare-covered service, you may meet your entire Part B deductible at this visit.

Additional information on preventive services can be found in Medicare.gov's publication titled, Guide to Medicare's Preventive Services .

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5. What cancer screening does Medicare currently cover?

Medicare covers the full-range of colorectal cancer tests, annual mammogram tests for women over 40, a pap test and pelvic exam once every 24 months and annual prostate exams for men over 50.

Additional information on preventive services can be found in Medicare.gov's publication titled, Guide to Medicare's Preventive Services .

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6. What services are included in the �Welcome to Medicare� physical exam?

The �Welcome to Medicare� physical exam will include a thorough review of your health, education and counseling about the preventive services you need, like certain screenings and shots, and referrals for other care if you need it. The �Welcome to Medicare� physical exam is a great way to get up-to-date on important screenings and shots and to talk with your doctor about your family medical history and how to stay healthy.

During the exam, your doctor will record your medical history and check your blood pressure, weight and height. Your doctor will also give you a vision test and an Electrocardiogram (EKG). Depending on your general health and medical history, further tests may be ordered if necessary. You will also get a written plan (like a checklist) when you leave letting you know which screenings and other preventive services you should get.

Additional information on preventive services can be found in Medicare.gov's publication titled, Guide to Medicare's Preventive Services .

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7. What is the new diabetes screening?

Diabetes is a medical condition in which your body doesn't make enough insulin or has a reduced response to insulin. Diabetes causes your blood sugar to be too high because insulin is needed to use sugar properly. A high blood sugar level is not good for your health.

As of January 1, 2005, Medicare began covering tests to check for diabetes. These tests are available if you have any of the following risk factors: high blood pressure, high cholesterol, obesity, or a history of high blood sugar. Other risk factors may also qualify you for these tests. Talk with your doctor for more information.

Additional information on preventive services can be found in Medicare.gov's publication titled, Guide to Medicare's Preventive Services .

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8. What are the new cardiovascular screenings?

As of January 1, 2005, Medicare began covering cardiovascular screening tests. These tests check your cholesterol and other blood fat (lipid) levels. High cholesterol can increase your risk for heart disease and stroke. These tests will tell you if you have high cholesterol and can help you find cardiovascular problems in the early stages.

Additional information on preventive services can be found in Medicare.gov's publication titled, Guide to Medicare's Preventive Services .

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9. How often does Medicare cover the new cardiovascular screenings?

Medicare will cover these cardiovascular screening tests once every five years. You don't have to pay a deductible or co-payment for these tests.

Additional information on preventive services can be found in Medicare.gov's publication titled, Guide to Medicare's Preventive Services .

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10. How often is the new diabetes screening covered by Medicare?

Based on the results of your diabetes screening tests, you may be eligible for up to two diabetes screenings every year. You don't have to pay a deductible or co-payment for these tests.

Additional information on preventive services can be found in Medicare.gov's publication titled, Guide to Medicare's Preventive Services .

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11 .How are the new Medicare drug plans that are starting in 2006 different from the Medicare-approved drug discount cards that are already available?

Medicare prescription drug plans are a new type of insurance that can give you prescription drug coverage from Medicare. These plans work like other insurance you may already have. If you join one of these plans, you will pay a monthly premium, and you will have to pay a copayment or coinsurance for each prescription you fill. You will first be able to sign up for one of these new plans beginning November 15, 2005.

The Medicare-approved drug discount cards that became available in May 2004 are a way for you to get a discount on your prescriptions at the pharmacy. They work like other grocery store or pharmacy discount cards you may have. You can sign up for one of these cards only until December 31, 2005. They were offered as a transition step to help people with Medicare save money on prescription drug costs until Medicare prescription drug plans became available.

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12. What happens to my Medicare-approved drug discount card when I sign up for a Medicare prescription drug plan?

You can use your Medicare-approved drug discount card until May 15, 2006 or until you join a Medicare prescription drug plan, whichever is first. Once you have a Medicare prescription drug plan, you can't use your Medicare-approved drug discount card. You will get coverage for prescription drugs through the Medicare prescription drug plan instead of saving with the discount card.

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13. Can I still use any credits left on my Medicare-approved drug discount card after December 31, 2005?

Yes. You can continue to use your Medicare-approved drug discount card and your credit until May 15, 2006 or until you join a Medicare prescription drug plan, whichever is first. After you join a Medicare prescription drug plan, you can't use your Medicare-approved drug discount card. You also can't use any of the credit you have left.

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14. If I qualify, can I still get $600 credit on my Medicare-approved drug discount card in 2005? Does it matter when I enroll?

If you apply for the $600 credit for the first time during 2005, the company must receive your completed enrollment form in the beginning part of the year. If you apply later, you won't get the full $600 credit from Medicare. The chart below shows how much you will get depending on when in 2005 you join:

Please visit the Prescription Drug and Other Assistance Programs section of www.medicare.gov for additional information about the Medicare-approved drug discount card program.

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15. What is the new Together Rx Access Card program and who can get one?

Ten pharmaceutical companies have come together to launch the new Together Rx Access Card* program; Abbott, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, members of the Johnson & Johnson Family of Companies, Novartis, Pfizer, Sanofi-Aventis Group, Takeda, and TAP Pharmaceutical Products Inc. This new program is available now to the approximately 36 million uninsured Americans. Discounted savings is available on more than 275 brand name drugs, as well as to a wide range of generic drugs directly at the local pharmacy. Enrolled individuals can use this card at any one of the many participating pharmacies available nationwide.

To be eligible, you must:

• be a legal U.S. resident,
• under 65 years of age, not otherwise eligible for Medicare,
• without public or private prescription drug insurance, and
• with incomes up to $30,000 per year for a single person ($40,000 per year for couples)

This program will be expanded in February 2005 to individuals residing in Puerto Rico that meet the eligibility requirements listed above.

For more information on the new Together Rx Access Card program and how to enroll, please visit their website at www.TogetherRxAccess.com or call their toll free number 1-800-444-4106.

*Please Note: The new Together Rx Access Card should not be confused with the existing Together Rx Card that is offered by many of the same companies and is available to people with Medicare. For more information on the Together Rx Card, please visit their website at www.togetherrx.com .

Although these programs are beneficial and provide assistance to those in need, they are NOT endorsed or funded by the Medicare program.

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16. What are Medicare prescription drug plans?

Beginning January 1, 2006, new Medicare prescription drug plans will be available to people with Medicare. Insurance companies and other private companies will work with Medicare to offer these drug plans. They will negotiate discounts on drug prices. These plans are different from the Medicare-approved drug discount cards, which phase out by May 15, 2006, or when your enrollment in a Medicare prescription drug plan takes effect, if earlier.

Medicare prescription drug plans provide insurance coverage for prescription drugs. Like other insurance, if you join you will pay a monthly premium (generally around $35 in 2006) and pay a share of the cost of your prescriptions. Costs will vary depending on the drug plan you choose.

Drug plans may vary in what prescription drugs are covered, how much you have to pay, and which pharmacies you can use. All drug plans will have to provide at least a standard level of coverage, which Medicarewill set. However, some plans might offer more coverage and additional drugs for a higher monthly premium. When you join a drug plan, it is important for you to choose one that meets your prescription drug needs.

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17. Information about the Flu Medicines Demonstration

Medicare announced a demonstration project that may help pay for antiviral flu treatments for people with Medicare. If you have Medicare Part B and do not have drug coverage, you will be able to get up to two prescriptions filled during the demonstration period. If you have met your Part B deductible, Medicare will pay 80 percent of the cost of the drug up to the Medicare allowed payment. You must use a Medicare participating pharmacy.

If you have a Medicare-Approved Drug Discount Card, you will pay 20% of the card sponsor's cost for the drugs, or , 20% of the Medicare allowed payment, whichever is lower.

If you are in a Medicare Advantage plan, you can also participate in this demonstration. Please fill your prescription(s) at your plan participating pharmacy.

If you are currently in the hospital and have Medicare Part A, the antiviral flu drugs will also be covered.

This demonstration project will last until May 31, 2005. In the United States, four antiviral medications (amantadine, rimantadine, oseltamivir, and zanamivir) are approved for treatment of flu. Detailed information about each medication, including dosage and approved persons for use, may be found at
http://www.cdc.gov/flu/professionals/treatment .

Information about how to file a claim can be found by viewing our FAQ titled, " How do I submit a Medicare claim (bill)? "

If you think you have the flu, or think that you may have been exposed to flu, please contact your doctor as soon as possible. Additional information about the flu can be found in the Stay Healthy section of Medicare.gov's website.

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18. When can I join a Medicare prescription drug plan?

If you currently have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance), you can join a Medicare prescription drug plan between November 15, 2005, and May 15, 2006. If you join by December 31, 2005, your Medicare prescription drug plan coverage will begin on January 1, 2006. If you join after that, your coverage will be effective the first day of the month after the month you join. In general, you can join or change plans once each year between November 15 and December 31.

Even if you don't use a lot of prescription drugs now, you still should consider joining a plan. If you don't join a plan by May 15, 2006, and you don't have a drug plan that covers as much or more than a Medicare prescription drug plan, you will have to pay more each month (a surcharge) to join later.

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19. When will I get more information about choosing a Medicare Prescription Drug Plan?

Throughout 2005, Medicare will provide you more information about Medicare prescription drug plans, including how to choose and join a drug plan that best meets your needs. In the fall of 2005, the �Medicare & You 2006� handbook will list the Medicare prescription drug plans available in your area, and you will be able to get personalized information at this website.
In mid-2005, SSA will send people with certain incomes information about how to apply for extra help paying their prescription drug costs.

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20. What if I have prescription drug coverage from an employer or union?

If you have prescription drug coverage from an employer or union, you will get a notice from your employer or union that tells you if your plan covers as much or more than a Medicare prescription drug plan.

• keep your current drug plan. If you join a Medicare prescription drug plan later your monthly premium won't be higher (no surcharge), or
• drop your current drug plan and join a Medicare prescription drug plan, but you may not be able to get your employer or union drug plan back.

• keep your current drug plan and join a Medicare prescription drug plan to give you more complete prescription drug coverage, or
• just keep your current drug plan. But, if you join a Medicare prescription drug plan later, you will have to pay more for the monthly premium (a surcharge), or
• drop your current drug plan and join a Medicare prescription drug plan, but you may not be able to get your employer or union drug plan back.

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21. What if I already have prescription drug coverage from a Medigap (Supplemental Insurance) Policy?

If you have a Medigap policy with drug coverage, you will get a detailed notice from your insurance company telling you whether or not your policy covers as much or more than a Medicare prescription drug plan.This notice will explain your rights and choices.

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22. Do Medicare prescription drug plans work with all types of Medicare health plans?

Yes. There will be Medicare prescription drug plans that add coverage to the Original Medicare Plan. These plans will be offered by insurance companies and other private companies.

There will also be other drug plans that are a part of Medicare Advantage Plans (like HMOs), in some areas.

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23. Does the Medicare-approved drug discount card program vary if I live in Puerto Rico?

Each U.S. territory has its own program to provide lower-income Medicare beneficiaries with additional assistance in paying for their prescription drugs. If you are a resident of one of the territories, you are not eligible for the $600 credit that goes along with the Medicare-approved drug discount card.

If you are a Medicare beneficiary who lives in Puerto Rico and your monthly income is no more than $931 as a single person or no more than $1,249 for a married couple, then you may be eligible for the MediMed program. If you qualify, you will receive a credit of $150.00 each quarter to help with the cost of your prescription drugs. You do not qualify for the MediMed program if you are already enrolled in Medicaid, the health insurance plan of the Commonwealth of Puerto Rico (Reforma) or a private program that pays for prescription drugs. The MediMed Program in Puerto Rico can be contacted toll-free by calling 1-877-725-4300.

If you wish to apply for this program, you should ask for an appointment at your local Medicaid Office. When you go in for your appointment, you should bring a photo ID, your Medicare card, evidence of your home address, and evidence of your income. (Your Medicaid office will tell you what documents you need to bring for proof of income.)

Please visit the Prescription Drug and Other Assistance Programs section of www.medicare.gov for additional information about the Medicare-approved drug discount card program.

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24. How do I get a new Medicare card if my card is lost, stolen, or damaged?

You can now request a replacement red, white, and blue Medicare card online on Social Security's web site. Your card will be mailed within 30 days to the address SSA has on record. This service can be accessed during the following hours:

To make an online request, you will need the following information:

• Your last (exact) payment amount or the month and year you last received a payment if you have received benefits in the last 12 months.
• Your name as it appears on your most recent Social Security card
• Your Social Security Number
• Your Date of Birth
• Your phone number in case we need to contact you about your request
• Your e-mail address (optional)

You may also need:

• Your Place of Birth
• Your Mother's Maiden Name (to help identify you)

This new service can be accessed via the Social Security Administration website. If you prefer, or if you are unable to use the online request to obtain a replacement Medicare card, call Social Security's toll-free number, 1-800-772-1213. Their representatives there will be glad to help you. You can also visit a local social security office. For the office closest to you try their Field Office Locator .

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25. How can I get my name and address changed?

You may report a change of name or address by calling the Social Security Administration at 1-800-772-1213 or by visiting your local field office. Addresses and directions to the Social Security field offices may be obtained from the Social Security Office Locator . You can get more information on changing your name on Social Security's web site . If you get benefits from the Railroad Retirement Board, call your local RRB office, or call 1-800-808-0772.

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26. I've heard that I might be able to get a $600 credit to help pay for my prescription drugs. How does that work?

If your annual gross income is below a certain level, Medicare may pay your enrollment fee for the Medicare-approved drug discount card and provide up to a $600 credit on your card toward your prescription drugs. You can use the $600 credit toward most prescriptions, even those not on the discount drug list. If you get the $600 credit to help you pay for your prescriptions, you will still have to pay a percentage of the cost for each prescription.

You may be able to get the $600 credit to help pay for your prescriptions if:

• you have Medicare Part A and/or Part B, and
• your annual income in 2005 is no more than $12,919 ($1077/month) if you are single, or no more than $17,320 ($1444/month) if you are married (this includes your income and your spouse's income).

You can't get the $600 credit if you already have outpatient prescription drug coverage from any of the following:

• Medicaid
• TRICARE for Life (military health insurance)
• Employer group health plan or other health insurance coverage including a few Medicare Managed Care Plans (other than a Medicare Advantage plan or Medigap policy)
• FEHBP (health insurance for Federal employees or retirees)

Even if you don't qualify for the $600 credit, you may be able to save money on your prescriptions with a Medicare-approved drug discount card.

If you and your spouse both qualify for the credit, you will each get the credit and won't have to pay your annual enrollment fee.

Income limits in Alaska are $16,133 ($1,345/month) if you are single and $21,641 ($1,804/month) if you are married.
Income limits in Hawaii are $14,864 ($1,239/month) if you are single and $19,926 ($1,661/month) if you are married.

The following sources of income should be included when calculating your gross income for your $600 credit enrollment form:

• Employee compensation (salary, wages, tips, bonuses, awards, etc.)
• Unemployment compensation
• Pensions and annuities
• Social Security benefits (including Social Security Equivalent portion of RR Retirement)
• Railroad Retirement benefits
• Veterans Affairs (VA) benefits
• Military and government disability pensions � armed forces, Public Health Service (PHS), National Oceanic and Atmospheric Administration (NOAA), Foreign Service (based on date pension began, combat-related pension, etc.)
• Individual Retirement Account (IRA) distributions
• Interest (savings accounts, checking accounts, etc.)
• Ordinary dividends (stocks, bonds, etc.)
• Refunds, credits, or offsets of state and local income taxes
• Alimony received
• Business income
• Capital gains
• Farm income
• Rental real estate, royalties, partnerships, trusts, etc.
• Other gains (sale or exchange of business property)
• Other income (lottery winnings, awards, prizes, raffles, etc.)

The following sources of income should not be included when calculating your income for $600 credit enrollment form:

• Inheritances and gifts (taxed to estate or giver if not under limits for exemption)
• Interest on state and local government obligations (e.g., bonds)
• Workers compensation payments
• Federal Employees Compensation Act payments
• Supplemental Security Income (SSI) benefits
• Income from national senior service corps programs
• Public welfare and other public assistance benefits
• Proceeds from sale of a home
• Lump sum life insurance benefits paid upon death of insured
• Life insurance benefits paid in installments
• Accelerated life insurance death benefit payments (e.g., viatical settlements, terminal illness, chronic illness)
• Medical Savings Accounts (MSA) withdrawals for medical expenses
• Payments from long-term care insurance policies (subject to limitation)
• Accident or health insurance policy benefits
• Accident compensatory damages
• Child support payments received
• Most foster care provider payments received
• Disaster Relief grants
• Disability payments as the result of a terrorist attack

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27. If I get a flu shot from a doctor or provider who doesn't bill Medicare, what should I do?

If you get your flu shot from a doctor or provider who doesn't bill Medicare, you will have to send Medicare a special form and receipt. You can get a receipt from the doctor or provider who gives you the flu shot. Make sure the receipt has the following information on it: the doctor or provider's name, the address, service provided (�flu shot�), the date you got the flu shot, and the amount you paid. To get this form and to find out where to send it, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

You can also click here to get a copy of this form. Please send your completed form to your local Medicare Carrier at the address listed below. For further assistance, please contact 1-800-MEDICARE (1-800-633-4227).