An Introduction to Medicare Medicare is only of immediate use to your client if he/she is age 65 or older, or if he/she has had a Social Security disability determination. Below is information to help you determine if you should pursue this program for your clients. To review all of the tips and to get more detailed information on Medicare, scroll down.

Tips:

> What is Medicare?
> Know Your Client's Age and Disability Determination
> Identify "Dual Eligible" Clients

For more detailed information on Medicare, scroll down.

What is Medicare?
Medicare is not Medicaid. It is a Federal health insurance program your client will automatically be enrolled in if:

• He/she is age 65 or older and already receives retirement benefits from Social Security or the Railroad Retirement Board, or
• He/she is under the age of 65 and has received disability benefits from Social Security, or the Railroad Retirement Board for 24 months

(Note: if your client is receiving disability benefits because he/she has Amyotrophic Lateral Sclerosis [also called Lou Gehrig’s disease], the 24-month waiting period is waived. This means your client will receive Medicare the first month he/she is entitled to disability benefits from Social Security or the Railroad Retirement Board.)

Individuals with End-Stage Renal Disease (ESRD) are not automatically enrolled in Medicare. If your client has ESRD, he/she must apply for Medicare benefits.

For more information about Medicare eligibility for your client, go to Medicare’s Web site, www.Medicare.gov and click on the Medicare Eligibility Tool. The Medicare Eligibility Tool can provide you with detailed information about eligibility and enrollment status based on responses to a series of questions. In addition, the tool offers general eligibility and enrollment information, eligibility date and surcharge calculators and links to other valuable Medicare resources.

Know Your Client's Age and Disability Determination
Essentially, Medicare is a program that may be of immediate use to case managers or outreach workers if your client is 65 or older, has received disability benefits for at least 24 months from Social Security or the Railroad Retirement Board, or has End Stage Renal Disease.

Identify "Dual Eligible" Clients
If you have a client who has Medicare or is Medicare eligible, keep in mind he/she may also be “dual eligible.” Dual eligibles are categories of individuals who are entitled to Medicare Part A (Hospital Insurance) and/or Part B (Medical Insurance) and are eligible for some form of Medicaid benefit.

For more information about the different categories of dual eligibles, go to http://cms.hhs.gov/dualeligibles/bbadedef.asp or visit the “Medicare/Medicaid Dual Eligibility” section in the detailed Medicare program information below.

> More information on Medicare:

Benefits Your Client May Receive
What Makes Your Client Eligible
What Your Client Needs to Enroll
If Your Client is an Immigrant
Contact Information
Sample Application
Training Materials for Case Managers
Medicare Program Q & A
Medicare Fact Sheet