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Medicare

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Elderly Patient in Hospital

This section of PALawHelp.org has information and resources about Medicare issues in Pennsylvania.

Click on a resource category listed below to see information related to that category.

PA Health Law Project Toll-Free Helpline - Call: 1-800-274-3258

The PA Health Law Project provides free legal services and advocacy to Pennsylvanians having trouble accessing publicly funded health care coverage or services. For assistance, call the PHLP Helpline at 1-800-274-3258 or 1-866-236-6310 TTY or e-mail the PHLP at staff@phlp.org. Information from the PHLP is also available online at www.phlp.org.

Need Help with Medicare? Call PA MEDI!

Information on Pennsylvania Medicare Education and Decision Insight (PA MEDI, formerly called APPRISE), an agency that helps people of any age to make informed health insurance decisions regarding Medicare.

Medicare Drug Plan Finder

The Medicare Drug Plan Finder from the Centers for Medicare & Medicaid Services can help you find and compare Medicare prescription drug plans in your area.

Medicare Eligibility & Premium Calculator

Use this calculator from the Centers for Medicare & Medicaid Services to get an estimate of when you’re eligible for Medicare and your premium amount. This calculator provides information for many but not all situations. If your situation isn’t in this calculator, contact Social Security to see if you’re eligible to enroll.

Application for Payment of Medicare Premiums, Coinsurance and Deductibles [PDF]

The PA 600M is a mail-in application for payment of the Medicare Part B premium only. It is used to help elderly individuals or individuals with disabilities who are eligible for Medicare to pay some or all of their Medicare Part B premium. A face-to-face interview is not required when using this application. The application cannot be used to apply for Medicaid (Medical Assistance), cash assistance or food stamps. (PA 600 M (AS) 8/19)

Benefits Eligibility Screening Tool (B.E.S.T.)

The Social Security Adminisitration's Benefit Eligibility Screening Tool (BEST) is an online tool that you can use to find out if you could be eligible for benefits from any of the programs Social Security administers. This tool will give you eligibility information based on answers you give on the online form.

Benefits.gov

Benefits.gov is the official benefits website of the U.S. government whose mission is to increase citizen access to benefit information, while reducing the expense and difficulty of interacting with the government. It is a free, online confidential tool that helps you find government benefits you may be eligible to receive.

Pennie - Pennsylvania's Health Care Marketplace

Pennie provides information on health care coverage available and how to sign up. All Pennsylvanians can search and choose coverage from November to January 15. After January 15th, folks who experience a Qualifying Life Event are still eligible to apply for financial assistance and shop for health insurance. Visit their website to learn more on qualifying life events.

Social Security Benefit Application - Medicare

Online Medicare application from the Social Security Administration.

Application for Payment of Medicare Premiums, Coinsurance and Deductibles [PDF]

The PA 600M is a mail-in application for payment of the Medicare Part B premium only. It is used to help elderly individuals or individuals with disabilities who are eligible for Medicare to pay some or all of their Medicare Part B premium. A face-to-face interview is not required when using this application. The application cannot be used to apply for Medicaid (Medical Assistance), cash assistance or food stamps. (PA 600 M (AS) 8/19)

Benefits Eligibility Screening Tool (B.E.S.T.)

The Social Security Adminisitration's Benefit Eligibility Screening Tool (BEST) is an online tool that you can use to find out if you could be eligible for benefits from any of the programs Social Security administers. This tool will give you eligibility information based on answers you give on the online form.

Benefits.gov

Benefits.gov is the official benefits website of the U.S. government whose mission is to increase citizen access to benefit information, while reducing the expense and difficulty of interacting with the government. It is a free, online confidential tool that helps you find government benefits you may be eligible to receive.

Pennie - Pennsylvania's Health Care Marketplace

Pennie provides information on health care coverage available and how to sign up. All Pennsylvanians can search and choose coverage from November to January 15. After January 15th, folks who experience a Qualifying Life Event are still eligible to apply for financial assistance and shop for health insurance. Visit their website to learn more on qualifying life events.

Social Security Benefit Application - Medicare

Online Medicare application from the Social Security Administration.

Medicare Drug Plan Finder

The Medicare Drug Plan Finder from the Centers for Medicare & Medicaid Services can help you find and compare Medicare prescription drug plans in your area.

Medicare Eligibility & Premium Calculator

Use this calculator from the Centers for Medicare & Medicaid Services to get an estimate of when you’re eligible for Medicare and your premium amount. This calculator provides information for many but not all situations. If your situation isn’t in this calculator, contact Social Security to see if you’re eligible to enroll.

Medigap Policy Search

This interactive tool from the Centers for Medicare & Medicaid Services helps you Find a Medigap Policy in Your Area.

Hospital Compare - A quality tool provided by Medicare

This tool from the U.S. Department of Health and Human Services provides you with information on how well the hospitals in your area care for all their adult patients with certain medical conditions. This information will help you compare the quality of care hospitals provide.

Medicare

Information from the Erie County Bar Association on the Medicare health insurance program for senior citizens from the Erie County Bar Association. (August 2018)

A Guide to Legal Issues for Pennsylvania Senior Citizens [PDF]

The handbook from the Pennsylvania Bar Association provides valuable information on legal issues and questions that concern Pennsylvania's senior citizens and the persons and organizations that care for them. (2016-2017) [PDF Format, 83 pages]

Need Help with Medicare? Call PA MEDI!

Information on Pennsylvania Medicare Education and Decision Insight (PA MEDI, formerly called APPRISE), an agency that helps people of any age to make informed health insurance decisions regarding Medicare.

What's Medicare?

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities. This provides more information about what coverage is available through Medicare.

Community HealthChoices

Information from the Pennsylvania Department of Human Services about Community HealthChoices, a program that will coordinate your health care coverage to improve the quality of your health care experience with a goal of increasing opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes.

Community HealthChoices (Video)

This video from the Pennsylvania department of Human Services explains the new Community HealthChoices program. Community HealthChoices will coordinate your health care coverage to improve the quality of your health care experience — serving more people in communities rather than in facilities, giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life.

Medicare Drug Plan Finder

The Medicare Drug Plan Finder from the Centers for Medicare & Medicaid Services can help you find and compare Medicare prescription drug plans in your area.

Medicare.gov: Prescription Drug Coverage (Part D)

Information on the Medicare Prescription Drug Benefit from Medicare.gov.

Medicare - Preventive & Screening Services

Information about preventive services that may be covered by Medicare.

Medigap Policy Search

This interactive tool from the Centers for Medicare & Medicaid Services helps you Find a Medigap Policy in Your Area.

Hospital Compare - A quality tool provided by Medicare

This tool from the U.S. Department of Health and Human Services provides you with information on how well the hospitals in your area care for all their adult patients with certain medical conditions. This information will help you compare the quality of care hospitals provide.

Medicare Benefits

Information from the Social Security Administration providing an overview of the Medicare program.

Understanding Medicare: Medicare in Simple Terms (Video)

This video from the Health Care Financing Administration shows you how to ask questions or resolve problems with Medicare quickly through toll-free telephone help numbers and provides valuable information on the latest changes to the program. (1994)

APPRISE now PA MEDI

Effective July 1, 2021, APPRISE is now Pennsylvania Medicare Education and Decision Insight or PA MEDI – Same Program, Same Services for Pennsylvania’s Medicare Beneficiaries, now with a New Name. Pennsylvania Medicare Education and Decision Insight (PA MEDI) offers free Medicare counseling to older Pennsylvanians. PA MEDI Counselors are specially trained to answer your questions and provide you with objective, easy-to-understand information about Medicare, Medicare Supplemental Insurance, Medicaid, and Long-Term Care Insurance. PA MEDI Counselors do not sell Medicare products but rather offer current, unbiased Medicare education to help you make the most informed choice about the Medicare options available to you.

Health Reform & Medicare (Video)

This video from HealthCare.gov discusses what the Affordable Care Act means for Medicare recipients.

Benefit Publications from the Social Security Administration

Large collection of publications providing information on the various programs such as: disability benefits, appeal process, benefits for people with HIV, how workmans' compensation can affect your disability benefits, children with disabilities, info on receiving your payments, benefits for those who are blind or have low vision, details on ticket to work incentives, info on working while disabled, retirement benefits, government pension offset, medicare, windfall provision, survivors benefits, SSI, SSI for non-citizens, food stamps and other nutrition progams, protecting your on social security numbers, and more. Many publications available in Spanish.

Medicare Prescription Drug Donut Hole

Explanation of Medicare Prescription Drug Donut Hole from HealthCare.gov.

Medicare Publications

Listing of publications from Medicare.gov on a vairiety of issues. Publications are in PDF format with links to copies converted to web pages.

Pennie - Pennsylvania's Health Care Marketplace

Pennie provides information on health care coverage available and how to sign up. All Pennsylvanians can search and choose coverage from November to January 15. After January 15th, folks who experience a Qualifying Life Event are still eligible to apply for financial assistance and shop for health insurance. Visit their website to learn more on qualifying life events.

Pennsylvania Health Insurance Premium Payment (HIPP) Program

Information from the Pennsylvania Department of Human Services on the PA Health Insurance Premium Payment Program. The Health Insurance Premium Payment (HIPP) Program is a program developed to help families, who have at least one person enrolled in Medical Assistance (MA), pay for private health insurance through an employer.

Self Employed: Social Security and Medicare

Fact Sheet from the Social Security Administration for people who are self-employed regarding paying Social Security and Medicare taxes, earning credits, calculating net earnings, and more. (2022) [PDF]

Social Security Benefit Application - Medicare

Online Medicare application from the Social Security Administration.

Your Ticket To Work

Information from the Social Security Administration regarding the Ticket To Work Program and how more Americans with disabilities have the opportunity to participate in the workforce and lessen their dependence on public benefits. Some of the work incentives allow you to keep some Social Security Disability Insurance (SSDI) or SSI benefits, and your Medicaid or Medicare, while you transition to the workplace. (July 2020) [PDF]

An Overview of Medicare

This fact sheet from the Kaiser Family Foundation provides a basic overview of the Medicare program, including how it is financed, who is eligible and what benefits are covered under the program. In addition, it describes supplemental health insurance, benefits provided by the new drug law and data on Medicare expenditures and financing. (Feb. 13, 2019)

An Overview of the Medicare Part D Prescription Drug Benefit

This fact sheet provides an overview of the Medicare Part D program, plan availability, enrollment, and spending and financing, based on data from the Centers for Medicare & Medicaid Services (CMS), CBO, and other sources. (Oct. 13, 2021)

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