Human Resources

Difference between Medicare Part A and Part B

There are two parts to Medicare: Hospital Insurance (Part A) and Medicare Insurance (Part B). Generally, individuals who are over 65 and getting Social Security automatically qualify for Medicare. Individuals became eligible for Medicare for three reasons: 1)Age; 2) Disability; 3) End-stage renal desease (ESRD). Part A, helps pay for inpatient hospital care, skilled nursing care, and other services. Part B, helps pay for doctor's fees, outpatient hospital visits, and other medical services and supplies. Medicare regulations are very specific on who the primary payor of medical services is when an individual has both Medicare and group health coverage. When an individual becomes entitled to Medicare because of age (65 yrs) and continues to work, that individual CAN SELECT which coverage they want to be the primary. Because those individuals can make a selection, the State Health Plan sends a Medicare Eligiblity and Election form 60 days prior to the employees or dependent 65th birthday to be completed and returned. When an individual is retired and is also eligible for Medicare, Medicare is automatically the Primary Plan. For information about Medicare, please visit the website at: http://www.socialsecurity.gov

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