For people over the age of sixty, New York City is a cluttered attic-a mess of valuables that cannot be ignored, but that for the most part remains buried in jargon, agencies, regulations, and eligibility forms. New York City is, after all, a place that offers seniors everything from discount tickets for Broadway shows to social service agencies for those who speak foreign languages including Spanish, Cantonese or Tagalog. It is a place of endless benefits for those who can dig through the junk in the attic, organize what is there and still have the desire to leave the house. Take Charge! The Complete Guide to Senior Living in New York City is the first book to gather, in a single volume, information and advice for people over sixty who want to make the most of the city. Here at last is an all-inclusive guide that addresses every concern for senior New Yorkers, from entertainment and healthcare to housing and taxes. Take Charge! reaches beyond merely listing phone numbers and programs to giving advice on a number of areas, from choosing an HMO, a reverse mortgage, or an elder law attorney, to receiving travel discounts and negotiating home care. Containing everything a person over sixty needs to know to make the most of life in New York City, Take Charge! is the only comprehensive guide available for New York seniors and their families.
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Medicare is the national health insurance program for people age 65 and older, the disabled, and some 200,000 people with end-stage kidney disease. About 39 million people are covered. In 1997 the average beneficiary nationwide received about $5,000 worth of Medicare services.
The benefits under Medicare are grouped into two sections: Part A and Part B. Part A is paid for by a 1.4 percent tax on all wages (2.9 percent for the self-employed). This money is held in the Hospital Insurance Trust Fund. Part B is paid for partly by monthly premiums (25 percent) and partly by general funds from the U.S. Treasury (75 percent).
Who Is Eligible?
A person who is not disabled is eligible to receive Medicare benefits if he/she is (1) 65 or older, and (2) qualifies for Social Security, Railroad Retirement benefits, or Civil Service Retirement benefits. Also eligible at age 65 is the spouse or surviving spouse of an eligible person.
Medicare Reminders
ā¢ Keep a photocopy of your Medicare card with you at all times. If the original is lost or stolen, replace it immediately by calling Social Security.
ā¢ Keep a record of all your medical expenses. Include dates, services provided, and charges.
ā¢ If you receive a billing statement from Medicare containing false charges or other false information, call the Inspector General of the U.S. Department of Health and Human Services,
800/447-8477.
A disabled person is eligible at any age if he/she (1) has received Social Security or Railroad disability payments for at least 24 months, or (2) has chronic kidney disease.
Others may enroll in Medicare at age 65, but they will be charged a premium for Part A ($170ā$309 a month in 1999) as well as the regular premium for Part B.
How and When to Enroll in Medicare
If, at age 65, you are already receiving Social Security, Civil Service, or Railroad Retirement payments, you automatically will be enrolled in Medicare. Your Medicare card will be mailed to you about three months before you turn 65.
If you are disabled, you automatically will be enrolled in Medicare after you have received Social Security or Railroad disability payments for 24 months.
If, at age 65, you are not already receiving Social Security, Railroad, or Civil Service retirement payments, you must apply for Medicare at a Social Security office (for information and the office nearest you call
800/772-1213, TDD 800/325-0778). You should apply three months before you turn 65 or, at the latest, within four months after you turn 65. If you miss this seven-month enrollment period, you will have to wait until the next āgeneral enrollmentā period, which occurs each year from January through March.
Part A
Part A is provided without charge to those who meet the eligibility requirements stated above. Those age 65 or older who do not qualify for Social Security benefits may purchase Part A coverage for $170ā$309 a month. Part A covers institutional services provided by hospitals, nursing homes, and hospice programs. Until 1998 all home care services were included in Part A; they now are being transferred in stages to Part B.
Hospital Care
Hospital benefits depend on the length and timing of a hospital stay. For the first 60 days Medicare pays all hospital costs except for the first $768 (1999 amount), which the patient must pay. This is called the ādeductible.ā If you remain in a hospital beyond 60 days, you must pay $192 a day for the next 30 days. This is called the ācopayment.ā If you remain even longer (that is, beyond the 60 plus 30 days), you must pay the full cost for each new day. However, Medicare provides a lifetime allowance of 60 āreserveā days during which you make copayments of $384 a day and Medicare pays the rest.
Once you have been out of the hospital for 60 consecutive days, Medicareās hospital benefits (60 days plus 30 days) can begin again in full. (However, reserve days will continue to be limited to no more than 60 during your lifetime.)
If you are readmitted to a hospital before the 60-day waiting period expires (that is, within 60 days after discharge), Medicareās coverage continues as though it had not b...
