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About Medicare Benefits and Programs

Part A

Monthly Premium

Most individuals are entitled to "premium-free" Part A benefits based on their or their spouse's work history. Individuals who have less than 40 quarters of Social Security coverage may be eligible to purchase Part A benefits at $499 per month (0 to 29 quarters) or $274 per month (30 to 39 quarters).

Benefits

Part B

Monthly Premium

The Part B premium will be $170.10.

The Part B premium of $170.10 per month in 2022 will be paid for by the State of Maryland for those qualifying for the Qualified Medicare Beneficiary (QMB) or Specified Low-Income Medicare Beneficiary (SLMB) programs. Individuals enrolled in QMB or SLMB in 2021, but lost the program because their income increased or they failed to recertify, will pay $170.10 per month.

If an individual has an income over $91,000 or a couple has an income over $182,000, an income-related monthly adjustment amount (IRMAA) may apply and they will pay a higher Part B premium (and a higher Part D premium) each month. To find out more, call Social Security.

Benefits

Part D

Prescription drug coverage, called Medicare Part D, is available to everyone with Medicare. Insurance companies and other private companies approved by Medicare offer the drug plans. Drug plans will vary in monthly premiums, the type of drugs covered, deductibles, copays and pharmacies accepting the plan. 

Annual Part D Open Enrollment from October 15 to December 7. The Open Enrollment period is the time to search for the best and least expensive Prescription Drug Plan for 2022.

Typical Services Not Covered by Medicare

  • Long-term custodial care (nursing home)
  • Private hospital room (unless determined to be medically necessary), telephone and television
  • Private duty nursing
  • First three pints of blood if you cannot replace them in some manner
  • Routine physical exams including most presurgical exams and tests
  • Dental care and dentures
  • Routine hearing exams and hearing aids
  • Routine eye exams and eyeglasses, except cataract lenses (routine eye exams for individuals with medical conditions that affect sight may be covered)
  • Eye refractions
  • All over-the-counter drugs
  • Routine podiatry care (routine care for persons with certain medical conditions, such as diabetes or vascular heart disease, may be covered)
  • Inpatient psychiatric care after 190 days (lifetime limit)
  • Acupuncture (except for low back pain) and most chiropractic services
  • Cosmetic surgery, unless caused by accidental injury or to improve the function of a malformed body part
  • Full-time home care, homemaker services, home-delivered meals
  • Christian Science practitioners and naturopath's services
  • Orthopedic shoes, unless part of a leg brace and included in orthopedist's charges
  • Ambulance service from home to doctor's office
  • Services provided outside the United States (except for certain hospital and physician services in Canada or Mexico, under certain conditions)

Medicare Beneficiary Programs

If a person is income-eligible, they can apply for Medicaid, the Qualified Medicare Beneficiary Program (QMB) or the Specified Low Income Medicare Beneficiary (SLMB) Program, which provide financial assistance to people with low income and limited assets.

Medicare Prescription Drug Plan

The Medicare Prescription Drug Program offers coverage to everyone with Medicare. Medicare Prescription Drug Coverage is insurance. Private companies provide the coverage. You choose the drug plan. Although premiums and deductibles may vary according to the plan, in general they will be similar to the following for 2022:

  • You will pay a premium ranging from $7.10 to $100.60 per month.
  • You may pay the first $480 (a deductible) at the beginning of each year.
  • You will pay typically less than 25 percent of brand prescription drug costs from $480 to $4,430.
  • You will pay 25 percent of brand drugs and 25 percent of generic drugs in the coverage gap ($4,430 to $10,690).
  • You will pay five percent of very low cost drugs: $3.95 for generic and $9.85 for brand in the catastrophic level.

Each plan has a list of covered drugs called a formulary list. To apply for the Medicare Prescription Plan, call 1-800-MEDICARE (1-800-633-4227) or visit the Medicare website. Provide your ZIP code and list of drugs to find out which Medicare Prescription Drug Plan covers all your drugs and will best fit your needs. Or you may contact Baltimore County's SHIP Office at 410-887-2059 for assistance. In addition, the SHIP staff will be assisting Medicare beneficiaries by phone appointment on a one-on-one basis during Part D open enrollment from October 15 through December 7.

Other Plan Savings Programs

If a person is income-eligible, they can apply for prescription drug plan savings through the Maryland Senior Prescription Drug Assistance Program (MD SPDAP) or Social Security Administration Extra Help and Low Income Subsidy (LIS), which provide financial assistance to people with low income and limited assets.

Explore Medicare Help

 

Contact Us

State Health Insurance Program (SHIP)

Bykota Senior Center
611 Central Avenue
Towson, Maryland 21204

Hours

Monday through Friday
9 a.m. to 4 p.m.

Phone

 
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