Health Care

Coverage

Directory for

People with

Medicare

Coverage choices that may save you money including:

• Federal and State Programs

• Private Insurance 

• Military Coverage

• Other Resources

Centers for Medicare & Medicaid Services
Health Care Coverage Directory for People with Medicare

A note about the symbols used in this directory: 

 means a mailing address.

means a telephone number.

 means a number for TTY or TDD, text telephones for people with hearing and 

speech impairments. 

 means a computer website address. 

If you do not have a computer, your local library or senior center may be able to help

you find information on their computers.
1

Health Care Coverage Directory for People with Medicare

Table of Contents

Introduction............................................................................................................2

Federal and State Programs ............................................................................3

Medicare Savings Programs ..............................................................................3-4

Medicaid................................................................................................................4 

Programs of All-Inclusive Care for the Elderly (PACE) ......................................5

Federally Qualified Health Centers (FQHCs) ..................................................5-6

Home and Community-Based Service (HCBS) Waiver Programs ......................6

Private Insurance..................................................................................................7

Medigap Policies ..................................................................................................7

Employee or Retiree Coverage from an Employer or Union................................8

Long-Term Care Insurance ................................................................................8-9

COBRA ................................................................................................................9

Military Coverage................................................................................................11

U.S. Department of Veterans Affairs ..................................................................11 

TRICARE for Life/Military Retiree Benefits................................................11-12

Resources on the Web......................................................................................13

Access America for Seniors ................................................................................13

American Association of Retired Persons (AARP) Consumer Resources ........13 

Administration on Aging................................................................................13-14

Consumer ............................................................................................................14

FirstGov for Seniors ............................................................................................14

Healthfinder ........................................................................................................14

Participating Physician Directory........................................................................15

Prescription Drug Assistance Programs..............................................................15

Social Security Administration (SSA) ................................................................15

Supplier Directory ..............................................................................................16
2

Health Care Coverage Directory for People with Medicare

Introduction

This resource directory tells you about a wide range of health care

coverage choices that may help pay for some of your health care

costs. These health care choices work with the benefits you have

from Medicare. You might be able to:

• Get more health care coverage 

• Help to lower your out-of-pocket costs

You should learn about all the different kinds of health care coverage

choices even if you can get employer, union, military, or other health

care coverage. What you choose will affect how much you pay, what

benefits you may have, which doctors you can see, and other things

that may be important to you. 

In addition to finding information on health care coverage choices,

this directory also provides you with websites related to help paying

health care costs. If you don't have access to a computer, your local

library or senior center may be able to help you find the information

on their computers.

This directory is divided into four easy-to-read sections to help you

find what you need. The four sections include:

1. Federal and State Programs

2. Private Insurance

3. Military Coverage

4. Resources on the Web
3

Health Care Coverage Directory for People with Medicare

Federal and State Programs

Federal and state programs provide health care coverage to people

who qualify, at a low cost or at no charge. You must meet specific

state and/or federal rules to get benefits.

There are programs that help millions of people with Medicare save

money each year. These are programs for people with limited

incomes and resources that pay some or all of Medicare's premiums.

Some of these programs may also pay Medicare's deductibles and

coinsurance.

You can apply for these programs if:

• You have Medicare Part A (Hospital Insurance). If you have

Medicare Part A but don't think you can afford it, there is a

program that may pay the Medicare Part A premium for you. 

• You are an individual with a monthly income of less than $1,273,

or are a couple with a monthly income of less than $1,714. If you

live in Hawaii or Alaska, income limits are slightly higher. Income

limits will change slightly in 2002.

• You are an individual with resources of $4,000 or less, or are a

couple with resources of $6,000 or less. Resources include money

in a checking or savings account, stocks, or bonds.

Note: If your income is less than the amounts listed above, you may

qualify for Medicaid. See "Medicaid" description on page 4. 

For more information on Medicare Savings Programs:

Medicare Savings Programs

Insure Kids Now

Free or low-cost health

insurance is available

now in your state for

uninsured children

under age 19. Call

1-877-KIDS-NOW

(1-877-543-7669)

toll-free for more

information. Or visit

www.insurekidsnow.gov
4

Health Care Coverage Directory for People with Medicare

Federal and State Programs (continued)

Call your State Medical Assistance Office. Look in the Blue 

Pages section of your local telephone directory for the phone 

number;

or

Call 1-800-MEDICARE (1-800-633-4227) and ask for the 

phone number of your State Medical Assistance Office.

 Call 1-877-486-2048 (toll-free).

 Go to www.medicare.gov and select "Helpful Contacts." Select 

the state you want and select “Other Health Insurance 

Programs.” Select “View Results.” Go down the listing of 

agencies to State Medical Assistance Office and your state’s 

phone number.

Medicaid is a joint federal and state program that helps pay medical

costs for some people with limited incomes and resources. Most of

your health care costs are covered if you qualify for both Medicare

and Medicaid. People with Medicaid may also get coverage for

nursing home care and outpatient prescription drugs that are not

covered by Medicare. Medicaid programs vary from state to state.

Each state has different rules that you must meet to get Medicaid.

To get more information on Medicaid: 

Call your State Medical Assistance Office. Look in the Blue 

Pages section of your local telephone directory for the phone 

number;

or 

Call 1-800-MEDICARE (1-800-633-4227) and ask for the 

phone number of your State Medical Assistance Office.

 Call 1-877-486-2048 (toll-free).

 Go to www.medicare.gov on the Internet and select "Helpful 

Contacts." Select the state you want, then select "Other Health 

Insurance Programs."

Medicaid

Medicare Savings Programs (continued)
5

Health Care Coverage Directory for People with Medicare

Federal and State Programs (continued)

PACE combines medical, social, and long-term care services for frail

people. PACE is available only in states that have chosen to offer it

under Medicaid. To be eligible, you must be at least age 55, live in

the service area of a PACE program, and be certified as eligible for

nursing home care by the appropriate state agency. Persons enrolled

in a PACE program may have to pay a monthly premium.

Services are given by a team of health care professionals. The

services are usually given in a PACE center but may also include

some home or referral services. Services include primary health

services, some therapy, social services, personal care and support

services, nutrition counseling, and meals. The goal of PACE is to

help people stay in their homes, while getting the high quality

services they need. 

To find the phone number and location of a PACE site near you: 

Call your State Medical Assistance Office. Look in the Blue 

Pages section of your local telephone directory for the phone 

number;

or

Call 1-800-MEDICARE (1-800-633-4227) and ask for the 

phone number of your State Medical Assistance Office.

 Call 1-877-486-2048 (toll-free).

 Go to www.medicare.gov/Nursing/Alternatives/Pace.asp on the

Internet.

FQHCs are special health centers that can give you routine health

care at a lower cost. FQHCs may include:

• Community health centers,

• Tribal health clinics,

• Migrant health services, and

• Health centers for the homeless.

Programs of All-Inclusive Care for the Elderly (PACE)

Federally Qualified Health Centers (FQHCs) 
6

Health Care Coverage Directory for People with Medicare

Federal and State Programs (continued)

To find an FQHC near you: 

Call 1-800-MEDICARE (1-800-633-4227) and ask for the 

phone number of the Primary Care Association in your state. 

 Call 1-877-486-2048 (toll-free).

 Go to www.medicare.gov on the Internet and select "Helpful 

Contacts." Select the state you want, then select “Health Care 

Facilities and Services in Your Area.”

The Home and Community-Based Service (HCBS) programs offer

different choices to some people with Medicaid. If you qualify, you

will get care in your home and community so you can stay independent and close to your family and friends. HCBS waiver programs help

the elderly and disabled, mentally retarded and developmentally disabled, and certain other disabled adults. These programs give quality

and cost-effective services. 

For more information on HCBS programs, services, and specific eligibility requirements in your state:

Call your State Medical Assistance Office. Look in the Blue 

Pages section of your local telephone directory for the phone 

number;

or

Call 1-800-MEDICARE (1-800-633-4227) and ask for the 

phone number of your State Medical Assistance Office.

 Call 1-877-486-2048 (toll-free).

 Go to www.medicare.gov on the Internet and select "Helpful 

Contacts." Select the state you want and select “Other Health 

Insurance Programs.” Select “View Results.”

Home and Community-Based Service (HCBS) Programs

Federally Qualified Health Centers (FQHCs) (continued)
7

Health Care Coverage Directory for People with Medicare

Private Insurance

You may get health care coverage through a private insurance

company if you would like extra coverage for services and items that

are not covered by Medicare or any other health insurance you

currently have. The cost of private health insurance can vary

depending on the type of policy. 

If you want health insurance from a private insurance company, it is

important for you to think about the services you will need, how

much it will cost, and how you will pay for it. You may also want to

speak with a family member or someone you trust to see if it is a

good choice for you. 

The most common type of private health insurance that is sold with

Medicare is called a Medigap policy. A Medigap policy fills the

"gaps" in Original Medicare Plan coverage. To learn more about

Medigap policies, read the "Guide to Health Insurance for People

with Medicare: Choosing a Medigap Policy.” To get your free copy:

Call 1-800-MEDICARE (1-800-633-4227).

 Call 1-877-486-2048 (toll-free).

 Go to www.medicare.gov on the Internet and select 

"Publications."

Medigap Policies
8

Health Care Coverage Directory for People with Medicare

Private Insurance (continued)

You may be able to get health care coverage based on your or your

spouse's past or current employment. When you have retiree

coverage from an employer or union, they manage this coverage.

They may change the benefits or premiums, and may also cancel the

coverage if they choose. If you drop your employer or union group

health coverage, you may not be able to get it back. 

Call the benefits administrator at your or your spouse's current

or former employer or union. 

Long-term care insurance covers medical care and non-medical care

to help you with your daily needs, such as bathing and dressing,

eating, and using the bathroom. In general, Medicare does not cover

long-term care. 

For more information about long-term care insurance, get a copy of

"A Shopper's Guide to Long-Term Care Insurance" from the

National Association of Insurance Commissioners. 

 The National Association of Insurance Commissioners (NAIC)

2301 McGee Street, Suite 800

Kansas City, MO 64108-3600

Call 1-202-824-1600.

 Go to www.naic.org on the Internet and select "Consumer 

Publications."

Or to get a copy through your State Insurance Department:

Call 1-800-MEDICARE (1-800-633-4227) and ask for the 

phone number for your State Insurance Department.

Employee or Retiree Coverage from an Employer or Union

Long-Term Care Insurance
9

Health Care Coverage Directory for People with Medicare

Private Insurance (continued)

 Call 1-877-486-2048 (toll-free).

 Go to www.medicare.gov on the Internet and select 

"Helpful Contacts." Select the state you want, then select 

“General Medicare Information.”

COBRA (Consolidated Omnibus Budget Reconciliation Act

of 1985)

COBRA is a law that requires employers with 20 or more employees

to let employees and their dependents keep their group health

coverage for a time after they leave their group health plan under

certain conditions. This is called "continuation coverage." You may

have this right if you lose your job or have your working hours

reduced, or if you are covered under your spouse's plan and your

spouse dies or you get divorced. 

COBRA generally lets you and your dependents keep the group

health plan coverage for 18 months (or up to 29 or 36 months in

some cases). You may have to pay both your share and the employer's

share of the premium. If you already have continuation coverage

under COBRA when you enroll in Medicare, your COBRA may end.

However, if you choose COBRA coverage after you enroll in

Medicare, you can keep it.

For more information on health insurance coverage under COBRA:

Call your benefits administrator at your or your spouse's 

current or past employer;

or 

Call 1-800-MEDICARE (1-800-633-4227) and ask for your 

State Insurance Department's phone number.

 Go to the U.S. Department of Labor's website at

www.dol.gov/dol/pwba/public/health.htm 

Long-Term Care Insurance (continued)
10

Health Care Coverage Directory for People with Medicare

NOTES
11

Health Care Coverage Directory for People with Medicare

Military Coverage

If you are a Veteran or military retiree, you may be able to get

prescription drugs or health care coverage through the Department of

Veterans Affairs (VA). 

For more information about military benefits:

Call 1-877-222-8387.

 Go to www.va.gov on the Internet.

TRICARE for Life (TFL) starts October 1, 2001. It provides

expanded medical coverage for Medicare-eligible military retirees,

including retired guard members and reservists; Medicare-eligible

family members and widow/widowers; and certain former spouses if

they were eligible for TRICARE before age 65. You must have

Medicare Part B to be eligible for TFL.

If eligible, you get all Medicare-covered benefits under the Original

Medicare Plan, plus all TFL-covered benefits. If you use a Medicare

provider, Medicare will be the first payer for all Medicare-covered

services, and TFL will be the second payer. TFL will pay all

Medicare copayments and deductibles for TRICARE-covered

benefits and cover most of the costs of certain care not covered by

Medicare.

U.S. Department of Veterans Affairs

TRICARE for Life/Military Retiree Benefits

Health care coverage may be available if you have served in

the military. You may also be able to get health care benefits if

you are a dependent of a currently active duty, retired, or

deceased service person.
12

Health Care Coverage Directory for People with Medicare

Military Coverage (continued)

For more information on TFL:

Call 1-888-DOD-LIFE (1-888-363-5433);

or

Call 1-800-538-9552 for other military retiree benefit questions.

 Go to www.tricare.osd.mil on the Internet.

TRICARE for Life/Military Retiree Benefits (continued)
13

Health Care Coverage Directory for People with Medicare

Resources on the Web

The Access America for Seniors website is designed to help seniors

conduct business online—easier and faster—with federal agencies.

 Go to www.seniors.gov on the Internet.

AARP is a non-profit, nonpartisan membership organization for

people age 50 and over. They provide information and resources;

advocate on legislative, consumer and legal issues; assist members to

serve their communities; and offer a wide range of unique benefits,

special products, and services for their members.

 Go to www.aarp.org on the Internet.

The Administration on Aging (AoA) website provides a wide range

of information to older Americans and their families as well as to

those concerned about providing opportunities and services to enrich

the lives of older persons. The AoA website has links to various state

directories that help locate support services for older people on a

Access America for Seniors

American Association of Retired Persons (AARP) Consumer

Resources

Administration on Aging

The World Wide Web is an excellent tool for finding

information on health care topics. In this section, you will find

descriptions and links to valuable websites. These sites have

information ranging from general health-related topics, like

programs and services for seniors to more specific information

on long-term care and prescription drugs. If you don't have a

computer, your local library or senior center may be able to

help you find the information you need. Medicare does not

sponsor these websites, but you may find them useful.
14

Health Care Coverage Directory for People with Medicare

Resources on the Web (continued)

local level, including the Directory of State Agencies on Aging, the

Directory of State Long-Term Care Ombudsman Programs, the

Directory of Area Agencies on Aging, and the Eldercare Locator. The

website also has information on retirement and financial planning,

news releases, health topics for seniors, caregiver resources, and links

to other websites. 

 Go to www.aoa.gov on the Internet.

Consumer is the first Internet site with one-stop access to federal

consumer information including information on health and health

care quality. 

 Go to www.consumer.gov on the Internet.

FirstGov for Seniors is the first government website to provide the

public with easy, one-stop access to all online U.S. Federal

Government resources and state websites for seniors. It also includes

information on topics like health, travel and leisure, work and

volunteer opportunities, education and training, and more.

 Go to www.firstgov.gov on the Internet.

The healthfinder website is run by the U.S. Department of Health and

Human Services. It offers consumer information from the Federal

Government and its many partners. Healthfinder can lead you to

selected online publications, clearinghouses, databases, websites, and

support and self-help groups, as well as government agencies and notfor-profit organizations that produce reliable information for the public.

 Go to www.healthfinder.gov on the Internet.

Consumer

FirstGov for Seniors 

Administration on Aging (continued)

Healthfinder
15

Health Care Coverage Directory for People with Medicare

Resources on the Web (continued)

The national Participating Physician Directory contains names,

addresses, and specialties of Medicare participating physicians who

have agreed to accept "assignment" on all Medicare claims and

covered services. Assignment is an agreement between Medicare and

doctors, other health care providers, and suppliers of health care

equipment and supplies (like wheelchairs, oxygen, braces, and

ostomy supplies). Using doctors and suppliers who agree to accept

assignment can save you money. Assignment only applies if you are

in the Original Medicare Plan. It does not apply if you are in a

Medicare managed care plan or Private Fee-For-Service plan. 

 Go to www.medicare.gov on the Internet and select 

"Participating Physician Directory." 

The Prescription Drug Assistance Programs’ website tells you about

prescription drug discounts or free medication. To learn about

eligibility requirements, how to apply for assistance, and who to

contact for more information, go to the Medicare website.

 Go to www.medicare.gov on the Internet and select 

"Prescription Drug Assistance Programs."

The SSA website provides information on more than 570 topics in its

searchable database. Some of the services you can complete online

include the following: apply for Social Security retirement benefits;

request a replacement Medicare card; obtain 2001 cost of living

information; replace, correct, or change your name on your Social

Security card; get benefit information publications; request a Social

Security statement; and find a local Social Security office. 

 Go to www.ssa.gov on the Internet.

Participating Physician Directory

Prescription Drug Assistance Programs

Social Security Administration (SSA)
16

Health Care Coverage Directory for People with Medicare

Resources on the Web (continued)

The Medicare website has a new Supplier Directory that provides

beneficiaries (or interested users) with contact information for

Medicare participating suppliers in their area. The Supplier Directory

includes the name, address, telephone number, and information on

the specific type(s) of supply being offered by Medicare's

participating suppliers.

 Go to www.medicare.gov on the Internet and select "Supplier 

Directory."

Supplier Directory
Health Care Coverage Directory for People with Medicare

NOTES
DEPARTMENT OF HEALTH AND 

HUMAN SERVICES

Centers for Medicare & Medicaid Services 

(Formerly the Health Care Financing Administration)

7500 Security Boulevard

Baltimore, Maryland 21244-1850

Official Business

Penalty for Private Use $300

Publication No. CMS-02231

July 2001

• ¿Necesita usted una copia en español? Por favor llame gratis al 

1-800-MEDICARE (1-800-633-4227; TTY/TDD: 1-877-486-2048 para

personas con impedimentos auditivos o del lenguaje oral).

• Do you need a copy in Spanish? Look at www.medicare.gov on the Web.

Select “Publications.” Or, call 1-800-MEDICARE (1-800-633-4227;

TTY/TDD: 1-877-486-2048 for the hearing and speech impaired) and ask

for a free copy of this booklet.