Community Resources
Medicare
Medicare is a federal health insurance program operated by the Social Security Administration for persons 65 years of age and over or who are disabled. These are the most common parts used. For questions and advice on selecting a plan, call a SHIP counselor. See below for telephone numbers.
- Hospital Insurance (Part A) helps pay for care in hospitals with certain follow-up care. Medicare pays benefits directly to the provider. You will get a Medicare benefits notice, which gives the office to contact if you have questions.
- Medical Insurance (Part B) pays a portion of doctor bills, certain outpatient services, other medical items, and services not covered under Part A. This is optional, with monthly premiums.
- Prescription drug benefit (Part D) pays for prescription drugs. Optional, with monthly premiums, copays, deductibles and restrictions depending on plan selected.
Medicare Advantage plans have lower premiums but manage your care through a network of participating providers, similar to an HMO or PPO.
Statewide toll free number (Social Security & Medicare information)
- 800 772-1213
- Web site: www.medicare.gov
- Web site www.mymedicare.gov – personal account to view your own plan details.
- For a list of Medicare participating physicians, call Empire Medical Services, 800-462-9306
MEDICARE SUPPLEMENTAL INSURANCE
For a listing of the individual supplemental policies available for sale, contact:
NJ Dept of Health & Senior Services
Division of Senior Affairs
P O Box 807
Trenton, NJ 08625-0807
800 792-8820
MEDICARE SAVINGS PROGRAMS help people who do not qualify for Medicaid pay for some of the costs of Medicare. Income and asset levels vary. Asset limits are generally $4000 single and $6000 married.
Pays for Medicare's Part B premium, Income limits (2005): $1068 single, $1426 married/month.
QUALIFIED MEDICARE BENEFICIARY (QMB)
Anyone 65 and older or disabled who receives Medicare A and/or Medicare B whose income and resources are at or below the federal poverty guidelines.
- (609) 989-4664
- Income eligibility for 2006:
- Individual: $817/mo. Resources $4,000
- Married: $1100/mo. Resources $6,000
Coverage provides:
- Medicare Part B premiums of $50/mo.
- Medicare Part A and B deductibles of $764 and $100 /yr respectively
- Substantial co-payments for doctor bills, outpatient care, hospital stays over 60 days, and skilled nursing home care over 21 days.
- Application: Mercer Co. Board of Social Services for an appointment to complete an application. Be sure to tell them you are applying for QMB.
SPECIFIED LOW INCOME MEDICARE BENEFICIARY (SLMB)
SLMB is a program providing payments of Medicare Part B premiums and deductibles for persons not eligible for New Jersey Care because their income is too high. Application made through PAAD
- 800 792-9745
- Income eligibility for 2006:
- Individual:$980/mo Resources $4,000
- Married: $1,320/mo Resources $6,000
STATE HEALTH INSURANCE ASSISTANCE PROGRAM (SHIP)
A statewide program administered by the New Jersey Dept. of Health and Senior Services, Division of Senior Affairs, with major funding from the U.S. Dept. of Human Services, Health Care Financing Administration. Provides trained volunteers to assist Medicare enrollees at no cost in filing claims with Medicare, Medigap, Medicare Advantage, Prescription Plans and long-term care options.
- 800 792-8820
- Mercer County, call RWJ Medical Center at Hamilton: (609) 584-5900, opt. 1
- Somerset County: Call RSVP: (908) 704-6319
- Monmouth County: Call RSVP: (732) 531-5511
PRO (PEER REVIEW ORGANIZATION)
- Medicare patient's rights. Investigates and mediates discharges from hospital for Medicare patients—if you feel you were discharged prematurely.
- 557 Cranbury Rd, Ste 21, East Brunswick, NJ 08816
- (732) 238-5570 or 800-624-4557
The Princeton Senior Resource Center does not endorse any of the resources listed on these pages. We collect and provide information from many sources as a service to those seeking services in the Princeton area. No listed provider pays to be in our directory.
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