One of the most common issues that affect people across Southern and Eastern Kentucky is Medicare. Whether you need help enrolling in Medicare or have questions about your current health care plan, I will try to help. 

Please fill out a privacy release form and send it to my office so I can begin working on your case.

If you need help getting Medicare, send your privacy release form to my District Office in Somerset, Kentucky.

If you are already enrolled in Medicare and need help with an issue, please send your privacy release form to my District Office in Prestonsburg, Kentucky.

Frequently Asked Questions:

Who is eligible to enroll in Medicare?

Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). 

Medicare has two parts, Part A (Hospital Insurance) and Part B (Medical Insurance).

You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:

  • You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
  • You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
  • You or your spouse had Medicare-covered government employment.

Part A may also be purchased by individuals who have attained age 65 who have paid Medicare Taxes through their employment with the state or local government entity and not otherwise eligible for Social Security Retirement or Disability.  These folks will be responsible for paying a quarterly premium directly to the Social Security Administration.

If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:

  • You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. (Note: If you have Lou Gehrig's disease, your Medicare benefits begin the first month you get disability benefits.)
  • You are a kidney dialysis or kidney transplant patient.

While most people do not have to pay a premium for Part A, nearly everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.

There are exceptions for the Part B Premium.  If the individual or couple have a low monthly benefit amount, they may qualify for a Premium waiver through the Qualified Medicare Beneficiary Program (QMB).  These folks can seek assistance through the local Social Security Office or through the individual state Medicaid Office.  

If you believe you are within the guidelines to receive a reduced premium or premium waiver, visit the Social Security Online Service or call 1-800-772-1213. In cases where dual entitlement for Supplemental Security Income exists, the individual state assumes the payment of the premium.

If you have questions about your eligibility for Medicare Part A or Part B, or if you want to apply for Medicare, call the Social Security Administration or visit their website.

The toll-free telephone number is: 1-800-772-1213. The TTY-TDD number for the hearing impaired is 1-800-325-0778.

You can also get information about buying Part A as well as Part B if you do not qualify for premium-free Part A. See also our FAQ on how to enroll in Medicare.


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I lost my Medicare card. How do I get a new one?

If you lose your card, contact the Social Security office at 1-800-772-1213 or click here for Social Security Online Services.
Please protect your Medicare card just as you would a credit card. Your Medicare card in the wrong hands can be used to submit fraudulent claims. 

Medicare Web Site 

Social Security Administration

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How can I get help with Medicare Part D?

Download the 2010 Official Government Handbook for Medicare

You can download and print information about Medicare changes for 2010 and details about health and prescription drug plans.

Visit the Kentucky SHIP website for local help for people with Medicare 

The State Health Insurance Assistance Program has representatives in every county to provide assistance with Medicare issues, such as choosing the best prescription drug plan for you and fraud protectio

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Will my Medicare Part B premium increase in 2010?

Most Medicare beneficiaries will continue to pay the same $96.40 Part B premium amount in 2010. Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium for 2010.

For all others, the standard Medicare Part B monthly premium will be $110.50 in 2010, which is a 15% increase over the 2009 premium. The Medicare Part B premium is increasing in 2010 due to possible increases in Part B costs.  If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $110.50 per month.  For additional details, see Medicare's FAQ titled:  2010 Part B Premium Amounts for Persons with Higher Income Levels.  

In 2010, New Part B beneficiaries will pay $110.50 (because they did not have the premium withheld from their Social Security benefit in the previous year).

Beneficiaries who do not currently have the Part B premium withheld from their Social Security benefit will pay $110.50.

Higher-income beneficiaries pay $110.50 plus an additional amount,  based on the income-related monthly adjustment amount (IRMAA) Medicare Premiums and Coinsurance Rates for 2010


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How do I submit a Medicare claim (bill)?
If you are in the Original Medicare Plan, providers (eg: hospitals, skilled nursing facilities, home health agencies, physicians, pharmacies, and suppliers) that are enrolled in the Medicare program are required by law to file Medicare claims for covered services or supplies you receive. You should not need to file any Medicare claims. 

It is important to ask the pharmacy or supplier if it is enrolled in the Medicare Program. If you go to a pharmacy or supplier that is not enrolled, Medicare will not pay. You will be responsible for paying the entire bill for any prescriptions or supplies. Medicare claims must be filed within one full calendar year following the year in which the services were provided. For example, if you see your physician on March 22, 2009, the Medicare claim for that visit must be filed by December 31, 2010. 

Note: This information on filing a Medicare claim only applies if you are in the Original Medicare Plan. If you get your Medicare health care through a managed care plan (like an HMO) or a Private Fee-for-Service Plan, Medicare claims are not filed. Medicare pays these private insurance companies a set amount every month. 

For more information, call 1-800-Medicare (1-800-633-4227) or click here for Medicare services online. Return to Top
Although I am able to walk, I have a difficult time walking long distances. Would Medicare allow payment for a wheelchair or Power Operated Vehicle (POV)?
Medicare wheelchair and POV coverage guidelines indicate that in order to allow payment for a wheelchair, a person with Medicare must be bed or chair-confined without the use of a wheelchair. 

Furthermore in terms of POV all of the following criteria must be met: 

  • You require a wheelchair to maneuver in your home
  • You cannot operate a manual wheelchair
  • You can safely operate the controls of a POV 
  • You can transfer safely to and from a POV and have adequate trunk stability to safely ride in a POV 

You need a prescription from your physician prior to purchasing the POV, and the physician and supplier must complete a Certificate of Medical Necessity (CMN). Return to Top