Medicare  
                        The official U.S. government 
    & You Medicare handbook 
    2021
          What’s  
          new?
          Coronavirus disease 2019 (COVID-19)
          Medicare is committed to getting you the information you need on COVID-19. For 
          the most up-to-date information on coverage and benefits, visit Medicare.gov or 
          call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
          Lower out-of-pocket costs for insulin
          If you join a Medicare drug plan that participates in the “Part D Senior Savings 
          Model,” you could save hundreds of dollars each year in out-of-pocket costs for 
          insulin. See page 84.
          Medicare Advantage & End-Stage Renal Disease (ESRD)
          If you have ESRD, you can join a Medicare Advantage Plan during Open 
          Enrollment (October 15–December 7, 2020). Your plan coverage will start  
          January 1, 2021. See page 59.
          Acupuncture for back pain
          Medicare now covers up to 12 acupuncture visits in 90 days for chronic low back 
          pain. See page 30.
          Telehealth & other virtual services 
          Telehealth benefits allow you to get medical or health services that generally 
          occur in-person (like office visits and consultations) from a doctor or other health 
          care provider whos located elsewhere using real-time interactive audio and video 
          technology (see page 48). Medicare also covers certain virtual services, like E-visits 
          (see page 39) and virtual check-ins (see page 50).
          Get help with your Medicare coverage choices 
          Visit Medicare.gov/plan-compare to shop for and compare health and drug plans 
          that meet your needs. You can also enter your drugs to get more accurate costs 
          for plans in your area. 
          Compare health care providers & services
          Visit Medicare.gov to find and compare doctors, hospitals, nursing homes, and 
          other health care services near you. You can now get contact information, quality 
          ratings, and other information in a centralized place. 
           Important!   This year its more important than ever to get a flu shot to protect 
                        your health and your familys. See page 40.
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            Contents
            Get started ........................................................................................................................4
            What are the parts of Medicare? ............................................................................. 5
            Your Medicare options ................................................................................................. 6
            Original Medicare vs. Medicare Advantage ....................................................7–8
            Get the most out of Medicare ...................................................................................9
            Index of topics ............................................................................................................... 10
            Section 1: 
            Signing up for Medicare .............................................................................................15
            Section 2: 
            Find out if Medicare covers your test, item, or service ...............................25
            Section 3: 
            Original Medicare .........................................................................................................53
            Section 4: 
            Medicare Advantage Plans & other options .....................................................57
            Section 5: 
            Medicare Supplement Insurance (Medigap) ......................................................71
            Section 6: 
            Medicare drug coverage (Part D) ..........................................................................75
            Section 7: 
            Get help paying your health & drug costs .........................................................87
            Section 8: 
            Know your rights & protect yourself from fraud .............................................93
            Section 9: 
            Get more information ...............................................................................................105
            Section 10: 
            Definitions ......................................................................................................................117
     4
              Get started
              If you’re new to Medicare:
              •  Learn about your Medicare coverage options. There are 2 main ways to get 
                your Medicare coverage„Original Medicare (Part A and Part B) and Medicare 
                Advantage. See the next few pages to learn more.
              •  Find out how and when you can sign up. If you dont have Medicare  
                Part A or Part B, see Section 1, starting on page 15. If you dont have Medicare 
                drug coverage (Part D), see Section 6, starting on page 75. There may be 
                penalties if you dont sign up when youre first eligible. 
              •  If you have other health insurance, see pages 21–22 to find out how your other 
                insurance works with Medicare.
              If you already have Medicare:
              •  Review your Medicare health and drug coverage and make changes if it no 
                longer meets your needs, or if you could lower your out-of-pocket costs. You 
                dont need to sign up for Medicare each year, but you should still review your 
                options.
              •  Mark your calendar with these important dates! This may be the only chance 
                you have each year to change your coverage.
                       October 1, 2020     Start comparing your current coverage with other 
                                           options. You may be able to save money or get 
                                           extra benefits. Visit Medicare.gov/plan-compare.
                       October 15 to       Change your Medicare health or drug coverage for 
                       December 7, 2020    2021, if you decide to. This includes changing to 
                                           Original Medicare, or joining or changing a Medicare 
                                           Advantage Plan.
                       January 1, 2021     New coverage begins if you made a change. If you 
                                           kept your existing coverage and your plans costs or 
                                           benefits changed, those changes also start on this 
                                           date.
                       January 1 to        If you’re in a Medicare Advantage Plan, you 
                       March 31, 2021      can change to a different Medicare Advantage 
                                           Plan or switch to Original Medicare (and join a 
                                           separate Medicare drug plan) once during this 
                                           time. Any changes you make will be effective the 
                                           first of the month after the plan gets your request. 
                                           See page 59.
                  See pages 5–9 for an overview of your Medicare options.