Medicare
Did you know that 4 out of 5 patients who requested assistance from Celgene Patient Support® received their medication? We
have helped more than 25,000 patients since 2007.
Your dedicated Celgene Patient Support® Specialist will help you explore the benefits available to you. For many
patients, this includes Medicare. You will find an overview of Medicare in this section and what you need to know about finding
the right plan for you. Click on the links below to learn more:
› What is Medicare?
› Medicare plans
› What to know about finding a Medicare Part D plan
› Medicare links
What is Medicare?
Medicare is government-sponsored health insurance for:
- People age 65 or older
- People under age 65 with certain disabilities
- People of any age with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant)
Medicare is different from Medicaid; however, you may be eligible for both programs. This is called dual eligibility.
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Medicare plans
There are different programs within Medicare: Parts A, B, C, and D. The chart below gives general information about
these programs. Please call Celgene Patient Support® at 1-800-931-8691 to better understand your Medicare benefits.
| Medicare Coverage |
Part A
Hospital Insurance |
Part B
Medical Insurance |
Part C
Medicare Advantage Plans |
Part D
Prescription Drug Coverage
For an example of how Medicare Part D works, click here. |
| What is Covered |
- Hospital stays
- Home health services
- Hospice care
- Nursing facility care
|
- Doctors services
- Outpatient care
- Home health care
|
- Includes Part A, Part B, and usually prescription medications
|
|
| Enrollment |
- You are automatically enrolled at age 65 if you get benefits from Social Security
- If you are age 65 or older and are not getting Social Security, you will need to sign up
for Part A
- If you are under the age of 65 and are disabled, you are automatically enrolled after you get disability benefits from Social Security
|
- You are automatically enrolled at age 65 if you get benefits from Social Security
- If you are age 65 or older and are not getting Social Security, you will need to sign up
for Part B
- If you are under the age of 65 and are disabled, you are automatically enrolled after you get disability benefits from Social Security
|
- You can join if you:
| - | Live in the service area of the plan |
| - | Do not have end-stage renal disease |
- Enrollment is only available during certain times
- Enroll through private insurance companies
|
- You can join if you:
| - | Have Part A and/or Part B |
| - | Live in the service area of the plan |
- Enrollment is only available at certain times
- Enroll through private insurance companies
|
| Patient Financial Responsibility |
- No premium in most cases
- Deductible applies for hospital care, mental health care, and nursing home care
- You pay 20% of Medicare-approved durable medical equipment
- You pay 5% of Medicare-approved costs for respite care. (This care is provided by another caregiver to give your usual caregiver rest.)
- Prescription medications for managing pain and symptoms in hospice care requires a co-payment of up to $5 per drug
|
- Monthly premium
- Deductible for all services
- Co-payments apply for tests, screenings, prescription medications, and services given at the hospital in an outpatient setting
- You pay 20% of most doctor visits
- You pay 20% of Medicare-approved durable medical equipment in home care
- You pay 45% coinsurance of Medicare-approved amount for mental health care
|
|
- Different plans have different premiums, deductibles, and cost-sharing (co-payments and/or coinsurance)
- Not all medications are covered by the plan. You may have to pay 100% out-of-pocket for medications not covered
|
This chart is based on information from Medicare & You 2010.
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What to know about finding a Medicare Part D plan
- Identify and select a plan in your local area that fits your needs
- Plans can differ by cost, drug coverage, and what pharmacies are used, so it is best to compare plans to see which one is right for you
- Each year, you can review your plan choices for the upcoming year. You can either rejoin your current plan or choose a
new one. The open enrollment period begins on November 15 and ends on December 31 of each year
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Medicare links
› General information about Medicare
› Find and compare Medicare Health Plans
› Medicare Prescription Drug Plan Finder
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Your Celgene Patient Support® Specialist can help you navigate your Medicare coverage.
For more help, contact Celgene Patient Support® at 1-800-931-8691. Your Celgene Patient
Support® Specialist is a dedicated, central point of contact who
will work on your behalf to coordinate resources available to you. Together we will exhaust all
options to help you get the information and support you need.
Celgene Patient Support® Checklist
Your Celgene Patient Support® Specialist may need this information when helping you.
Download Checklist
Need more help?
Contact us at 1-800-931-8691 or send us an e-mail.