There are a few different ways a beneficiary can go about contacting Medicare, such as through the Medicare phone number, online chat, or via mail address. Medicare agents are available 24⁄7 to speak with beneficiaries about their questions, comments, or concerns related to Medicare benefits, Medicare coverage for various services, Medicare costs, and more.
Prior to speaking with a Medicare agent, beneficiaries should be sure to have their Medicare card and all relevant documents (claim or plan information) near them.
Other institutions such as the Social Security Administration or the Railroad Retirement Board may also provide helpful information on Medicare insurance.
Supplemental plans such as Medicare Advantage (MA) plans, Part D plans, and more are operated by private insurance companies and therefore require different methods of communication than Original Medicare.
Medicare is the Federal Government’s health insurance plan for those aged 65 and older that have paid Medicare taxes for at least ten years. In certain cases, those younger than 65 may also qualify for health care if they live with certain medical conditions. Most beneficiaries are automatically enrolled in Medicare Part A during the initial enrollment period that begins three months prior to their birth month. However, for Part B coverage, beneficiaries must enroll separately and pay a monthly premium. Medicare also provides Part C (Medicare Advantage plans) and Part D prescription drug plans through partnerships with private insurance companies.
For any information related to health insurance, even employer-sponsored health insurance not related to Medicare, it’s valuable for a beneficiary to contact their insurance provider for specific plan details. This article details all there is to know about contacting Medicare services and other pertinent institutions with Medicare information.
When it comes to contacting Medicare, there are a few different approaches a beneficiary can take. Contact Medicare by:
Calling by Telephone
Speaking with an Agent via Live Online Chat
Sending a Request via Mail
Medicare Contact Information
Licensed Medicare insurance agents are available 24 hours a day, 7 days a week via the Medicare phone number: 1-800-MEDICARE (1-800-633-4227). TeleType (TTY) users can call 1-877-486-2048 to speak with a representative. In addition to their round-the-clock call centers, Medicare agents are also available via a live online chat 24⁄7.
If a beneficiary wishes to mail information or request help via mail, they can use the following address to reach Medicare agents:
Medicare Contact Center Operation
PO Box 1270
Lawrence, KS 66044
Medicare Call Menu
When a beneficiary reaches the call menu, they will first be prompted to answer if they’re calling about a processed or denied claim. If they are calling about a claim, they should respond “Yes”; if not, they should respond “No.” Answering “Yes,” will lead to the prompter asking for the beneficiary’s date of birth and other identifying information. Answering “No,” will trigger the following menu options to be read to ensure one’s call is directed accordingly:
Press 1 for Claim Status: To uncover a claim status or to discuss issues with a particular claim, this is the number a beneficiary should press.
Press 2 for Coverage & Benefits: If a beneficiary is seeking assistance with plan options, Medicare Advantage (MA) plan enrollment, Part D (prescription drug) enrollment, or information on a plan’s covered services, then they should press 2.
Press 3 for Premiums: For more information on various premiums and what a beneficiary is responsible for with premium payments, they should press 3.
Press 4 for Preventive Exams: This sector is to learn more about the preventive procedures covered by Medicare, such as annual wellness exams, mammograms, cancer screenings, and more.
Press 5 for Deductible: If a beneficiary is seeking more information on Medicare’s annual deductibles, how close one is to meeting their deductible, or information on the benefit periods linked to deductibles, they should press 5.
Press 6 for Other Services: If none of the following sections apply to the information a beneficiary is seeking, they should press 6 to speak with an operator who can direct their specific request.
Press 0 to Speak With an Agent: At any time during the call, a beneficiary can press 0 to speak with an agent.
Calling Medicare With Limited Hearing Ability
Users with limited hearing ability can call 1-877-486-2048 to access teletype. Furthermore, to request Medicare information in more accessible formats (e.g. braille, large print, audio files, relay services, and more), one should email [email protected].
Preparing for a Call With Medicare
Prior to speaking with a Medicare agent, either via phone or live chat, a beneficiary should have a few things prepared:
Medicare Card: Having one’s Medicare Card and membership number closeby is crucial as it’s likely an agent will ask a beneficiary for this information once they’re on the phone.
Claim Information: If a patient is calling to discuss their claim or any other information related to their insurance plan (e.g. deductible, premium, etc.), they should have that information and paperwork handy prior to the call.
Writing Utensils: In case a patient wishes to take notes during their call, it can be useful to have a pen and paper or a cell phone nearby to record anything that seems valuable.
Note: Beneficiaries are always able to request for a written transcription of the call to be sent to them afterwards.
Other Methods of Finding Medicare Information
While speaking with a Medicare agent is the most direct way to discover information regarding one’s plan or claim, there are a few other places one can seek out Medicare information as well.
The main Medicare website offers a lot of information that’s substantial for answering general inquiries such as:
Medicare appeal information
Provider locator services
General list of services Medicare covers
Plan locator services (MA plans, Part D plans, Medigap plans, etc.)
Medicare blog topics
Beneficiaries that are already enrolled in a Medicare plan are also able to access their “MyMedicare” site from this online source. MyMedicare shares all personal plan information with beneficiaries such as:
List of current or past medications
Medicare summary notices
Current or past medical records
Out-of-pocket expenses such as deductibles or co-payments
Medicare & You handbook that covers Medicare insurance at length
Contact Social Security Administration (SSA)
A beneficiary’s Medicare insurance is closely linked to their Social Security coverage since it relates to their Medicare eligibility and their Part B premium is often deducted from their SS payment. Common reasons to contact SSA include:
Enroll in Medicare (Part A or Part B)
Confirm Medicare Eligibility
Replace a Medicare Card
Report a Death
Alter Personal Information
Beneficiaries can contact Social Security by calling 800-772-1213 or 800-325-0778 for those needing TeleType.
Contact Railroad Retirement Board (RRB)
Those with Railroad Retirement benefits may contact their local RRB office to uncover information regarding Medicare insurance as well. Common reasons to contact the Railroad Retirement Board are the same as those listed above for contacting the SSA.
To reach a local RRB office, call 877-772-5772 or 312-751-4701 for TeleType users.
Contacting Medicare Advantage Providers
Medicare Advantage plans are provided through private insurance companies that correspond with Medicare but are operated separately from the Federal Medicare Program. Common MA plan providers include:
Aetna: Call 1-855-335-1407 for MA plan questions; call 1-800-358-8749 for Part D prescription drug plan questions.
Blue Cross Blue Shield: Call 877-774-8592.
Health Partners: Call 1-866-901-8000 or 1-877-454-8477 for TeleType users.
Kaiser Permanante: Call 1-866-973-4584.
Seniors Preferred: Call 800-394-5566.
If a beneficiary does not see their MA plan provider listed above, they should look online to find the contact information for their provider.
For any information regarding Medicare Advantage plans, a beneficiary should contact a licensed insurance agent from their insurance company.
Contacting Medicare Part D Providers
Medicare Part D prescription drug plans are provided through private insurance companies that correspond with Medicare but are operated separately from the Federal Medicare Program. For any information regarding Part D plans, a beneficiary should contact a licensed insurance agent from their insurance company.
Contacting Medigap Providers
Medigap (MedSupp) plans are provided through private insurance companies that correspond with Medicare but are operated separately from the Federal Medicare Program. For any information regarding Medigap plans, a beneficiary should contact a licensed insurance agent from their insurance company.
Contacting Centers for Medicare & Medicaid Services (CMS)
Patients that qualify for both Medicaid and Medicare may be eligible to enroll in what is called a “Dual Eligibles” plan. In a Dual Eligibles plan, Medicare acts as the primary insurance while Medicaid acts as the supplementary insurance.
To contact the Centers for Medicare & Medicaid Services (CMS) regarding Medicaid eligibility, one should call 800-465-3203 or 800-692-2326 for TeleType users.
Note: For more information on contact information for CMS, visit this source.