Sometimes, it may be preferable to speak with someone at Medicare. The Medicare phone number is 800-MEDICARE, or 800-633-4227. A deaf or partially deaf person may call 877-486-2048.
An individual may call Medicare with questions about coverage, medical records, claims, billing, and expenses.
In addition to speaking with Medicare over the phone, individuals may acquire much of the information they need through two websites.
This article provides an overview of Medicare, explains what to expect when calling Medicare, and discusses alternate contact methods and contact methods for people with specific needs. Lastly, it examines non-Medicare sources for Medicare information.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare is the federal insurance program for individuals who are aged 65 and older, along with some younger people who have specific health conditions. It also provides coverage for a person of any age with end stage renal disease.
Original Medicare
Original Medicare consists of Part A and Part B.
Part A covers inpatient hospital care, skilled nursing facility care, and hospice stays.
Part B provides coverage for outpatient services, such as visits to a doctor’s office, durable medical equipment, therapeutic services, and some limited prescription medication.
Medicare Advantage
Medicare Advantage, or Medicare Part C, combines the benefits of original Medicare under one bundled plan.
These plans must provide all of the coverage of Medicare parts A and B, but may also include extra benefits.
Private insurance companies administer Medicare Advantage plans.
Part D (prescription drug plans)
Medicare Part D is also known as a prescription drug plan (PDP).
PDPs are also administered by private insurance companies, and are available as standalone plans alongside original Medicare.
Most Medicare Advantage plans include coverage for prescription drugs.
Medigap
Medigap is Medicare supplement insurance that helps pay the out-of-pocket expenses associated with parts A and B, such as deductibles, copayments, and coinsurance.
Medigap plans are available from private insurers and can be held alongside original Medicare.
Medigap policies do not work alongside Medicare Advantage.
The Medicare hotline, 800-MEDICARE (800-633-4227), is available 24 hours per day, 7 days per week.
It is an automated phone system, which will take a caller through a step-by-step process. Once the automated system is complete, a caller either receives the information they were looking for, or they will connect with a live agent.
After dialing the number, if a person wishes to speak to a Medicare agent in Spanish, they may indicate their preference.
Next, the system asks for the general reason for the call, and an individual may choose from several options, such as claims or coverage inquiries.
When calling, a person should have their Medicare card in hand. The automated phone system will ask a person to either say or key in their account number.
An individual may use the phone number to get a wide range of information that may include:
- coverage
- medical records
- claims
- billing
- expenses
Aside from contacting Medicare by phone, a person can contact them by visiting either of two websites.
MyMedicare website
After someone registers for MyMedicare, they may do the following:
- Sign up to download the Medicare & You handbook.
- Update their personal information, such as allergies and medical conditions.
- Manage their list of prescribed medications.
- Keep track of out-of-pocket expenses, such as the Part B deductible.
- Track Medicare claims.
- Maintain a list of favorite providers.
- View Medicare Summary Notices.
Medicare website
If a person needs general information instead of personal information about their Medicare account, they can do the following on the Medicare website:
- locate healthcare providers who participate with Medicare
- obtain Medicare appeal information
- find out what Medicare covers
- get detailed information about Medicare prescription drug and health plans in a certain area
- find out the quality of care to expect from health plans and healthcare providers
- read Medicare publications
Individuals with particular needs may not be able to access the information they seek by calling the Medicare telephone number or visiting Medicare websites. However, there are alternate contact methods.
A deaf or partially deaf person may call 877-486-2048. They may also request the relay service, which involves using an assistant to send messages back and forth.
A person with low vision may ask for information in large print, Braille, or data/audio files.
Someone who wishes to have information in an accessible format may:
- email altformatrequest@cms.hhs.gov
- call 800-MEDICARE (800-633-4227)
- send a fax to 844-530-3676
In addition, they may request the accessible format by sending a letter to the below address:
For the attention of Customer Accessibility Resource Staff
Centers for Medicare & Medicaid Services
Offices of Hearings and Inquiries (OHI)
7500 Security Boulevard, Mail Stop S1-13-25
Baltimore, MD 21244-1850
When making the request, a person should provide the following information:
- name
- phone number
- mailing address
- the type of information needed
Sometimes, a person may need to go to non-Medicare sources to get Medicare information or take certain actions.
These sources include Social Security, the Railroad Retirement Board, and the Benefits Coordination and Recovery Center, as well as an individual’s health plan or their state Medicaid office.
Social Security (SSA)
The phone number for SSA is 800-772-1213 or 800-325-0778 for a deaf or partially deaf person. Alternatively, a person may visit their website.
Someone may contact SSA to do the following:
- enroll in Medicare Part A, Part B, or both
- check Medicare eligibility
- replace a Medicare card
- report a death
- change personal information
Railroad Retirement Board (RRB)
An individual may contact their local RRB office at 877-772-5772. A deaf or partially deaf person may call 312-751-4701.
Someone with railroad benefits can check the same information and make the same notifications and changes as those contacting SSA. They can also enroll in Medicare or check Medicare eligibility.
Benefits Coordination and Recovery Center
Contact phone numbers for the Benefits Coordination and Recovery Center include 855-798-2627 and 855-797-2627 for a deaf or partially deaf person. A person may call this agency to report that their private insurance is either ending or beginning.
Medicare Advantage, Part D, and Medigap plans
Private insurance companies administer Medicare Advantage, Part D, and Medigap plans. People who have questions about their policy should call their plan provider’s phone number or visit the website listed on their membership card.
State Medicaid office
To contact their state Medicaid office, a person may call 800-MEDICARE (800-633-4227) and speak the word “Medicaid.” A deaf or partially deaf person may call 877-486-2048.
Medicaid is there for those seeking help with paying out-of-pocket Medicare expenses.
Individuals may call the Medicare phone number, 800-633-4227, or visit Medicare websites to get the information they need. Alternate contact methods are available for individuals with specific needs.
Sometimes, a person may need to contact non-Medicare sources to get information or take certain actions. Primary examples of these sources include Social Security and the private insurance companies that administer Medicare Advantage, Medicare Part D, and Medigap plans.