Medicare in Illinois

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There were over 2 million people (2,057,571) enrolled in Medicare in Illinois as of 2015, according to the Centers for Medicare and Medicaid Services (CMS).

Medicare Part A (hospital insurance) and Part B (medical insurance) make up Original Medicare. Original Medicare includes only limited prescription drug coverage; Part A covers prescription drugs used in your treatment as a hospital inpatient, while Part B may cover certain drugs you receive as an outpatient – generally medications you wouldn’t administer yourself.

So, what if you need prescription drug coverage in Illinois? You can enroll in a stand-alone Medicare Part D Prescription Drug Plan. Available from private companies that contract with Medicare, these plans help cover prescription drug costs. Each Medicare Prescription Drug Plan has its own formulary, which is a list of covered drugs. The formulary may change at any time. You will receive notice from your plan when necessary.

You may have another Medicare plan option. The Medicare Advantage (Medicare Part C) program lets you get your Original Medicare coverage through a private, Medicare-approved insurance company. Medicare Advantage plans provide the same coverage as Medicare Part A and Part B, except for hospice care, which is covered by Medicare Part A even when you have a Medicare Advantage plan. Extra benefits such as dental and vision services are often included, depending on the plan. And most Medicare Advantage plans include prescription drug coverage, so you can get all your Medicare benefits in a single plan. You do need to continue paying your Medicare Part B premium, however, along with any premium the Medicare Advantage plan may charge.

You might want to learn about Medigap (Medicare Supplement) plans if you decide to stay with Original Medicare. Click here to read about Medigap.

Medicare resources in Illinois

Illinois Department on Aging: This agency provides aging and health related services to help elderly citizens in Illinois maintain their independence. By helping both elderly citizens and their families, the Department of Aging aims to improve life quality for current and future generations. The department’s State Health Insurance Program (SHIP) program can answer questions about various Medicare issues, including eligibility and enrollment. Also, the Department on Aging can help Medicare beneficiaries seek financial help with the Medicare Savings Program.

A few of the programs offered by the Illinois Department on Aging include:

  • Legal services and case management
  • Community Care Program
  • Illinois Family Caregiver Support Program
  • Foster Grandparents Program
  • Retired Senior Volunteer Program
  • Adult Protective Services Program
  • Community Services and Training

City of Chicago Senior Services: This is the Senior Services Area Agency on Aging, which offers programs to aid older Chicago citizens, both healthy and homebound. There are six regional senior centers that offer services in fitness, health education, and recreation in Illinois. The Senior Services also partners with other non-profit groups that offer similar opportunities. Some of the services they offer include assisted living information, benefits checkups, information and assessment for senior services, well-being checkups, caregiving assistance, and senior health insurance programs.

AgeOptions: This non-profit organization serves older adults in the Cook County area of Illinois with a bounty of programs and services. This agency connects older citizens to those who care for them, and provides resources and options for independent living. AgeOptions also serves as the area’s Senior Medicare Patrol (SMP) program to help fight Medicare fraud and abuse through detection, reporting, and consumer protection services. Medicare beneficiaries in Illinois can find publications, better-living programs, and a host of additional aging services through AgeOptions.

Medicare statistics in Illinois

Here are some statistics from CMS regarding Medicare in Illinois as of 2015:

  • There were 1,436,768 with Medicare prescription drug coverage.
  • 1,051,092 of the above were enrolled in a stand-alone Medicare Part D Prescription Drug Plan, while 385,676 were enrolled in a Medicare Advantage Prescription Drug plan.
  • CMS estimates that 90% of the beneficiaries listed above have access to Medicare Prescription Drug Plans with lower premiums in 2016 than they paid in 2015.

Statistical data from the Centers for Medicare & Medicaid Services, “On its 50th anniversary, more than 55 million Americans covered by Medicare” as of July 28, 2015; and “2016 MA Part D Landscape State-by-State Fact Sheet” as of September 21, 2015.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

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