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IS ENROLLMENT IN MEDICARE AUTOMATIC AT 65?

Dear Do-It Man:

I wondered if you could answer a few questions about Medicare. My mom will turn 65 in Feb., 1993. Will she be automatically placed on Medicare?Can you name sources that have information about Medicare supplements? How much do these policies cost and what do they cover?

- R.J., Salt Lake City. If your mother is already receiving Social Security benefits, then she will automatically be enrolled in both Part A (hospital) and Part B (doctor) of Medicare when she turns 65.

If she is not drawing Social Security benefits at the time she turns 65, she must file an application with her local Social Security office.

Not everyone is eligible for Medicare. A person's eligibility for Medicare depends on his (or her) eligibility for Social Security benefits.

And a person's eligibility for Social Security benefits depends on whether or not he (or she) was employed for the required length of time. The time requirement varies depending on the year the applicant was born.

For example, a person such as your mother, who turns 65 in 1993, needs to have worked for 10 years to be eligible for Social Security and Medicare.

A person is also eligible for Social Security/Medicare based on his or her spouse's eligibility.

For information on Social Security and Medicare benefits you may call this toll-free number, 1-800-772-1213, or contact your local Social Security office.

The Salt Lake area has two Social Security offices. One is downtown in American Towers at 46 W. 300 South, Suite 100. The other is in Murray at 6065 S. 300 E.

There are also offices in Provo and Ogden.

Federal legislation that went into effect July 1 of this year requires that a Medicare supplement policy (also referred to as Medigap policy) must include the following benefits:

It must cover the Part A (hospital) co-insurance amount for the 61st thru 90th days of hospitalization of any inpatient hospital stay at a rate of $163 per day.

It must cover the co-insurance amount of $326 per day for each day after the 90th day for a full 60 days.

After that, it must provide full coverage of an inpatient hospital stay for up to 365 additional days.

In the case of a transfusion, it must cover the reasonable cost of the first three pints of blood. And it must cover the 20 percent co-insurance amount for Part B (doctor's services, outpatient care, etc.) after the annual $100 deductible is met.

The Health Care Financing Administration provides a pamphlet that explains all this and more. For a free copy of "A Guide to Health Insurance for People with Medicare," call 1-800-772-1213. Or you can pick one up at any Social Security office.

To find out the names of insurance companies that sell Medicare supplement policies in Utah, contact the Utah State Insurance Department, room 3110, State Office Building (the one behind the capitol), or call 538-3800.

As is the case in buying any kind of insurance, it's important to shop around and compare benefits and prices.

There are 10 different Medicare supplement policies. Their benefits do not differ from one company to another.

Premiums vary, depending on the type of policy and the person's age. They can range anywhere from $80 to $250 a month.