Calling 1-800-MEDICARE? Here’s What to Expect

1-800-MEDICARE (1-800-633-4227) is the official Medicare phone number that beneficiaries may call for help with their coverage, claims, payments and more. You may call 24 hours a day, 7 days per week, and help is available in both English and Spanish as well as for the hearing impaired (the TTY Medicare toll-free line is 1-877-486-2048).

Woman using the phone while on her laptop computer

The prompts, questions and menus that you hear when calling the Medicare phone number can change at different times of the year for different reasons. Listed below are the standard prompts and information that are presented to callers as of November, 2018.

Using 1-800-MEDICARE

For help with...

Call...

Claim status

1-800-MEDICARE and press “1

or say “Claim status

Coverage and benefits

1-800-MEDICARE and press “2

or say “Coverage and benefits

Premium payments

1-800-MEDICARE and press “3

or say “Premium payments

Preventive exams

1-800-MEDICARE and press “4

or say “Preventive exams

Deductibles

1-800-MEDICARE and press “5

or say “Deductible

Anything else related to your Medicare insurance

1-800-MEDICARE and press “0

or say “Help me with something else

or press “6

or say “Agent

Replacing a lost Medicare card

1-800-772-1213

Medicare questions for the hearing impaired

1-877-486-2048

Social Security

1-800-772-1213

Below is what you can typically expect when you call 1-800-MEDICARE, as well as some of the various topics for which you might call the federal Medicare helpline.

Question about a processed or denied Medicare claim

When you call the Medicare phone number, you will be asked whether you are calling about a processed or denied Medicare claim. If you say “yes,” you will be routed to a representative who will help you with your claim. If you answer “no,” you will be routed to the main directory.

The 1-800-MEDICARE main directory

The main directory is where you will be asked what you are calling about. You can either say any of the prompts out loud as listed above, or you can simply press the number associated with each menu option: 

  1. Claim status
  2. Coverage and benefits
  3. Premium payments
  4. Preventive exams
  5. Deductibles

If none of the above options apply to your need, you can say “help me with something else” or “agent,” or you can press the number 0 or the number 6.

Claim status (press “1”)

Some people may call 1-800-MEDICARE to find out about the status of a filed claim or the reason a claim may have been denied.

While you can always call Medicare to check on a Medicare claim status, you can also do so by visiting MyMedicare.gov. You will need to set up an account for the website, which will allow you to access certain information about your Medicare coverage:

  • You can check the status of any Medicare Part A or Part B claim, usually within 24 hours after the claim is processed.
  •  
  • You can check your Medicare Summary Notice (MSN), which shows all of your Medicare coverage and billing activity for the previous three months.
  •  
  • You can download and save your Medicare Part A and Part B claims information.

For information about claims filed for Medicare Advantage or Medicare Part D coverage, contact your plan provider directly. 

Coverage and benefits (press “2”)

Medicare Part A and Part B (also call Original Medicare) cover a wide range of services, so it’s understandable why so many beneficiaries call 1-800-MEDICARE with questions about whether or not a particular service or health care product will be covered by Original Medicare.

Speaking to a representative about what Medicare covers can certainly be helpful, and Medicare has also made much of this information available online.

You can visit the "Your Medicare Coverage" page of Medicare.gov and simply type in the test, item or service that you are curious about in the search box. You can then click “Go” to find out what information may be available on the Medicare.gov website.

Contact your plan directly with any questions about Medicare Advantage or Medicare Part D coverage or benefits.

Premium payments (press “3”)

Calling with a question about your Medicare premiums? Here’s some general information about Medicare costs that may be helpful:

Most people receive “premium-free” Part A of Medicare. This can include: 

  • Anyone who worked and paid Medicare taxes for 40 quarters (10 years)
  •  
  • Those who receive or are eligible to receive retirement benefits from Social Security or the Railroad Retirement Board
  •  
  • People who worked in Medicare-covered government employment (or have a spouse who did)
  •  
  • Anyone who receives disability benefits or has End-Stage Renal Disease and meets certain requirements

If you do not meet the above requirements, your Medicare Part A premium can cost up to $437 per month in 2019, depending on how long you have worked and paid into Social Security.

The standard premium for Medicare Part B is $135.50 in 2019. Some people (such as those who have recently reported higher incomes) may pay more. 

Here you can find a more detailed breakdown of what you can expect to pay for Medicare Part A and Part B costs.

For any questions about Medicare Advantage plan premiums or Medicare Part D plan premiums, contact your plan directly.

Preventive exams (press “4”)

You might call 1-800-MEDICARE to find out if a particular preventive exam will be covered. Just as you can with other Medicare coverage or benefits questions, you can use the Medicare coverage finder to search for benefit information pertaining to any preventive exam.

For additional help, the Centers for Medicare & Medicaid Services (CMS) released a comprehensive guide to Medicare’s preventive services. The guide is free to view and contains helpful information about all of the preventive exams and screenings covered by Medicare.

Deductibles (press “5”)

You might also call the Medicare phone number to inquire about your annual Medicare deductibles and to find out how close you are to meeting the deductibles.

The Medicare Part A deductible does not operate on a yearly basis. Rather, the deductible is based on a benefit period, which can reset throughout the year. The Medicare Part A deductible is $1,364 per benefit period in 2019.

The deductible for Medicare Part B is $185 per year for 2019. 

Deductibles for Medicare Advantage and Medicare Part D plans will vary from one plan to the next and can change every year.

Before you call the Medicare phone number

Before calling 1-800-MEDICARE, have your Medicare card ready in case the representative needs to know your Medicare number. If you are calling with a question about a claim or a bill, have the bill or the Explanation of Benefits (EOB) handy for reference.

It can also be helpful to keep a pen and paper ready to write down any important information your Medicare representative may share, such as additional phone numbers, dollar amounts, dates and more.

Is there a Medicare Advantage phone number?

Medicare Advantage plans (also called Medicare Part C) are offered by private insurance companies, so you may want to call your plan provider directly with any questions about your Medicare Advantage plan. For general information about Medicare coverage, you can still call 1-800-MEDICARE, even if you are enrolled in a Medicare Advantage plan.

Are you considering switching to a Medicare Advantage plan, changing your current Medicare Advantage plan or enrolling in Medicare Advantage for your first time? A licensed insurance agent can help answer any questions you have about Medicare Advantage plans and can help you compare plans that may be available in your local area.

Speak with a licensed insurance agent today by calling   TTY Users: 711 24 hours a day, 7 days a week.

Copyright © 2018 TZ Insurance Solutions LLC. All rights reserved.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.