Welcome to the ultimate guide to Medicare in Chicago! The Windy City has no shortage of top-tier hospitals and doctors, but you could miss out on some of the best ones if you don’t have the right insurance.
If you’re eligible for Medicare in Illinois (or if you think you might be eligible but aren’t sure) and you live in the greater Chicago area, this is the guide for you. We’ll go over everything you need to know about Medicare in Chicago, from what types of plans are available to which doctors accept them!
Medicare Plan Finder has licensed Medicare agents in the Chicago area ready to help you and your loved ones navigate the confusing world of Medicare. If at any time while reading this guide you think you’re ready to speak with an agent, just click here or call 833-438-3676.
Since Medicare is a federal program, the basics are the same in every state. Whether you live in Chicago or in more rural parts of Illinois, Medicare is the same. However, private plans, resources, and doctor networks can be different depending on where you live.
We’ll start by going over the basics of Original Medicare, meaning the federal program available in all 50 states and U.S. territories.
Original Medicare includes Part A and Part B. Part A includes inpatient hospital, hospice, skilled nursing facility, and home health coverage. Part B includes outpatient care, preventative services (like your annual wellness visit), outpatient mental health, lab tests/X-rays, emergency transportation, and durable medical equipment.
Your costs for Medicare Part A and Part B in Chicago will depend on what savings you qualify for. Premiums, deductibles, coinsurance, and copayments may apply.
If you were employed and paid Medicare taxes for at least 40 quarters (about ten years), or if you get retirement benefits from Social Security or the Railroad Retirement Board, you may have premium-free Part A (premium-free does not necessarily excuse you from other costs). If you only worked for between 30 and 39 quarters, your Part A premium will be $240/month in 2019. If you worked for less than 30 quarters, your Part A premium will be $437/month in 2019.
The standard Part B premium in 2019 is $135.50. Qualifying for premium-free Part A in Chicago does not mean that you will qualify for premium-free Part B. If you have a high income, your Part B costs may be higher than $135.50.
Next, let’s skip ahead a bit to talk about Part D. Part D refers to private prescription drug plans. Original Medicare does not cover prescription drugs, so Part D can be a valuable add-on. You may also hear Part D called “PDPs,” or “Prescription Drug Plans.”
Before you select a Part D plan, make a list of all the prescriptions you need coverage for to make sure that the plan you choose can cover them. Each plan will come with a ‘formulary,” a list of covered drugs.
Medicare Part D plans generally only cover prescription drugs, nothing else. Plans can vary greatly in cost based on the types of drugs that are covered and how much coverage you have. If you’re looking for an additional plan that includes more benefits other than just prescription drugs, Part C (Medicare Advantage) may be best for you.
Now that you’ve heard about Parts A, B, and D, let’s fill in the blanks with Part C. While Part D only covers prescription drugs, Part C plans are able to cover a wide variety of health benefits. Like Part D, Medicare Advantage plans are private. If you have Medicare Advantage (or Part D, for that matter), you’ll still have to pay your Original Medicare bills. These private plans would be additions to your current coverage.
Medicare Advantage plans can include benefits like prescription drugs, dental, vision, meal delivery, non-emergency medical transportation, physical fitness, and more.
Not all Medicare Advantage plans include a prescription benefit, but you can’t have both Part D and Part C at the same time.
Medicare Supplements, often nicknamed “Medigap,” are a different type of private Medicare plan. Medigap plans don’t typically include health benefits. Instead, they offer additional financial coverage. By paying a Medigap premium every month, you could save on your deductibles, copayments, and coinsurance.
Hospitals and Doctors in Chicago Who Accept Medicare
Hospitals, doctors, and specialists of any kind can choose whether or not they want to accept Medicare (and they can change their decision at any time). Using Medicare.gov’s provider search tool, we were able to deduce that there are over 50 hospitals ALONE accepting Medicare in the Chicago metro area. That’s just hospitals!
Since we don’t really have the room to list out every single Medicare provider in Chicago, we’ll name a few providers who have good reviews.
We used Medicare.gov's provider search tool to locate these hospitals in the Chicago area that accept Medicare (the real list is actually much longer - use the search tool to find the hospital closest to you).
Located less than three miles outside of Chicago, near Greektown and the University of Illinois
Contact at (312) 942-5000
Chicago Medicare Doctors
We used ZocDoc’s Chicago doctor search tool to find some of the most highly-rated doctors in Chicago that accept Medicare. Be sure to ask about Medicare when you set your appointment to make sure that this information is still true.
You can use this website to search for other nursing homes in the Chicago area.
Chicago Area Caregiver Agencies for In-Home Care
Sometimes doctor visits and hospitals don't cut it, and you or your loved one requires long-term care. However, making the decision to move into a nursing home is taxing. Instead, Medicare may cover in-home care for you or your loved one. The following are caregiver agencies that can connect you with in-home caregivers in the Chicago area:
Home Instead:This agency offers home care services as well as transportation for seniors
Care.com: Instead of calling a taxi, you can hire a driver from Care.com!
Who is Oak Street Health in Chicago?
Oak Street Health is a health system specifically for adults on Medicare. It got its start in Chicago in 2013 but has already spread as far as Rhode Island and North Carolina! There are 16 Oak Street Health centers in Chicago, and each one is focused on wellcare. Their website states that they “often [spend] twice as long or longer with [their] patients and [know] them as individuals.”
Presence Medigal Group in Chicago is part of the larger AMITA Health Medical Group. With locations all throughout the greater Chicago area (see map for reference), AMITA offers flexible hours and a variety of primary care physicans for you to choose from. Just remember to call ahead and confirm that the practice and doctor you select will accept your insurance.
You can use the AMITA website to search for a Prescense Medigal Group or other AMITA provider near you.
There are a few ways to apply for Medicare in Chicago. You can enroll for Original Medicare online at SocialSecurity.gov, you can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778), or you can visit your local office.*
Other Resources in Chicago for Seniors and Families
Adult Protective Services - This is who you want to call if you or a loved one is experiencing any form of neglect, abuse, or exploitation.
Area Agency on Aging - AAA’s promote and fight for elder rights. Their mission is to help seniors and disabled people “live with dignity and choices in their homes and communities for as long as possible.” If you’re passionate about elder rights, contact your local AAA for information about becoming a member.
Caregiver Resource Centers - Being a primary caregiver for an older adult is no easy task, especially if that older adult is a family member and emotions are involved. Illinois Caregiver Resource Centers can help you find adult day services for when you can’t be there, provide meal delivery, home modification, transportation, housekeeping, and more, and even provide financial guidance, legal services, and caregiver training.
Coalition of Limited English Speaking Elderly (CLESE) - Thousands of Illinois Medicare beneficiaries speak a language other than English. It can be especially difficult for the elderly to find proper health care when English is not their first language. The CLESE works to increase and improve the rights granted to non-native English speakers and prevent abuse. CLESE also brought the Refugee Urban Farming Project to Chicago “to promote health and economic independence for newly arrived refugees.”
Foster Grandparent Program - Through the Illinois Foster Grandparent Program, older adults can volunteer to assist troubled teens, disabled or premature children, and other youths who need love, comfort, and support from an outside source. Not only would you be helping kids, but you’d also be making friends and giving yourself a wonderful way to spend your days.
Long-Term Care Ombudsman Program - If you or a loved one has experienced neglect, abuse, or fraud involving long-term care, you’ll want to contact the Long-Term Care Ombudsman Program in your area.
Nutrition Project Centers - Illinois nutrition project centers provide congregate meals on weekdays at local senior centers, churches, and other community buildings. Some older adults may be eligible for home-delivered meals through this program.
OWL (Older Women’s League) - OWL exists to help older women grow, make important life decisions, and have access to financial assistance, quality health care, and legal support.
RSVP Senior Corps - Looking for more volunteer opportunities? From the same group that sponsors the Foster Grandparents program, RSVP finds and supports volunteer opportunities for those 55 and older. Those who are more physically active may enjoy home renovation and construction projects and helping natural disaster victims, while others may enjoy tutoring disadvantaged kids or organizing neighborhood watch programs.
Senior Companion Programs - The Senior Companion Program can set you up with help with anything from meal preparation to grocery shopping.
Senior Farmer’s Market Nutrition Program - Hand in hand with the Nutrition Project is the Illinois Senior Farmers Market Nutrition Program. Eligible seniors can receive a check which can be redeemed for fresh fruits and vegetables at local farmers markets from July 1 through October 31.
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