Find out general Medicare information about Parts A, B, C, or D so you can plan ahead for your health care.
What Is Medicare?
Medicare is a federal program that provides health insurance coverage to American citizens as well as other eligible individuals. The primary program, known as Original Medicare, is made up of two parts: Part A and Part B.
Who can get Medicare?
Medicare is available to U.S. citizens and legal residents. Legal residents must have lived in the United States continuously for at least five years, including the five years immediately before applying for Medicare.
When am I eligible for Medicare?
- Individuals age 65 or older
- Individuals younger than 65 who have a qualifying disability
- Individuals of any age who have been diagnosed with end-stage renal disease
- (ESRD) or amyotrophic lateral sclerosis (ALS)
When is it time to enroll?
If you are already receiving Social Security or Railroad Retirement Board benefits when you become eligible, you will be automatically enrolled in Medicare Part A and Part B. In this case, your Medicare card will be mailed to you. If you are not receiving Social Security benefits at the time you become eligible, you will need to enroll in Medicare yourself.
Medicare enrollment is tied to your Initial Enrollment Period (IEP), which lasts for seven months. Coverage begins on the first day of your 65th birthday month if you complete your enrollment during the first three months of your IEP. If your birthday falls on the first day of the month, your coverage will begin the month before your birthday. If you enroll during your 65th birthday month or in the three months following, your coverage will start on the first day of the next month. If you do not enroll during your IEP, you may have to pay a penalty.
Are you working past 65?
You will still have an Initial Enrollment Period when you turn 65, even if you continue working. Depending on the health insurance coverage provided by your employer, you may be able to delay enrolling in Medicare without incurring a penalty if:
- Your employer-sponsored health insurance is considered “creditable.”
- Your employer has 20 or more employees.
- Your employer does not require you or your spouse to enroll in Medicare at age 65.
Let us help guide you through these steps!
Medicare coverage options.
When enrolling in Medicare, you may choose to sign up for Part A, Part B, or both. You also have the option to add additional coverage, such as a Medicare Advantage plan (Part C), prescription drug coverage (Part D), or a Medigap plan. Each of these parts is designed to cover different aspects of healthcare. Original Medicare consists of Parts A and B.
- Part A
Part A helps pay for inpatient care in hospitals, critical access hospitals, and skilled nursing facilities. It also helps cover Hospice care and some home health care. - Part B
Part B covers medical services or supplies to diagnose and treat your medical condition. Preventive services to prevent or detect illness at an early stage. In addition, Part B generally includes outpatient care, doctor visits, certain types of home health care, durable medical equipment, and some preventive screenings and vaccines. - Part C
Part C is also known as Medicare Advantage, which combines Part A, Part B, and often prescription drug coverage (Part D). Some plans may offer additional benefits like coverage for routine vision and dental care. These plans are offered by Private Insurance companies approved by Medicare. - Part D
Part D helps pay for medications prescribed by a doctor or other healthcare professional. You may have to pay a Part D late enrollment penalty if not enrolled when initially eligible or within 63 days of losing credible coverage.
Medicare supplement insurance plans (Medigap).
These plans are offered by Private Insurance companies but are standardized by the Federal Government. Each plan is labeled with a letter and has varying levels of coverage to help pay some of the out-of-pocket costs not paid by Medicare Parts A and B. This includes copayments, coinsurance, and deductibles. If you enroll in this type of plan when you are first eligible, your coverage is guaranteed. Outside of this time, your pre-existing conditions may influence your eligibility for the plan. This plan does not include Part D prescription drug coverage and typically does not cover services like dental, vision, eyeglasses, hearing aids, long-term care, and private-duty nursing. We want to educate you so you can make an informed decision. Let us help you navigate your Medicare Plan Options, helping you choose a plan that fits your needs.
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