What is Medicare?

Medicare is a federally funded health insurance program in the United States. It was established in 1965 under the Social Security Act and is primarily aimed at providing health coverage for individuals who are 65 years old or older, as well as certain younger individuals with certain disabilities or specific medical conditions.

Medicare is divided into several parts, each covering different aspects of healthcare:

Medicare Part A (Hospital Insurance)
Medicare Part B (Medical Insurance)
Medicare Part C (Medicare Advantage)
Medicare Part D (Prescription Drug Coverage)

Parts of Medicare

Part A
(Hospital Insurance)

This part covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services.

Part A is an earned benefit. Whether you have to pay for Medicare Part A depends on your work history and how long you or your spouse paid Medicare taxes (also known as payroll taxes) while employed.

Part B
(Medical Insurance)

Part B covers outpatient care, doctor's visits, preventive services, and some home health care. Beneficiaries pay a monthly premium for Part B coverage.

Paying for Medicare Part B involves a monthly premiums, and the process may vary depending on your circumstances.

Part C
(Medicare Advantage)

Also known as Medicare Advantage Plans, these are offered by private insurance companies approved by Medicare. They combine coverage from Part A, Part B, and often Part D (prescription drug coverage) into a single plan. Medicare Advantage Plans may offer additional benefits like vision, dental, wellness programs, and more.

Medicare Advantage Plans have no plan premiums. However, you must continue to pay for your Part B premium.

Part D
(Prescription Drug Coverage)

Part D provides prescription drug coverage through private insurance plans. Beneficiaries can choose a standalone Part D plan to add to their original Medicare coverage.

Medicare Part D plans require beneficiaries to pay a monthly premium. The premium amount can vary widely based on the specific plan you choose, its coverage, and the insurance company providing the plan.

How to get started with Medicare

1. Determine Your Eligibility: Most people become eligible for Medicare when they turn 65. Your Initial Enrollment Period (IEP) is a 7-month period that includes:

Three months before your 65th birthday month
The month of your 65th birthday
Three months after your 65th birthday month

2. Enrollment Options: If you're already receiving Social Security benefits, you'll likely be automatically enrolled in Medicare Part A and Part B. You'll receive your Medicare card in the mail about three months before your 65th birthday.

If you're not receiving Social Security benefits and need to enroll manually, you can do so through these methods:
- Online: Visit the Social Security Administration (SSA) website at www.ssa.gov to apply for Medicare.
- In Person: Visit your local Social Security office to apply in person.
- By Phone: Call the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778) to apply over the phone.

3. Choose Your Coverage:

You have options for Medicare coverage, including:
- Original Medicare (Part A and Part B)
- Medicare Advantage (Part C)
- Medicare Supplement (Medi Gap)
- Medicare Part D (Prescription Drug Coverage)

When choosing your coverage it is recommended to use a health plan advisor, also known as a Medicare advisor or insurance broker, who can offer several benefits. Advisors are knowledgeable about different Medicare plans and can provide personalized guidance to help you find the best coverage. They save you time by comparing plans, assisting with enrollment, and keeping you informed about changes. Advisors offer unbiased advice at no cost and provide peace of mind that you've made an informed decision about your healthcare coverage.

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