Medicare is a federal health insurance program that covers millions of Americans. In general, you are eligible for Medicare if you are 65 or older, or you are younger than 65 and meet criteria for certain disabilities.
The Medicare basics have four main components.
- Medicare Part A: Hospital Insurance
You are entitled to receive Medicare Part A on the first day of the month in which you turn 65. In most cases, Medicare Part A is free. You typically won’t pay a premium for Medicare Part A if you or your spouse paid Medicare taxes for at least 10 years.
When eligible, you will be enrolled automatically in Medicare Part A if you already receive benefits from Social Security or from the Railroad Retirement Board (RRB). If you aren’t getting Social Security benefits (for example, if you are still working), you need to sign up for Part A by calling Social Security (800) 772-1213.
Medicare Part A helps to cover the following services: Inpatient care in hospitals (such as critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals) Inpatient care in a skilled nursing facility Hospice care services Home health care services
- Medicare Part B: Medical insurance
Medicare Part B is optional medical insurance purchased from the federal government. If you are 65 or over, you are eligible. Most people pay a monthly premium for Medicare Part B, usually deducted from their Social Security benefit checks. Sign up for Part B by calling Social Security (800) 772-1213.
You may have to pay a late enrollment penalty if you don’t sign up for Medicare Part B during your initial enrollment period, which is 3 months before AND 3 months after your 65th birthday equaling 7 months total. Medicare Part B premium levels are set each year by the Centers for Medicare & Medicaid Services (CMS), and vary based on your annual income. Medicare Part B helps to cover the following services: Office visits to a primary care physician or a specialist Some preventive services, such as flu shots and mammograms Laboratory costs, including blood work and X-rays Medical equipment, such as wheelchairs and walkers Outpatient physical therapy Mental health care Ambulance services Preventive services
- Medicare Part C: Medicare Advantage
A Medicare Part C plan, also known as Medicare Advantage (MA), is offered by private insurers. The main purpose of acquiring a Medicare Advantage plan is to cover the 20% of medical costs that Part A & B do not cover. You also have the option of purchasing a Medicare Supplement plan to cover these costs. For differences between the two, please take a look at our Medicare Advantage vs Medicare Supplement chart. If you are considering a Medicare Advantage plan, please call us @ (800) 300-0205 to discuss the many plan types that are available.
If you choose Medicare Part C you will generally have access to the following services in addition to all services covered by Parts A and B: Emergency and urgent care Vision services Hearing services Dental services Health and wellness programs Medicare Part D prescription drug coverage
- Medicare Part D plans: Prescription Drugs
You are eligible to enroll in a Medicare Part D prescription drug coverage plan if you have Medicare Part A and/or Medicare Part B. Information on how to enroll and select the appropriate Part D plan can be found in our Part D Information section.
There are 2 ways to get Medicare Part D prescription drug coverage: Through a Medicare Advantage plans or Medicare Cost plans that includes Medicare Part D in the cost of their premiums. A stand-alone Medicare prescription drug plans (PDP), which is usually purchased if you choose a Medicare Supplement plan to cover the 20% of medical costs Medicare Parts A & B does not.
NOTE: You may have to pay a late enrollment penalty if you don’t sign up for a Medicare Part D Prescription Drug plan during your initial enrollment period, which is 3 months before AND 3 months after your 65th birthday equaling 7 months total. Medicare Part D premiums are based on the type of Prescription plan you select.