What is Medicare?

Medicare is a federal program run by the Centers for Medicare & Medicaid Services (CMS). It provides health insurance for most people age 65 and older, as well as people under the age of 65 who have a qualifying disability.

Medicare Part A helps cover inpatient hospital, skilled nursing facility, hospice, and some home healthcare. Part A is premium-free for most people.

Medicare Part B helps cover medically necessary outpatient services, such as doctor visits, durable medical equipment, lab tests, ambulance services, mental health care, and preventive services.

Most Medicare beneficiaries pay a monthly premium for Part B, which may vary based on your situation, and the monthly premium changes most years. You may have additional costs related to Part B coverage, such as deductibles, copayments, and/or coinsurance.

Who is Eligible for Medicare?

United States citizens or legal permanent residents of five or more years who are:

  • Turning 65 or older
  • Under 65 with a qualifying disability
  • Any age with end-stage renal disease or amyotrophic lateral sclerosis (ALS)

Enrolling in Medicare Parts A & B

Initial Enrollment Period (IEP)

Medicare enrollment is only available at certain times. For individuals who become eligible at 65, there is a seven-month enrollment period that begins three months before their 65th birthday.

For individuals who become eligible for Medicare through a qualifying disability or other circumstances, there are Special Enrollment Periods.

Beyond Original Medicare

Once you’re enrolled in Part A and/or Part B, you may have other Medicare coverage options, including Medicare Part C coverage (Medicare Advantage Plans – with or without prescription drug coverage), Medicare Part D coverage (standalone prescription drug plans), and Medicare Supplement Plans (also known as Medigap). Some of these Medicare plans work alongside Original Medicare, while other types (such as Medicare Advantage Plans) are an alternative way to get your Original Medicare benefits.

Many additional healthcare benefits are not covered by Medicare Parts A and B. Some of those benefits include:

  • Vision
  • Dental
  • Hearing
  • Prescription Drug Coverage
  • Fitness Membership

Under Original Medicare, you will still be responsible for some healthcare costs. However, if you are also enrolled in Medicaid, you may be eligible for cost assistance and additional benefits at no additional cost.

Learn more about Medicare Advantage Dual-Eligible Special Needs Plans

 

Find Medicare Advantage Dual-Eligible Special Needs Plans That May be Available in Your Area

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