What is Medicare

Medicare is the publicly funded government health insurance program that provides hospital and medical insurance to America’s seniors and those with disabilities.

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Medicare Eligibility

Eligibility for Medicare begins when you are age 65 or if you meet the criteria for benefits with a disability. If you are younger than 65 and have been receiving disability insurance for at least 24 months, you will be automatically enrolled in Medicare. People with amyotrophic lateral sclerosis (ALS) are automatically enrolled in the first month they receive disability benefits. People with End Stage Renal Disease (ESRD) can choose to enroll in Medicare in their fourth month of a regular course of dialysis treatment.

title Medicare Coverage: The Parts of Medicare

Original Medicare is made up of Medicare Part A and Part B. Medicare Part A is insurance for inpatient care in a hospital or skilled nursing facility. It also covers nursing home care, hospice care, and home health care. Medicare Part B is outpatient medical insurance, covering medically necessary and preventative care services. It covers doctor visits, emergency room visits, clinical research, ambulance services, durable medical equipment, mental health care, and limited outpatient prescription drugs.

Medicare Advantage plans, or Part C, are an alternative to Original Medicare that bring you the same Part A and Part B coverage through a private health insurance company. These companies have been approved by Medicare to handle your coverage. Medicare Advantage plans can help fill the gaps in Medicare coverage by offering you benefits such as dental, hearing, and vision care or prescription drug coverage (Medicare Advantage Prescription Drug plans).

Medicare Part D plans cover your prescription drugs. Each plan covers at least two drugs in each of the most commonly prescribed categories of drugs: anticancer, anticonvulsant, antidepressant, antipsychotic, antiretroviral, and immunosuppressant.

Medicare Supplement plans do not cover your healthcare expenses. They cover your out-of-pocket costs associated with Medicare Part A and Part B. These covered expenses can include Part A coinsurance and hospital costs, Part B copayments and coinsurance, your first three pints of blood, Part A hospice care, skilled nursing facility care, Part A deductible, Part B deductible, Part B excess charges, and foreign travel emergency care.

Medicare Enrollment

Three months before the month of your 65th birthday, your initial enrollment period begins. You have seven months to apply for Medicare. If you qualify for premium-free Part A, it is best to sign up as soon as you are eligible. Part B has a late enrollment penalty for every 12 months you go without signing up once you become eligible.

Each fall is the Open Enrollment/Annual Election Period for Medicare Advantage and Part D plans. From October 15 to December 7, you can renew, switch, or drop plans and return to Original Medicare.

The time to sign up for Medicare Supplement plans is during the first six months after you are 65 and first enrolled in Medicare Part B. During those six months, you will not have to go through medical underwriting to purchase a plan.