What is Medicare?
Medicare is health insurance for people:
- 65 and older
- Under 65 with certain disabilities
- Any age with End-Stage Renal Disease (ESRD), permanent kidney failure requiring dialysis or transplant
Medicare is provided by the federal government and administered by CMS – Centers for Medicare & Medicaid Services.
What are the parts of Medicare?
Part A (Hospital Insurance) helps cover:
- Inpatient care in hospitals
- Skilled nursing facility care
- Hospice care
- Home health care
Part B (Medical Insurance) helps cover:
- Services from doctors and other health care providers
- Outpatient care
- Home health care
- Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)
- Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)
Part D (drug coverage):
- Helps cover the cost of prescription drugs (including many recommended shots or vaccines)
- Part D plans are run by private insurance companies that follow rules set by Medicare.
Part C (Medicare Advantage Plans):
- Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.
- Plans may have lower out-of-pocket costs than Original Medicare.
- In most cases, you’ll need to use doctors who are in the plan’s network.
- Most plans offer extra benefits that Original Medicare doesn’t cover— like vision, hearing, dental, and more.
- Medicare Advantage Plans are sold by private insurance companies.
Medicare Supplement Plans (“Medigap”, “Medsups”):
- Medicare Supplement Plans are sold by private insurance companies.
- Medsups fill in the gaps of Original Medicare, helping limit your out of pocket costs.
- These types of plans do no offer drug coverage or extra benefits such as dental, vision, hearing, and more.
- You can visit any doctor who accepts Original Medicare.
Enrolling into Medicare
- You will enroll into Original Medicare (Part A and Part B) through Social Security.
- You will automatically receive your Medicare card if you are receiving:
- Social Security Retirement
- Social Security Income (SSI)
- Social Security Disability (25th month on disability)
- If you are not taking Social Security, you will need to contact Social Security to enroll in Original Medicare:
Call Social Security
Visit your local Social Security Office
Go online: https://www.ssa.gov/benefits/medicare/
- If you do not enroll in Part B when you are first eligible you could incur a late enrollment penalty. Contact us for more information on this.
- If you have a special circumstance to enroll at a later date, such as employer coverage through you or a spouse (employer must have 20+ employees), you may be able to delay your Part B without incurring a penalty.
- For step-by-step help and assistance in enrolling in a Medicare plan, please call us: 843-848-8844