What is Medicare and when do I become eligible?
Medicare is a health insurance program for people aged 65 or older or younger people with certain medical conditions or disabilties that qualify under government rules.
Unless you have a qualifying condition, you are first eligible to apply for Medicare 3 Months before you turn 65 and can apply up to 3 months after. If you still have health insurance through an employer, you can continue that coverage instead of switching to Medicare.
3 months before
3 months after
Let's learn about Medicare and your plan options.
Medicare is made up of parts with each part providing a specific health care coverage.
- Part A and Part B make up Original Medicare and are federally provided programs.
- Part C, also known as Medicare Advantage, is a plan through a private company that bundles parts A, B and usually D.
- Part D is your prescription drug coverage plan.
Understanding Medicare Advantage
Medicare Part A
Also known as Hospital Insurance, Part A covers inpatient care in hospitals and certain skilled nursing facilities.
Medicare Part B
Also known as Doctor and Outpatient Insurance. Part B covers your primary care doctor, specialists, outpatient care, durable medical equipment, and many preventive services such as screenings, shots, vaccines and annual wellness visit.
Medicare Part C
Also known as Medicare Advantage plans, Part C is a Medicare-approved plan from a private company that bundles Parts A, B and usually Part D. Plans may also offer extra benefits not offered by Original Medicare such as vision, hearing, and dental services.
Medicare Part D
Also known as Prescription Drug Coverage. Part D is available to everyone with Medicare. To get prescription drug coverage, you must join an approved Medicare plan that offers prescription drug coverage. While optional, you must enroll by a certain deadline to avoid penalty costs added to your Original Medicare premium.
There are three main Medicare options:
Original Medicare is a health insurance program for people aged 65 or older or younger people with certain medical conditions or disabilties that qualify under government rules.
Original Medicare includes Part A and Part B and you can choose a separate Medicare drug plan to get drug coverage (Part D).
In general, Original Medicare pays for 80% of covered health care costs and you pay the remaining 20%.
Original Medicare does not cover most prescription drug costs or your vision, dental, hearing or long-term nursing home health needs.
Also known as Medigap, Medicare Supplement is extra insurance you can buy from a private company that helps pay your share of Original Medicare costs and carries a monthly premium you pay.
Medicare Supplements help cover your copay, coinsurance and deductible costs.
While some plans may include dental, vision and hearing, prescription drug coverage (Part D) is not included.
Medicare Advantage (Part C)
Medicare Advantage plans, also known as Part C, are Medicare-approved plans from private companies offering an alternative to Original Medicare for your health and drug coverage. These plans include Part A, Part B and Part D.
Medicare Advantage plans work to limit your out-of-pocket costs while providing access to other essential health and wellness benefits.
You still need to enroll in Original Medicare before you enroll in a Medicare Advantage plan.
What is the right plan for me?
Your Medicare choice influences what coverage you receive along with the cost of your prescription drugs and other key health and wellness benefits.
To help you understand your plan options better, we have partnered with BenefitsCheck. They would be happy to talk with you to discuss the basics of Medicare planning. They can help you:
- Ensure you do not miss your Individual Enrollment Period window and know your exact enrollment deadline
- Understand the different parts of Medicare and the plan options available to you
- Enroll in a plan that is appropriate for your personal needs