Medicare
Overview

What You Need To Know About Medicare

In order to understand Medicare, you need to start with the basics. Our Medicare overview helps you understand what Medicare is, it’s main parts, and what it covers.

Medicare Overview and Guide

Medicare Basics

Medicare is a government health insurance program administered by the Centers for Medicare & Medicaid Services (CMS). Medicare is the largest health insurance service in the country, with around 47 million Americans participating. To be eligible you must be a citizen of the United States and meet certain requirements.

Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).You are eligible for Part A, premium free, if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can also get Part A at age 65 without having to pay premiums if:

  • You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
  • You are eligible to receive Social Security or Railroad benefits, but have not yet filed for them.
  • You or your spouse had Medicare-covered government employment.

While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.

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Medicare Part A

(Hospital Insurance)

Medicare Part A helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay). It also helps with some home health and hospice care.

Medicare Part B

(Medical Insurance)

Medicare Part B helps pay for office visits and doctors’ services and many other medical services and supplies that are not covered by Medicare Part A.

Medicare Part C

(Medicare Advantage)

With Medicare Part C, people can choose to receive all of their health care services through a private insurance carrier, instead of having coverage directly under Medicare.

Medicare Part D

(Prescription Drugs)

Medicare Part D is prescription drug coverage offered through private insurance carriers, and can help pay for medications doctors or providers prescribe for treatment.

What Medicare Does Not Cover

Medicare is a government health insurance program administered by the Centers for Medicare & Medicaid Services (CMS). Medicare is the largest health insurance service in the country, with around 47 million Americans participating. To be eligible you must be a citizen of the United States and meet certain requirements.

  • Care while traveling outside of the U.S.
  • Deductibles
  • Coinsurance
  • Copayments
  • Hearing aids and exams for fitting hearing aids
  • Routine dental care
  • Routine physicals*

*With the exception of the one-time “Welcome to Medicare” physical exam within the first 12 months of enrolling in Medicare Part B.

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