Medicare

Understanding Medicare

Medicare is the federal health insurance program for people who are  65 or older, certain younger people with disabilities, and people with  End-Stage Renal Disease (permanent kidney failure requiring dialysis or a  transplant, sometimes called ESRD).

The different parts of Medicare help cover specific services:


Medicare Part A (Hospital Insurance)

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.


Medicare Part B (Medical Insurance)

Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.


Medicare Part C (Medicare Advantage Plans)

A Medicare Advantage Plan is a type of Medicare health plan offered  by a private company that contracts with Medicare to provide you with  all your Part A and Part B benefits. Medicare Advantage Plans include  Health Maintenance Organizations, Preferred Provider Organizations,  Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical  Savings Account Plans. If you're enrolled in a Medicare Advantage Plan,  Medicare services are covered through the plan and aren't paid for  under Original Medicare. Most Medicare Advantage Plans offer  prescription drug coverage.


Medicare Part D (prescription drug coverage)

Part D adds prescription drug coverage to Original Medicare, some  Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and  Medicare Medical Savings Account Plans. These plans are offered by  insurance companies and other private companies approved by Medicare.  Medicare Advantage Plans may also offer prescription drug coverage that  follows the same rules as Medicare Prescription Drug Plans.


Not sure what kind of coverage you have?

  1. Check your red, white, and blue Medicare card.
  2. Check all other insurance cards that you use. Call the phone number on the cards to get more information about the coverage.
  3. Check your Medicare health or drug plan enrollment.
  4. Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Are you Eligible for Medicare?

Generally, you are eligible for Medicare if you or your spouse worked  for at least 10 years in Medicare-covered employment and you are 65  years old and a citizen or permanent resident of the United States.

If you are not 65, you might also qualify for coverage if you have a  disability or with End-Stage Renal disease (permanent kidney failure  requiring dialysis or transplant).

Here are some simple guidelines. You can get Part A at age 65 without having to pay premiums if:

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

If you are under 65, you can get Part A without having to pay premiums if:

  • You have received Social Security or Railroad Retirement
  • Board disability benefit for 24 months. You are a kidney dialysis or kidney transplant patient.

While you don’t have to pay a premium for Part A if you meet one of  those conditions, you must pay for Part B if you want it. It is deducted  from your Social Security, Railroad Retirement, or Civil Service  Retirement check. If you don’t get any of the above payments, Medicare  sends you a bill for your Part B premium every 3 months.

If you have questions about your eligibility for Medicare Part A or  Part B, or if you want to apply for Medicare, please call Social  Security at 1-800-772-1213 or visit or call your local Social Security office.  TTY users should call 1-800-325-0778. You can also get information  about buying Part A as well as Part B if you don’t qualify for  premium-free Part A

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