Medicare FAQs

What is Medicare?

Medicare is a federal health insurance program for people age 65 years and older, people under age 65 with certain disabilities, and people with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS).  To qualify, an individual must either be a US citizen or an alien who has been legally admitted for permanent residence and has lived in the United States for five continuous years prior to applying for coverage.

What are Medicare Parts A, B, C and D?

Medicare Part A - Hospital insurance coverage which also covers rehabilitation services, skilled nursing facilities, home health care and hospice services.  Individuals who are 65 and older and have worked and paid Medicare taxes for at least ten years are eligible for premium-free Part A benefits.  Individuals with ESRD or ALS are also eligible for premium-free Part A.  For information on Part A premiums, deductibles and co-insurance, click here.

Medicare Part B - Supplementary healthcare insurance covering a broad range of physician and specialty services such as outpatient care, Durable Medical Equipment (DME), certain treatments and preventative care.  Those who qualify for Part A also qualify for Part B.  There is a monthly premium for Part B coverage and Part B coverage is optional, however there are penalties associated with declining coverage.

Medicare Part C - Medicare Advantage plans offered by private insurance companies and available to those with Medicare Parts A and B and living within the plan's service area.  Part C coverage is available to those who have both Medicare Parts A and.  Some Medicare Part C plans have little or no monthly premiums or deductibles.

Medicare Part D - Prescription drug coverage for those with Medicare Parts A and/or B and living within the service area.  There is a monthly premium for a Part D Prescription Drug Plan (PDP) and Medicare beneficiaries may face penalties when there has been a lapse in credible coverage.

What do I need to know if I am turning 65 or just became eligible for Medicare?

Enrollment may be automatic - Some people are automatically enrolled into Medicare when they become eligible, but not always.  It is always best to check on your enrollment status to see if you need to sign up for coverage.

You can avoid penalities - Even though some Medicare beneifts like Part B and Part D are "optional", you may face penalties if you decide not to have these coverage options.

There are various options for Medicare coverage - You can have traditional Medicare with or without a Medicare supplement and prescription drug plan or you may select different coverage through a Medicare Advantage plan.  A licensed independent Medicare insurance agent can help you identify the options in your area and select the plan that is right for you.

There are certain times of the year that you can enroll or change health plans - There are certain "enrollment periods" throughout the year that allow you to change your Medicare coverage.  This gives you the freedom to select coverage without long-term commitments and allows you the ability to change plans when needed.

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