What is Medicare?

How Medicare Works

Medicare, or Original Medicare, is a federal program offered to seniors when they reach 65, people with certain disabilities, and those with ESRD. Original Medicare includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). Supplemental Medicare options are also offered to “fill the gaps” in Medicare coverage. Supplemental Medicare options include Medigap, Medicare Advantage (Medicare Part C), and Medicare Prescription Drug Coverage (Medicare Part D) and are sold by insurance companies and other private companies approved by Medicare.

Find and compare Medicare Advantage and Drug plans at MedicarePolicyHelper.com.

Am I Eligible For Medicare?

You are eligible for Medicare during the 7 month period surrounding your 65th birthday. This 7 month period is called an initial enrollment period and comprises the 3 months before you turn 65, the month you turn 65, and the 3 months after. Aside from folks turning 65 Medicare is also offered to certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).

Outside of initial enrollment, there are two annual enrollment periods where you can change your plan. You can also disenroll in Part B at any time. Please learn more about the Medicare enrollment process before making any changes. Enrolling in a plan outside of initial enrollment could mean higher premiums down the road.

Am I Eligible for Medicare Advantage, Medigap, or Medicare Part D?

If you already have Parts A and B you qualify for a supplemental Medicare plan. Please note that the best time to enroll in a supplement plan is during your initial enrollment period. Initial enrollment for supplement plans is typically 60 days from the point you enroll in Part B.

To get Medicare Advantage, Medigap, or Medicare drug coverage, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan can vary in cost and coverage. Similar plans may be sold at different prices by different insurers, so it pays to shop around.

If you are enrolled in Medicare Part A and B (Original Medicare), you may want to consider a supplemental plan to meet your medical needs better.

Parts of Medicare

Medicare includes Parts A, B, C, and D. Parts A and B are considered Original Medicare. When you sign up for Medicare, you are automatically enrolled in Parts A and B and must disenroll in Part B to avoid paying the part B premium if you don’t want it.

Medicare Advantage (Part C) is a supplemental plan offered by private companies. It works with Original Medicare to provide greater benefits and cost coverage.

Part D is a drug program that helps to cover drug costs.

Original Medicare can be paired with Medigap policies (Part A through N) which are an alternative to Advantage Plans.

Original Medicare, Medigap, and Advantage plans can be paired with Part D (although most Advantage Plans offer Part D as part of the package). Medigap and Advantage plans cannot be paired together, and you cannot purchase a Medicare Advantage or Medigap policy without having both Part A and Part B.

Now that you have a basic Medicare overview it’s time to take a look at what each of the parts does on their own.

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)

Part C essentially replaces Part A and Part B and typically includes Part D. Each Advantage Plan offers different cost and coverage options. Learn more about Medicare Advantage here or read the summary on Part C below.

Medicare Part D (prescription drug coverage)

Medicare offers Medicare Part D prescription drug coverage to everyone with Medicare. Medicare 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.

What is Medicare Advantage?