The Basics of Medicare
Medicare is the individual health insurance program for people over 65. Some people who are under 65 may also qualify in certain instances of disability, however the information provided on this website is geared towards those 65 and over.
Because Medicare has multiple parts, it can seem complicated and confusing. Our guide below is provided to help you get to know the basics of Medicare before it’s time for you to make the transition. Being prepared and thinking about your coverage options ahead of time will help you make the best decisions for your healthcare needs and financial goals.
Medicare has 4 parts (not to be confused with plans). Each part of Medicare helps pay for different health care costs. Some parts of Medicare are FREE, some require an additional premium.
Medicare Part A – Hospital Coverage
Part A is automatic and covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Most people get Part A for free. Those who are still getting employer sponsored healthcare coverage may decide to sign up for Part A anyway when the turn 65, because it is free.
Medicare Part B – Medical Coverage
Part B is automatic if you do not have other coverage through an employer. It resembles what you may think of as traditional health insurance and covers doctors visits, outpatient care, medical supplies, and preventive services. Most people will pay a standard Part B premium which is income based.
Medicare Part C – Advantage Plans
Offered by private carriers contracted by Medicare, and replaces your original Medicare Parts A and B, as they are rolled into one plan. You can select between an HMO or PPO, and most plans may cover more of your healthcare costs and have additional benefits, such as prescription drug coverage. Some may have dental or vision benefits. Premiums vary based on coverage, carrier and geographical location.
Medicare Part D Prescription Drug Coverage
Offered by private carriers contracted with Medicare and covers the costs of prescriptions. Plans and premiums vary greatly among carriers, so you should choose your plan wisely. Selecting the wrong plan can wind up costing you. Some Medicare Advantage plans may offer prescription coverage as well. You should sign up for Part D (even if you do not have prescriptions) when you first eligible. Waiting may result in a costly monthly penalty added to your premium.
Medicare Supplements (also known as Medigap)
Frequently Asked Questions
When you turn 65. The initial enrollment period for those aging into Medicare is 7 months, which starts 3 months before your 65th birthday, and includes your birthday month, and ends 3 months after your 65th birthday.
Once your Initial Enrollment Period is over, if you wish to change or purchase Advantage or Part D Plans, you must act during the open enrollment period. Open enrollment is from October 15th through December 7th annually.
NOTICE: Once you are eligible for Medicare, do not wait to enroll in a Medicare Part D Plan or you could end up paying a penalty every month.
Once enrolled in Medicare, if you wish to change or purchase Medicare plans you must act during the open enrollment period.
When open enrollment is closed, there are special circumstances in which one may qualify to enroll outside of the enrollment period. Listed below are the qualifying events:
- You are turning 65
- You move to a new area that is not in your current plan’s service area
- Recently moved back to the US
- You lose your current coverage (either Group or Medicaid)
- You now need a SNP (Special Needs Plan) or you no longer need a SNP
Medicare & You
The following videos are provided by and copyright of The Centers for Medicare and Medicaid Services (CMS) and are for informational purposes.
The content above represents national averages, and some parts were retrieved from Medicare.gov.
Boyce & Associates, Inc., nor it’s agents, are not part of the Federal Government Medicare System. The content in on this page has not been reviewed or approved by Medicare.
I/We do not offer every plan available in your area. Any information I/we provide is limited to the plans I/we do offer in your area. Please contact Medicare.gov or 1-800-Medicare to get information on all of your options.