Medicare is a federal health insurance coverage for qualified individuals. You can qualify for Medicare coverage if you’re 65 years old, have specific disabilities, or have end-stage renal disease. Medicare coverage can be complex, so it’s beneficial to speak with an agent before choosing your coverage.
What Is Medicare?
Medicare is multi-part healthcare coverage for qualified individuals. Once you determine whether or not you want to enroll, you will have to decide which parts you will enroll in. The parts of Medicare include the following:
- Part A, also known as hospital insurance, includes health care costs associated with hospital stays and limited stays at a nursing home, hospice care and some costs for home health care. Part of Original Medicare.
- Part B, also known as medical insurance, is for everyday health care expenses, any outpatient care you might receive, specific medical supplies and preventive care. Part of Original Medicare.
- Part C, also known as Medicare Advantage, is an alternative to Original Medicare. It becomes your primary coverage; most Medicare Advantage Plans include Part D Medicare prescription drug coverage. Some Medicare Advantage Plans offer additional dental and vision coverage and fitness memberships.
- Part D, also known as prescription drug coverage, will help cover the costs of medications prescribed for your health condition. Individual Medicare drug coverage plans use a formulary developed by a pharmacy and therapeutics committee composed of pharmacists and physicians to regulate which medications they’ll cover.
- Medigap, also known as Medicare Supplemental Insurance, is a supplemental health insurance program to cover health care costs that Original Medicare does not. You can only purchase Medigap insurance if you’re enrolled in Original Medicare. It cannot be used with a Medicare Advantage Plan.
When Do I Enroll in Medicare?
The enrollment process for Medicare can be a little different for everyone. Be sure to check with your Social Security Administration three months before your expected start date of Medicare to be sure everything is in order if you are eligible for automatic enrollment. Automatic enrollment is available for you if you:
- Are you already receiving Social Security benefits (at least four months before start)
- Receive U.S. Railroad Retirement Board (RRB) benefits (at least four months before start)
- Are under age 65 but have a Social Security disability for 24 months
- Have amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease or ESRD)
If you are about to turn 65 or are not receiving Social Security benefits, you will have to enroll on your own. Enrollment can vary based on individual circumstances, so be sure to contact an agent if you have questions about your enrollment process.