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Medicare Basics

Medicare is a federal health insurance program for:

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  • People age 65 or older.

  • People under age 65 with certain disabilities.

  • People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).

 

Most people should enroll in Medicare Part A, Hospital Insurance when they’re first eligible, but certain people may choose to delay Medicare Part B, Medical Insurance. 

 

In most cases, it depends on the type of health coverage you may have.

​​​Medicare has different Parts that help cover specific services:

 

  • Medicare Part A (Hospital Insurance) - Part A helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits. Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working.

  • Medicare Part B (Medical Insurance) - Part B helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. Most people pay a monthly premium for Part B.

 

  • 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, (HMO), Preferred Provider Organizations, (PPO), Private Fee-for-Service Plans, (PFFS), Special Needs Plans, (SNP), and Medicare Medical Savings Account Plans, (MSA). 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) - Medicare prescription drug coverage is available to everyone with Medicare. To get Medicare prescription drug coverage, people must join a plan approved by Medicare that offers Medicare drug coverage. Most people pay a monthly premium for Part D.

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