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What is Medicare
What is Medicare
Understanding how Medicare works can seem daunting, but this guide will break it down for you. We'll explore what Medicare covers, how to apply for Medicare, and the various parts and plans available to you.
How Medicare Works
Medicare is a federal health insurance program for people aged 65 and older. It also covers individuals with specific disabilities and end-stage renal disease. Original Medicare includes Part A and Part B, which cover hospital insurance and medical insurance, respectively.
Medicare Advantage plans, also known as Part C, offer an alternative way to get your Medicare coverage. These plans are provided by private insurance companies and must cover all the services original Medicare covers.
Parts of Medicare
Medicare is divided into different parts to streamline your health care services and supplies. Part A covers inpatient hospital stays, skilled nursing facility care, and home health care services. Part B covers outpatient care, medical supplies, and preventive services.
Medicare also includes prescription drug coverage (Part D) and Medicare supplement insurance (Medigap) to help pay out-of-pocket costs such as copayments and deductibles not covered by Original Medicare.
How to Enroll in Medicare
Enrolling in Medicare is essential for gaining access to health insurance. You can apply for Medicare during the Initial Enrollment Period, which starts three months before you turn age 65 and lasts seven months. If you miss this period, you may have to pay a higher premium.
Automatic enrollment is often triggered when you receive Social Security benefits. However, you can also manually apply through the Social Security office or website. Understanding the enrollment process helps you avoid missing your window to get coverage.
Medicare Eligibility Criteria
Most people become eligible at age 65, but some qualify earlier due to disabilities or conditions like end-stage renal disease. Eligibility extends to those who are U.S. citizens or permanent residents with at least 10 years of work history paying Medicare taxes.
Those under 65 who receive Social Security Disability Insurance (SSDI) for at least 24 months or those diagnosed with Lou Gehrig's disease (ALS) may also qualify. The eligibility criteria ensure that Medicare provides health insurance to those who need it most.
Medicare Advantage Plans
Medicare Advantage plans (Part C) are a popular choice for beneficiaries looking for additional services. These plans often include benefits not covered by Original Medicare, such as vision and dental care. These plans must cover all the services that Original Medicare covers but may offer lower out-of-pocket costs.
Additionally, Medicare Advantage plans sometimes require specific care providers or networks. Researching the available plans during the enrollment period will help you choose the best option for your health care needs.
For further information and personalized advice, contact Senior Health OTG. Our team is here to assist you in making the best Medicare choices.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Senior Health OTG represents Medicare Advantage HMO, PPO, AND PFFS organziations that have a Medicare contract. Enrollment depends on the plan's contract renewal. **Extra benefits require enrollment in an MA plan and depend on whether you are eligible to enroll in an MA plan in your area. Benefits are available only in select areas.
Medicare Supplement Insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease.
The purpose of this communication is a solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.
Medicare Supplement plans are not connected with or endorsed by the U.S. goverment or the federal Medicare program.