About Medicare insurance
An Introduction to Medicare
What is Medicare?
Medicare is a national health insurance program in the United States, begun in 1966 under the Social Security Administration and now administered by the Centers for Medicare and Medicaid Services
Medicare is a federally administered health insurance program providing health coverage to nearly 55 million Americans above the age of 65. Medicare also provides coverage to other individuals who are eligible due to certain disabilities, or permanent kidney failure, or amyotrophic lateral sclerosis (Lou Gehrig’s disease). The program helps with the cost of health related expenses, but it doesn’t cover all medical expenses. Long-term care is not covered by Medicare.
You have choices for how you get Medicare coverage. If you choose to have Original Medicare (Part A and Part B) coverage, you can buy a Medicare Supplement Insurance (Medigap) policy from a private insurance company. Supplements cover some of the costs that Medicare does not, like deductibles and coinsurance.
The Centers for Medicare and Medicaid Services (CMS) is the federal agency responsible for the Medicare program. But the Social Security Administration processes your application for enrolling in Original Medicare.
Who is eligible for Medicare?
A Person who has been a U.S. citizen / legal resident for at least five consecutive years and is at least one of the following :
- Age 65 or older
- Younger than 65 with a qualifying disabilitiy
- Any age with a diagnosis of end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant)
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Part A Coverage
If you are over the age of 65, and you are a U.S. citizen or permanent resident, you are eligible for Part A. And it won’t cost you anything per month if one of the following applies:
- You receive (or are eligible to receive) Social Security benefits or Railroad Retirement (RRB) benefits.
- Your spouse (even if deceased or you are divorced) receives (or is eligible to receive) Social Security or RRB benefits.
- You or your spouse worked long enough in a government job through which you paid Medicare taxes.
- You are a dependent parent of a fully insured deceased child.
If you don’t meet these requirements, you may be able to get Medicare Part A by paying a monthly premium.
Part B Coverage
If you are eligible for Medicare Part A at no cost, you can enroll in Medicare Part B by paying a monthly premium. If you have higher income, you may be required to pay a higher Part B premium.
If you are not eligible for Part A at no cost, you can buy Part B without having to buy Part A if you are age 65 or older and you’re one of the following:
- A U.S. citizen.
- A lawfully admitted noncitizen, who has lived in the United States for at least five years.
You have choices
When you understand the basics of Medicare, you will quickly learn that there isn’t a “one size fits all” plan. We are here to educate you about all your choices.
- Original Medicare: Coverage managed by the federal government.Generally, there is a cost for each service.
Original Medicare includes:
- inpatient hospital stays,
- care in a skilled nursing facility
- hospice care
- some home health care
- Original Medicare with a stand-alone prescription drug plan (Part D) and/or a Medicare supplement insurance plan
- Medicare Advantage (Part C) plan : 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. Most Medicare Advantage plans offer prescription drug coverage, vision, hearing and dental benefits.
Ready to get started?
Your first step is to enroll in Original Medicare, Parts A & B.
This is done through Social Security. You can call them at 1-800-772-1213, use their website at https://www.ssa.gov/, or walk into a local Social Security office to enroll in Medicare
Some people get Part A and Part B automatically:
If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), you will automatically be enrolled in Original Medicare (Part A and Part B) starting the first day of the month you turn 65.
If You Are 65 and Not Getting Social Security or RRB:
If you’re not already getting benefits, you should contact Social Security about three months before your 65th birthday to enroll in Medicare. You should sign up for Medicare even if you don’t plan to retire at age 65. You may delay Part B if you will continue medical insurance coverage through a current employer’s group health plan. Once you retire (or lose your employer plan), you will have a special election period to enroll in Part B. As long as you maintain creditable coverage through your employer, you will not incur a Late Enrollment Penalty.
Contact us if you have questions about this step.
Decide if you need additional coverage. You can choose 2 options:
Option 1 : Add one or both of the following to Original Medicare
- A Medicare Supplement Insurance plan (Offered by private companies.)
- A Medicare Prescription Drug plan (Offered by private companies.)
Option 2 : Choose a Medicare Advantage plan
- A Medicare Advantage plan (Offered by private companies.) Also known as Part C, this plan combines Parts A & B, provides additional benefits, and most plans cover prescription drugs.
Contact us to learn more. Our professional and experienced agents want to help you be successful in choosing your Medicare options.