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Medicare Basics
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Who is eligible for Medicare Coverage?
- You are eligible if you are 65 or older, a U.S. citizen or legal resident, and have worked and paid Medicare taxes for at least 10 years
- You are eligible if you are 65 or older, a U.S. citizen or legal resident, and have worked and paid Medicare taxes for at least 10 years
- Social Security Disability Insurance (SSDI) for 24 months
- End-stage renal disease (ESRD)
- Amyotrophic lateral sclerosis (ALS)
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Medicare FAQs
Medicare is a federal health insurance program primarily for people aged 65 and older, but it also covers some younger individuals with disabilities and specific medical conditions.
- Part A: Hospital Insurance – covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
- Part B: Medical Insurance – covers outpatient services, doctor visits, preventive services, and some home health care.
- Part C: Medicare Advantage – combines Part A and Part B coverage into a single plan, often including additional benefits like vision, dental, and hearing.
- Part D: Prescription Drug Coverage – provides coverage for prescription medications.
You are eligible if you are 65 or older, a U.S. citizen or legal resident, and have worked and paid Medicare taxes for at least 10 years. You may also qualify if you are under 65 and have been receiving Social Security Disability Insurance (SSDI) for 24 months or have specific conditions like end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).
You can enroll during your Initial Enrollment Period (IEP), which begins three months before you turn 65 and ends three months after you turn 65. You can also enroll during the General Enrollment Period (January 1 to March 31) or a Special Enrollment Period if you qualify due to certain circumstances.
- Part A: Most people do not pay a premium if they have worked and paid Medicare taxes for at least 10 years. There may be deductibles and coinsurance.
- Part B: Requires a monthly premium, which can vary based on income. There are also deductibles and coinsurance.
- Part C: Premiums vary by plan and may include additional costs beyond Parts A and B.
- Part D: Requires a monthly premium, and costs vary by plan. There may also be deductibles and co-payments for medications.
Medicare does not cover most long-term care, routine dental or vision care, cosmetic surgery, or over-the-counter medications. Some services and items might require additional coverage through a Medicare Advantage plan or a separate insurance plan.
Yes, you can have other health insurance alongside Medicare, such as employer-sponsored insurance or supplemental (Medigap) insurance. However, there are rules about how Medicare coordinates with other types of insurance.
You can apply online at the Social Security Administration website, by phone, or in person at a Social Security office. You can also apply through your state’s Medicaid office if you qualify for both Medicare and Medicaid or please dial 1-800-830-7574 for further assistance.
If you miss your Initial Enrollment Period, you can sign up during the General Enrollment Period (January 1 to March 31) or during a Special Enrollment Period if you qualify. There may be penalties for late enrollment.
Consider factors such as coverage needs, cost, and whether you want to stick with traditional Medicare or explore additional benefits offered by Medicare Advantage plans. Compare available plans to see which best fits your health care needs and budget.
If you have specific questions or need assistance with Medicare, consulting with a Medicare counselor or a representative who can provide personalized guidance please dial (800) 830-7574 for further assistance
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We do not offer every plan available in your area. Currently we represent 193 organizations which offer 4,264 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local state health insurance program (SHIP) to get information on all of your options.
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