What is Medicare?

Medicare is a federal health insurance program in the United States designed primarily for:

• People age 65 and older
• Certain younger individuals with disabilities
• People with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS)

Medicare helps cover various healthcare services, but it does not pay for everything, and there are costs (like premiums, deductibles, and copayments) associated with many services.

The Four Parts of Medicare

1. Part A – Hospital Insurance
   • Covers: Inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
   • Cost: Usually free if you or your spouse paid Medicare taxes for at least 10 years.
2. Part B – Medical Insurance
   • Covers: Doctor visits, outpatient care, preventive services, lab tests, and durable medical equipment.
   • Cost: Monthly premium (varies by income), plus deductibles and coinsurance.
3. Part C – Medicare Advantage
   • Offered by private insurers approved by Medicare.
   • Combines Part A and B coverage and often includes prescription drug coverage (Part D), dental, vision, and hearing benefits.
   • Cost: Varies by plan and provider.
4. Part D – Prescription Drug Coverage
   • Helps cover the cost of prescription medications.
   • Offered through private insurance companies.

Additional Coverage Options

• Medigap (Medicare Supplement Insurance): Helps pay for out-of-pocket costs not covered by Original Medicare (Parts A and B), such as copayments and deductibles. Offered by private companies.

Key Takeaways

• Original Medicare = Part A + Part B
• Medicare Advantage (Part C) is an alternative that often includes extra benefits.
• You must actively enroll in Part D or a Medigap plan if you want that additional coverage.
• There are enrollment periods, and missing them can lead to penalties or delays in coverage.