Medicare Overview:
Medicare is the federal health insurance program for people who are:
- age 65 or older,
- under age 65 with certain disabilities, and
- of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).
Medicare consists of:
Medicare Part A (Hospital Insurance)
Medicare 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)
Medicare Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. It also covers other medical services that Part A doesn't cover, such as some physical and occupational therapists. Part B helps pay for these covered services and supplies when they are medically necessary.
Most people pay a monthly premium for Part B, which helps cover doctors' services and outpatient care.
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 (some plans include additional benefits).
Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.
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)
Part D is a program that helps pay for prescription drugs for people with Medicare who join a plan that includes Medicare prescription drug coverage. You can get a stand alone Medicare Prescription Drug Plan or a Medicare Advantage Plan that includes drug coverage. These plans are offered by insurance companies and other private companies approved by Medicare.
Most people will pay a monthly premium for this coverage. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.
Not sure what kind of coverage you have?
- Check your red, white, and blue Medicare card.
- Check all other insurance cards that you use. Call the phone number on the cards to get more information about the coverage.
- Check your Medicare health or drug plan enrollment.
- Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
For more information visit www.medicare.gov
Note: Information for this article provided by www.cms.gov