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Medicare Health Insurance

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About Medicare Insurance Plans

A Medicare health plan is a plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits to people with Medicare who enroll in the plan.

What is Medicare?

Medicare is the federal health insurance program for people who are 65 or older, certain people younger than age 65 who have disabilities, and those who have permanent kidney failure. The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.

What Does Medicare Cover?

Types of Medicare:

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    1
    Medicare (Part A) Hospital insurance helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care and hospice care.
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    2
    Medicare (Part B) Medical insurance helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and some preventive services.
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    3
    Medicare (Part D) Prescription drug coverage helps pay for the costs of prescription drugs.

When to Sign Up for Part A & Part B

When you first become eligible for hospital insurance (Part A), you have a seven-month period (your initial enrollment period) in which to sign up for medical insurance (Part B). A delay on your part will cause a delay in coverage and result in higher premiums. If you are eligible at age 65, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65 and ends three months after that birthday.

Who Pays for Health Services Provided by Medicare?

Medicare hospital insurance is free for almost everyone, but you do pay a monthly premium for medical insurance.

Who’s Eligible for Medicare?

You are eligible at age 65 if:

  • You receive or are eligible to receive Social Security benefits.
  • You receive or are eligible to receive railroad retirement benefits.
  • Your spouse receives or is eligible to receive Social Security or railroad retirement benefits.
  • You or your spouse (living or deceased, including divorced spouses) worked long enough in a government job where Medicare taxes were paid.
  • You are the dependent parent of a fully insured deceased child.

If you do not meet these requirements, you may be able to get Medicare hospital insurance by paying a monthly premium. Usually, you can sign up for this hospital insurance only during designated enrollment periods.

Note: Even though the full retirement age is no longer 65, you should sign up for Medicare three months before your 65th birthday. You can apply at www.ssa.gov

What Are the Benefits of Medicare?

The Affordable Care Act has made many improvements to Medicare and free health insurance coverage. If you have Original Medicare, you can get a yearly “Wellness” visit and many other covered preventive services. Medicare medical insurance provides effective low-cost health insurance.

Don’t confuse Medicare with Obamacare insurance or Medicaid insurance. Basically, traditional Medicare is health insurance provided by the government. Obamacare is health insurance that you buy from an insurance company, or get from your employer.

Medicaid is a government health care subsidy that offers free or low-cost care for those who qualify based on income and family size.

How Do I Apply for Medicare?

  • Apply online at Social Security.
  • Visit your local Social Security office.
  • Call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.
  • If you worked for a railroad, call the RRB at 1-877-772-5772.