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Medicare Basics
Learn more about Medicare

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Get the Basics About Medicare

Making the right decisions about your Medicare options is easier when you have all the facts.

What is Medicare?

Medicare is a federally-managed health insurance program. It provides coverage for people age 65 and older, younger individuals with disabilities, and people with End Stage Renal Disease (ESRD). Medicare beneficiaries can choose to add additional coverage like a Medicare Advantage or Medicare Supplement (Medigap) plan from a private insurance company.

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Original Medicare

Part A

Part B

This is the hospital insurance part of Original Medicare. It covers:

  • Hospital stays
  • Skilled nursing care
  • Home health visits

This is the medical insurance part of Original Medicare. It covers:

  • Doctor visits
  • Outpatient services
  • Other medical expenses

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You can choose to add additional coverage provided by private insurance companies

Part C: Medicare Advantage plans

Medigap plans (Medicare Supplement)

This is a health plan (for example, an HMO or PPO). It covers all your Part A and Part B benefits as well as preventive care, and it may include extras such as:

  • Prescription drug coverage
  • Vision and hearing
  • Gym memberships

OR

This is additional coverage that supplements Part A and Part B (Original Medicare) coverage.

A Medicare Supplement plan helps with some or all of the out-of-pockets costs you're left with after Original Medicare pays its share.

Part D: Drug coverage

This is prescription drug coverage. It covers the generic and brand-name prescriptions that are listed on the plan's drug formulary list. (Every plan has a different formulary list. You should review each plan's formulary before enrolling.)

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How Much Will Medicare Cost?

Medicare premiums are not one-size-fits-all. Learn more about how much Medicare will cost based on which parts you sign up for, if you sign up on time or late, and if you choose to get supplemental insurance.


When Should You Enroll?

You should enroll in Medicare when you first become eligible. For most people this is:

  • When they turn 65
  • When they retire (if they work past their 65th birthday) or
  • Before they turn 65 due to a disability

When you are first eligible for Medicare, you have a seven-month Initial Enrollment Period (IEP) in which to enroll in Part A and/or Part B. It starts three months before the month you become eligible, includes the month of your birthday, and ends three months after the month you became eligible. If you miss your IEP, there are other opportunities during the year when you can enroll.

You must meet certain requirements to qualify for Medicare. If you are not sure if you are eligible, you can refer to the Medicare Eligibility Calculator.

What Medicare Doesn’t Cover

Medicare won't cover all of your costs. If you need certain services that Medicare doesn’t cover, you'll have to pay for them yourself unless you have other insurance or you’re in a Medicare health plan that covers those services. Even if Medicare covers a service or item, you will have to pay your deductible, coinsurance, and copayments.



Questions?

You can speak to an Independence Medicare Representative at a Medicare Basics Event.

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Website Last Updated: 6/1/2017
Y0041_HM_17_43499h Approved 6/26/2017