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MEDICARE
Medicare Basics
What is Medicare?
Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end-stage renal disease, amyotrophic lateral sclerosis or receive Disability benefits.
When to sign up for Medicare.
Once you become eligible to sign up for Medicare, you have 7 months (known as your Initial Enrollment Period) to enroll. Most people can sign up for Medicare three months before their 65th birthday, during the month they turn 65, and the months after their 65th birthday.
If you fail to enroll in Medicare during your Initial Enrollment Period, you could end up having to wait for the fall Open Enrollment Period, unless you qualify for a special enrollment period.
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Parts of Medicare
Part A (hospital insurance)
Part A helps pay for inpatient care at:
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Hospitals
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Skilled nursing facilities
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Hospice
It also covers some outpatient home health care.
Part A is free if you worked and paid Medicare taxes for at least 10 years. You may also be eligible because of your current or former spouse’s work.
Part B (medical insurance)
Part B helps cover:
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Services from doctors and other healthcare providers
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Outpatient care
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Home health care
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Durable medical equipment
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Some preventive services
Most people pay a monthly premium for Part B. The exact premium depends on your income level.
Review what you might pay for Medicare
Part C (Medicare Advantage)
Part C is known as Medicare Advantage. It’s an alternative to Parts A and B that bundles several coverage types, including Parts A, B, and usually D. It may also include:
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Vision
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Hearing
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Dental Insurance
You must sign up for Part A or Part B before enrolling in a Medicare Advantage plan.
Part D (prescription drug coverage)
Part D helps cover prescription drug costs.
You must sign up for Part A or Part B before enrolling in Part
If you are new to Medicare
If you're new to Medicare and interested in enrolling in a Medicare Advantage plan, you can do so during your Medicare Initial Enrollment Period. However, if you miss this initial window, don't worry—you'll have another opportunity to enroll during the Medicare Fall Open Enrollment Period, which takes place annually from October 15 to December 7. Take advantage of these enrollment periods to ensure you get the coverage that best fits your needs.
Understanding Medicare Advantage vs. Original Medicare
Unlike Original Medicare, which is managed by the federal government, Medicare Advantage plans are managed by private insurers who have control over the specifics of the plans they offer and their associated costs.
Even if you enroll in a Medicare Advantage plan, you will still be required to pay the standard monthly Part B premium, which is $174.70 in 2024. Depending on your income, your premium may be higher.
If your Medicare Advantage plan includes an additional premium, you will need to pay that in addition to your Medicare Part B premium.
It's important to note that your insurance company determines your out-of-pocket costs, including deductibles, copayments, and coinsurance, so the specific amounts can vary from plan to plan.
If you want to learn more about Medicare, check out our educational video series.
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