What you need to know

Medicare 101

How Medicare Works and who is eligible

  • Medicare is a federal program that offers health insurance to American citizens and other eligible individuals. The program is often referred to as Original Medicare. It has two parts -- Part A and Part B

  • Legal residents must live in the U.S. for at least 5 years in a row, including the 5 years just before applying for Medicare. 


You must also meet one of the following requirements 

  • Age 65 or older

  • Younger than 65 with a qualifying disability 

  • Any age with a diagnosis of end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS)


What benefits does Original Medicare provide?

  • Part A covers inpatient hospital and skilled nursing care

  • Part B covers doctor visits, outpatient care, and some drugs only covered by Part B


What are my coverage options?

You can add coverage to Original Medicare or choose to enroll in a Medicare Advantage plant instead.

Original Medicare

You can add a stand alone Part D plan (prescription drug plan), a Medicare supplement plan or both combined to Original Medicare (Part A and B).

Your options include:

  • Parts A + B

  • Parts A + B plus a Part D prescription drug plan

  • Parts A + B plus a Medicare supplement plan

  • Parts A + B plus a Part D prescription drug plan and a Medicare supplement plan combined

OR

Medicare Advantage

You may decide to receive your coverage through a Medicare Advantage plan (commonly known as Part C). Many plans include built-in prescription drug coverage.

Your options include:

  • Part C without drug coverage

  • Part C with Part D prescription drug coverage built-in

  • Part C with a standalone Part D prescription drug plan in certain situations

 

 


When can I enroll?

  • Your Initial Enrollment Period, commonly referred to as your IEP, is 7 months long. It begins 3 months before your 65th BIRTHDAY, the month of your 65th birthday, and continues for three months after.

  • Your IEP will begin and end one month earlier if your birthday is on the first of the month.

  • You may also have an IEP if you are currently receiving benefits for a qualifying disability for 24 consecutive months.

  • You should be enrolled in Part A and B automatically at age 65 if you are receiving Social Security or Railroad Retirement Board benefits. Your card will be mailed to you by Medicare.