The following is meant to explain the basics of Medicare in Plain English. If at any time you have questions and would prefer to speak to a licensed agent free of charge, simply call us at 888-654-3129 ext. 3.
Medicare is the Federal Government program that provides health care coverage (aka health insurance) to eligible people. The following people are eligible for Medicare:
Note: you must be a citizen or legal resident who has lived in the US for at least 5 consecutive years.
Medicare is run by the Centers for Medicare & Medicaid Services (CMS), and is funded via taxes, premiums, and the federal government.
Quick answer: Medicare is a program for Seniors 65 and older (and those with certain disabilities/afflictions), where Medicaid is for low income people of all ages. More here.
You have probably heard of different Medicare “parts” (Medicare Part A, Medicare Part D, etc.) Here they are, with a brief explanation of each:
Note: Parts A and B are known as “Original Medicare”
From 6 months before to 6 months after your 65 th birthday, you should complete certain steps. Here they are:
Schedule your Welcome to Medicare visit. The purpose of this visit is to create a record of your health and family history; check measurements like your blood pressure and weight; ensure that you’re up to date with preventive screens, and order any necessary tests based on your health. Learn more by visiting medicare.gov (external site).
Consider enrolling in the Medicare Advantage (Part C), Medicare Supplement Insurance Plan, and/or Medicare Part D (Prescription Drug) plan that fits your budget and needs. Note that your plan won’t be effective until you turn 65.
If you are considering a Medicare Supplement Insurance plan, please note that you may be subject to a waiting period and have to complete a medical questionnaire if you wait too long after your birthday. 14
If you are thinking about enrolling in a Medicare Advantage (Part C) or a Part D (Prescription Drug) plan, make sure to do so by this time.
Please note that if you don’t enroll in Part D Prescription Drug plan when you are first eligible, you may have to pay a penalty if you enroll later.
If you are thinking about enrolling in a Medicare Supplement Insurance plan, make sure to do so by this time.
If you enroll during this period, your plan will be effective on January 1.
During this time each year, you can make changes like the following:
* For Medicare Advantage (Part C) Plans
During this time you can choose to drop your Medicare Advantage plan and switch back to Original Medicare. If you do, you have the option to enroll in a Part D plan
* For Medicare Advantage (Part C) and Part D (Prescription Drug) Plans
You can make changes to your Medicare Advantage or Part D plan when certain types of events happen in your life such as moving or dropping coverage provided by an employer or union. Learn more at medicare.gov (external site).