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Medicaid
Medicare
Other Health Care Programs
 
What Is Medicare?
 
Am I Eligible?
 
What Benefits Will I Get?
 
How Do I Apply?
 
How Do I Use My Benefits?
 
Medicare Health Plans
 
Useful Links
 
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Glossary of Terms

Medicare

An Overview


For more information, click on one of the questions below:

What is Medicare?

Medicare is a national health insurance program for people who are 65 or older, certain people under 65 with disabilities, and people with End-Stage Renal Disease (permanent kidney failure). Medicare is basic protection, and does not cover all medical expenses or most long-term care. Medicare includes Part A Hospital Insurance, Part B Medical Insurance, Part C Medicare Advantage plans, and Part D Prescription Drug coverage. 

Am I eligible?

Most people age 65 or older are eligible for Medicare. You may also be eligible if you or your spouse worked in Medicare-covered employment and you are under 65 and disabled, or you have end-stage renal disease (permanent kidney failure). Your income and assets do not affect your eligibility.

What benefits will I get?

Medicare is a basic health insurance program that pays only a portion of your health care costs. There are two parts to Medicare. Part A Hospital Insurance includes inpatient hospital care, skilled nursing care, and home health care. Part B Medical Insurance includes doctors' fees, medical tests, and outpatient care. Most people who are eligible for Medicare get Part A for free and pay a monthly premium for Part B. You must also pay a hospital deductible, a medical deductible, and coinsurance. Prescription drugs are not included in Medicare at this time.

How do I apply?

People getting Social Security or Railroad Retirement benefits will automatically be enrolled in Medicare at age 65. People getting Social Security disability payments will automatically be enrolled after 24 months of disability (with some exceptions). Other people who are eligible for Medicare must apply by calling the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778).

How do I use my benefits?

Once you have been approved, Medicare will send you an enrollment package and your Medicare card. You must then decide if you want to keep Part B Medical Insurance, if you want to buy Medigap supplemental insurance, and which Medicare health plan you want to use. You must show your Medicare card whenever you go for health services. If you are denied benefits or if Medicare pays less than you think they should, you may appeal.

Medicare Health Plans

You must decide how you want to get your Medicare benefits. You may choose the Original Medicare Plan, which is a federal fee-for-service plan available nationwide, or you may join a Medicare Advantage plan offered by private companies under contract with Medicare. If you keep the Original Medicare Plan, you may buy supplemental Medigap insurance to cover some of the "gaps" in your Medicare benefits. If you choose a Medicare Advantage plan, you will usually have to pay an extra monthly fee, but will also get extra benefits. Your health plan choices will vary depending on where you live.

Useful links

Links to other web sites with information about Medicare.

 

 
 
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