Understanding Medicare

New to Medicare

Medicare drug coverage (Part D) helps pay for prescription drugs you need. You can obtain Part D coverage in two different ways.

Turning 65

You’re turning 65 and all those years of hard work are behind you. You’re looking forward to retirement and want to make sure your healthcare…

Medicare Advantage

New to Medicare or have had Medicare for a while, you know that Original Medicare (Part A and Part B) only covers 80% of your hospital and medical bills.

Medicare Drug Coverage

Medicare drug coverage (Part D) helps pay for prescription drugs you need. You can obtain Part D coverage in two different ways.

MediGap

A (MediGap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like co-payments…

Medicare for Veterans

The Veterans Administration does not recommend that Veterans forego their Medicare Benefits. Some Veterans eligible for Medicare Part A do not…

Medicare Savings Program

You may be eligible for a Medicare Savings Program (MSP) which will pay your Part B premium. While each state may have different guidelines…

Low Income Subsidy

The Low Income Subsidy (LIS), also referred to as Extra Help is a program run by the Social Security Administration that may help pay your Medicare…

Download Medicare and You 2024

Download the updated 2023 version of the popular Medicare guide in either English or Spanish. You will need Adobe Acrobat Reader or a PDF reader program to view these files. Most computers can read these files natively.

New to Medicare?

These Videos Explain it Simply

(Watch Them in Order!)

Video 1

Video 2

Video 3

The Parts of Medicare

What is Medicare Part A? What Does Part A Cover?

Part A is hospital insurance that assists you with the cost of inpatient care and skilled nursing facility stays. It also helps with things like hospice and home health care. In general, you should think of the inpatient hospital benefit as Medicare coverage for room and board in the hospital. It covers the cost of your semi-private room. However, Part A does NOT cover all of the treatments that might occur in a hospital or clinical setting, such as outpatient surgeries. Those could fall under Part B. The cost of Part A for most people at age 65 is $0. This is because during your working years you have paid taxes to pre-fund the premiums for your hospital benefits. You can also get Part A for $0 through a spouse or ex-spouse’s work history. Even if you don’t automatically qualify for premium-free coverage, most people age 65 can still get it – they would just pay a hefty premium for it.

What is Medicare Part B?

Part B is your outpatient medical coverage. Part B covers essentially all of your other medical services outside of your inpatient hospital care. Without Part B, you would be uninsured for doctor’s visits (including doctors who treat you in the hospital). You would also not have Medicare coverage for lab work, preventive services, ambulance services and outpatient surgeries. More importantly, Part B covers cancer therapy and kidney dialysis. These are extremely expensive items that would cost a fortune without Part B an supplemental coverage. The cost of Part B is set by Social Security and it changes from year to year. Individuals in higher income brackets pay more than those in lower incomes brackets. Your modified adjusted gross income reported to the IRS determines what your Part B premium will be. You can read more about the cost of Part B on our Medicare Cost page.

What is Medicare Part C?

What is Part C and why don’t you have to enroll in it at Social Security like A & B?

Part C refers to the Medicare Advantage program, or private insurance. The cost of Advantage plans varies by carrier, county of residence, and plan selected.

To enroll in a Part C plan, you must first be enrolled in both Parts A and B. Even if you find a Part C plan with a very low premium, you will still pay for Part B. You must also live in the plan service area and apply during a valid election period.

Once you enroll, your Medicare coverage will come from the Advantage plan itself, not from the government.

The reason you don’t enroll in Part C at Social Security is that Part C is voluntary. Many people prefer to get their Medicare coverage from Original Medicare and traditional Medigap plans. These people do not want a Part C Advantage plan, so they will simply not enroll in one.

It is your choice whether you wish to opt for one as opposed to just staying with your original Medicare A & B and enrolling in Medigap in addition to a Part D plan.

What is Medicare Part D?

Medicare Part D is the newest part of our national health insurance program for people age 65 & up. For half a century, there was no Medicare coverage for prescription medicines. In 2006, our federal government rolled out Part D and tens of millions of Medicare beneficiaries signed up to get coverage for their outpatient drugs. It covers retail prescription drugs that you pick up yourself at the pharmacy or order via mail order. You choose a carrier and enroll in their drug plan, and that’s how you sign up for a Part D drug plan. Most states have about 30 drug plans to choose from. However, the best way to determine which one is the right fit for you is to have your agent run a Part D analysis using Medicare’s prescription drug finder tool.