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Medicare is a federal program that offers health insurance to American citizens and other eligible individuals. The program is often called Original Medicare (Parts A & B).
Who can get Medicare?
U.S. citizens and legal residents
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:
What does Medicare cover?
Original Medicare (Parts A & B) provides many health care benefits
You can choose private plans to get more coverage
What are my coverage options?
You can add coverage to Original Medicare (Parts A & B) or choose a Medicare Advantage plan instead.
Original Medicare
You may add a stand-alone Part D plan, a Medicare supplement insurance plan (Medigap) or both to Original Medicare.
Medicare Advantage
You may choose to get your benefits through a Medicare Advantage plan (Part C). Many plans come with built-in prescription drug coverage. You can add a stand-alone Part D plan only with certain Medicare Advantage plan types.
What does Medicare cost?
Medicare isn’t free. The amount you’ll pay depends on the coverage you choose and the health care services you receive.
Costs you may pay with Medicare
The four kinds of payments you might have are:
Premium
Medicare Part B has a monthly premium. Some people also pay a premium for Medicare Part A. Medicare Advantage (Part C), Part D and Medigap plans may also have premiums, and amounts will vary by provider and plan.
Deductible
A set amount you pay for covered services before your plan pays.
Copay
A fixed amount you pay at the time you receive a covered service.
Coinsurance
A percentage of the cost you pay for a covered service.
When can I enroll in Medicare?
Your Initial Enrollment Period (IEP) is 7 months long. It includes your 65th birthday month plus the 3 months before and the 3 months after. Your IEP begins and ends one month earlier if your birthday is on the first of the month.
If you are receiving Social Security or Railroad Retirement Board benefits when you become eligible, you will be automatically enrolled in Medicare Parts A and B. Medicare will mail your card to you. Otherwise, you will need to enroll yourself directly with Social Security.
During your IEP, you can enroll in Medicare Part A, Part B, Medicare Advantage (Part C) and Part D. Additionally, you will have 6 months to be guaranteed coverage in a Medicare supplement insurance plan (Medigap), starting the first month you are age 65 or older and enrolled in both Medicare Part A and Part B. You may apply at other times, but you could be denied coverage or charged a higher premium based on your health.
When can I change coverage?
After you’re enrolled, you have a chance to make changes to your coverage each year during the Medicare Annual Enrollment Period (AEP).
You may make coverage changes at other times of the year in certain qualifying situations.
What if I work past 65?
You have Medicare decisions to make at age 65 even if you have coverage through an employer plan (yours or our working spouse’s).