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Medicare Insurance

Turning 65? Let's Walk You Through Medicare

Our job is to walk you through the confusing steps of Medicare and make the decision-making of one of the most important aspects of your life easy. We offer many Medicare insurance options to fit your lifestyle needs.

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What is Medicare?

Medicare is a federal health insurance program in the United States that provides healthcare coverage to individuals who are 65 years or older, as well as certain younger individuals with disabilities. Administered by the Centers for Medicare and Medicaid Services (CMS), Medicare plays a crucial role in ensuring affordable access to medical services for millions of Americans.

The Different Parts of Medicare

Medicare is divided into several parts, each offering specific coverage options to address different healthcare needs. Let's explore the key components of Medicare:

Medicare Part A (Hospital Insurance): Part A primarily covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health services. Most people are automatically enrolled in Part A without paying a premium if they or their spouse have paid Medicare taxes for at least 10 years.

Medicare Part B (Medical Insurance): Part B focuses on outpatient medical services, including doctor visits, preventive care, medical tests, durable medical equipment, and certain outpatient treatments. Part B requires a monthly premium, which is based on income, and enrollees must actively sign up for this part.

Medicare Part C (Medicare Advantage): Also known as Medicare Advantage plans, Part C combines the benefits of Part A, Part B, and often Part D (prescription drug coverage) into a single plan. Offered by private insurance companies approved by Medicare, Medicare Advantage plans may include additional benefits like dental, vision, and hearing coverage. Participants typically pay a premium in addition to their Part B premium.

Medicare Part D (Prescription Drug Coverage): Part D assists with the cost of prescription medications. This coverage is provided through private insurance companies that contract with Medicare. Beneficiaries can choose a standalone Part D plan to supplement their Original Medicare coverage or select a Medicare Advantage plan that includes prescription drug coverage.

Eligibility Requirements for Medicare

Eligibility Requirements for Medicare

To be eligible for Medicare, you must meet one of the following criteria:

Age Requirement: Individuals aged 65 years or older are generally eligible for Medicare. This includes citizens and permanent residents who have lived in the United States for at least five consecutive years.

Disability Requirement: People under the age of 65 may qualify for Medicare if they have received Social Security Disability Insurance (SSDI) benefits for at least 24 months. Individuals with certain disabilities, such as end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), can receive Medicare benefits regardless of their age.

It's important to note that Medicare enrollment is not automatic in all cases. Most individuals become eligible for Medicare upon turning 65, but they must actively enroll during their Initial Enrollment Period (IEP) to avoid potential late enrollment penalties. The IEP is a seven-month period that begins three months before the month of your 65th birthday and ends three months after your birthday month.