Questions you may have about Medicare
What is Medicare?
Medicare is a federal health insurance program primarily designed for individuals aged 65 or older. It also serves younger individuals with specific disabilities and those of any age diagnosed with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant).
Who is eligible for Medicare?
Medicare is available to: - People who are 65 years of age or older. - Individuals under 65 with certain disabilities as defined by the Social Security Administration. - Those of all ages with end-stage renal disease (ESRD), which includes individuals needing regular dialysis or a kidney transplant.
What are the different parts to Medicare?
Part A: Hospital Insurance – Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
Part B: Medical Insurance – Covers certain doctors' services, outpatient hospital care, some home health care, durable medical equipment, and preventive services.
Part C: Medicare Advantage Plans – Offers an alternative way to receive Medicare benefits through private health insurance plans.
Part D: Prescription Drug Coverage – Provides coverage for prescription medications through private insurance plans approved by Medicare.
What kinds of services does Medicare cover?
Medicare covers a variety of health services, including: - Inpatient hospital stays and skilled nursing care (Part A) - Doctor's visits and outpatient care (Part B) - Preventive services like vaccinations and screenings (Part B) - Home health care under certain conditions (Part A) - Prescription medications (Part D) - Health services through Medicare Advantage plans (Part C)
What are the costs associated with Medicare?
The costs for Medicare depend on various factors including: - Part A premium: Most people do not pay a premium if they or their spouse paid Medicare taxes for at least 10 years. - Part B premium: This is usually deducted from Social Security payments, and the cost can vary based on income. - Part C (Medicare Advantage): Costs and coverage vary by plan, and you may have premiums, deductibles, and co-pays. - Part D (Prescription drug coverage): Costs also vary based on the plan you choose, including monthly premiums and cost-sharing for medications.
How does Medicare work with other insurance?
If you have other health insurance in addition to Medicare, it’s essential to understand which policy pays first based on the coordination of benefits rules. Typically, if you have employer-sponsored health insurance, that may pay first before Medicare. You should check with your insurance provider and Medicare for detailed guidance.
Can I change my Medicare coverage?
Yes, you can change your Medicare coverage during specific enrollment periods, especially during the Annual Enrollment Period (October 15 to December 7) when you can switch from Original Medicare to a Medicare Advantage plan or vice versa, or change your prescription drug coverage.
What resources are available for more information on Medicare?
For further information, you can visit the official Medicare website at [medicare.gov](http://medicare.gov), or contact the Medicare helpline at 1-800-MEDICARE (1-800-633-4227). Local resources also include State Health Insurance Assistance Programs (SHIPs) for personalized assistance.