The Basics

 

Medicare is the federal health insurance program for:

  • people who are 65 or older 
  • certain younger people with disabilities and 
  • people of any age with End-Stage Renal Disease (ESRD) which is permanent kidney failure requiring dialysis or a kidney transplant


Today, there are nearly 60 million Americans enrolled in Medicare.

When to apply for Medicare depends on your unique situation.  Also, Medicare can be reached online at medicare.gov or by calling the Medicare phone number 1-800-MEDICARE. It is extremely important to get Medicare coverage right and I can guide you.  Here are the two most common scenarios for most people: 

Generally speaking, if you are turning 65 you are eligible to apply up to 3 months prior to your birthday month (ex.  you are turning 65 in August, then you may apply beginning on May 1st).

Or, say you are 65+ and will be losing your group health insurance (credible coverage), then you may apply 2 months prior to when that will be.

 

Medicare has two parts (A + B) which help cover specific services.

 

 

Medicare Part A or Hospital Insurance

Helps cover:

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care

 

Medicare Part B or Medical Insurance

Helps cover:

  • Services from Drs. and other health care providers
  • Outpatient care
  • Home health care
  • Durable medical equipment (wheelchairs, walkers, etc.)
  • Many preventative services (screenings, shots, vaccines, etc.)


While applying for Medicare A + B provides beneficial coverage, it does not cover all health care expenses.  There are a number of gaps in Medicare coverage that you either pay for out-of-pocket or by adding a plan offered by private insurance companies.  I cover both of your choices in the ‘Your Plan Options’ section.

 

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