What is Medicare?

Medicare is health insurance for people 65 and older, people under 65 with certain disabilities, and people of any age with end-stage renal disease (ESRD).

Medicare is made up of four different parts: Parts A, B, C, and D.

Medicare Part A:

Myth - Medicare covers all of your health care needs.

Truth: - Medicare does not cover:

  • Most dental care
  • Eye examinations related to prescriptions
  • Dentures
  • Cosmetic surgeries
  • Hearing aids and exams for fittings
  • Long-term care

Medicare Part A covers hospitalization, skilled nursing facility care (SNF), hospice care and home health care. It does not cover long term care. Usually you don’t pay a premium for Part A coverage. If you or your spouse worked 10 years, or 40 quarters, you are automatically enrolled in Part A when you turn 65. If you did not work the full 10 years or 40 quarters, you may be able to buy Part A and pay a premium. All in all, it covers you while you are an inpatient at the hospital.

Medicare Part B:

Myth - Medicare covers all of your health insurance costs with no copay or deductible.

Truth: - When you use a Medicare-covered service for your health care, Medicare typically pays 80% and you pay 20% after you have met your deductible. There is no annual limit to your out-of-pocket costs for your portion of the 20%.

Medicare Part B is the medical portion of your care. Most people pay a monthly premium for their Part B coverage. Coverage includes doctor visits and services, outpatient care including therapy, diagnostic tests for lab work, x-rays, MRI’s etc. along with many preventative services and some home health care and durable medical equipment.

Important! If you do not enroll in Medicare Part B when you first become eligible, you may pay a penalty if you enroll at a later time. Learn about Part B late penalties.

Medicare Part C

Part C, otherwise known as Medicare Advantage Plans, are health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Part A and Part B coverage through the Medicare Advantage Plan. Most plans include prescription drug coverage. You can read about Medicare Advantage Plans here.

Medicare Part D

Medicare Part D is your prescription drug coverage and it helps cover the cost of your prescription drugs. It is run by Medicare approved private insurance companies.

There are two ways to enroll in Medicare Part D drug coverage: Original Medicare with a stand-alone drug plan, or with a Medicare Advantage plan.

Important! If you decide not to enroll in a drug plan when you first become eligible, you may pay a penalty if you enroll at a later time.

Learn more about Part D, prescription drug plans here.