Medicare Insurance Coverage

Medicare is a federal health insurance program that provides healthcare coverage to eligible individuals, primarily those who are 65 years or older, as well as some younger individuals with disabilities or specific health conditions. Medicare is divided into several parts, each covering different aspects of healthcare services.

Medicare Parts

Part A: Hospital Insurance

• Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care
• Most people do not have to pay a premium for Part A if they or their spouse paid Medicare taxes while working

Part B: Medical Insurance

• Covers certain doctors’ services, outpatient care, medical supplies, and preventive services
• Requires a monthly premium, which can be deducted from your Social Security benefits or paid directly

Part C: Medicare Advantage Plans

• Offered by private insurance companies approved by Medicare
• Includes both Part A and Part B coverage, and often provides additional benefits such as prescription drug coverage (Part D), dental, vision, and hearing services
• Plans may have lower out-of-pocket costs compared to Original Medicare (Part A and B)

Part D: Prescription Drug Coverage

• Helps cover the cost of prescription drugs
• Run by private insurance companies approved by Medicare
• Available as a standalone plan or as part of a Medicare Advantage Plan (Part C)

Eligibility and Enrollment

You are eligible for Medicare if:

• You are 65 years or older and a U.S. citizen or permanent resident
• You are under 65 with a disability and have been receiving Social Security Disability Insurance (SSDI) for at least 24 months
• You have End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS)

Initial Enrollment Period:

• Begins 3 months before your 65th birthday and ends 3 months after your birthday month
• If you miss this period, you may face penalties or delays in coverage

Medicare Supplement Insurance (Medigap)

• Private insurance plans that help cover out-of-pocket costs not covered by Original Medicare (Part A and B)
• Can help pay for deductibles, copayments, and coinsurance
• Does not include prescription drug coverage; requires a separate Part D plan

Get Help with Medicare

Navigating the complexities of Medicare can be challenging. Our experienced insurance agents are here to help you understand your options, determine your eligibility, and find the right Medicare plan for your healthcare needs and budget. We’ll guide you through the process and ensure you make informed decisions about your coverage.

Contact us today to schedule a consultation and learn more about how we can assist you with your Medicare insurance needs.