Medicare Insurance

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Medicare is the US government health care program for people over the age of 65. It covers many medical costs, but not everything you may be faced with. It is important to figure out how you’ll manage some of the gaps in Medicare coverage as you approach 65. In this article, we’ll explain what Medicare is and what it covers.

What Is Medicare?

Medicare is a federal health insurance program for people in the US over the age of 65. It also serves some people with disabilities who are under 65. Remember that Medicare is distinct from Medicaid, which offers healthcare to low-income Americans.

Who Is Entitled to Medicare?

If you’re 65 or over and a U.S. citizen or a permanent legal resident for over the preceding five years, you are entitled to Medicare. You may also be entitled to Medicare if you are younger than 65 and disabled. If you’re receiving Social Security disability insurance, you will probably be able to receive Medicare after two years. With some conditions including end-stage renal disease and amyotrophic lateral sclerosis, you may be immediately eligible.

How Do You Enroll in Medicare?

You will automatically be enrolled in Medicare Part A, which covers hospital visits, and Part B, which covers doctor visits, if you’re receiving Social Security on your 65th birthday. For Medicare Part D, which pays for prescription drugs, you have to enroll yourself. If you aren’t receiving Social Security, you need to sign up via the website of the Social Security Administration. You should do this in the seven months around your 65th birthday. Otherwise, you may be subject to penalties. Moreover, if you want Medigap or Medicare Advantage supplemental coverages, you also need to sign up in this seven-month window. Providers are required to accept you in this window, but they can turn you down outside this window.

Is Medicare Free in Colorado?

If you or your spouse paid Medicare taxes for a decade or more, you won’t have to pay for Medicare Part A. If not, eligible individuals pay monthly premiums of up to $437. Other aspects of Medicare, such as prescription drugs and doctor visits, require separate monthly premiums.

What Is Covered by Medicare Part A and Part B?

Medicare Part A pays for inpatient care at a skilled nursing facility or hospital, as well as hospice care and some home health care. Part A has a deductible and coinsurance, meaning that you’ll pay part of the costs. This coinsurance kicks in after 60 days of inpatient care and then becomes more expensive after 90 days.

Medicare Part B pays for doctor visits and required medical supplies and services. Things like ambulance services, preventative health care, and mental health coverage are covered by Part B. It requires a monthly premium and also has a deductible.

You’ll probably have to pay a premium of 10% of the premium for every year you delay if you don’t sign up for Medicare Part B when you turn 65. This penalty will be paid for life, given that very few people drop Part B after getting it. You’ll find it hard to avoid this penalty, although you may if you had health insurance from your employer or your spouse’s employment. You have to sign up within eight months of that coverage ending.

What Is Original Medicare?

Original Medicare is Part A and Part B. These parts are managed by the federal government. Under original Medicare, you can see any doctor who accepts Medicare and the government will pay for part of the care.

What is Medicare Part C?

Medicare Part C, often referred to as Medicare Advantage, is a health plan that private insurance companies offer. It gives the advantages of Part A, Part B, and will often also include Part D benefits. Plans like this may include other forms of health care such as hearing, dental, and vision care.

What is Medicare Part D?

Medicare Part D pays part of the cost for prescription drugs. These plans are provided by private insurance companies and you’ll pay monthly premiums for them. There is generally a late penalty fee if you don’t sign up when you become eligible, like with Medicare Part B.

What Doesn’t Medicare Cover?

  • Long-term care
  • Overseas medical care
  • Hearing aids and exams
  • Glasses and eye exams
  • Most dental care
  • Massage therapy
  • Cosmetic surgery procedures

What Is Medigap?

Medicare supplement insurance or “Medigap” is an additional policy offered by private insurance companies which can pay some costs which Medicare Part A and B don’t cover. This includes care for foreign travel but doesn’t cover long-term care, dental, vision, hearing aids, private nursing care, or prescription drugs. Plan F is the most popular and full-coverage form of Medigap. The premium price depends on factors like gender, location, and whether you smoke or not. The cost can run from around $120 to $400+ per month and you need Medicare Part A and B before you can buy a policy.

You can learn more about Medicare on the Medicare.gov website.

Frequently Asked Questions

What Is Medicare?

Medicare is a federal health insurance program for people in the US over the age of 65. It also serves some people with disabilities who are under 65. Remember that Medicare is distinct from Medicaid, which offers healthcare to low-income Americans.

Who Is Entitled to Medicare?

If you’re 65 or over and a U.S. citizen or a permanent legal resident for over the preceding five years, you are entitled to Medicare. You may also be entitled to Medicare if you are younger than 65 and disabled. If you’re receiving Social Security disability insurance, you will probably be able to receive Medicare after two years. With some conditions including end-stage renal disease and amyotrophic lateral sclerosis, you may be immediately eligible.

How Do You Enroll in Medicare?

You will automatically be enrolled in Medicare Part A, which covers hospital visits, and Part B, which covers doctor visits, if you’re receiving Social Security on your 65th birthday. For Medicare Part D, which pays for prescription drugs, you have to enroll yourself. If you aren’t receiving Social Security, you need to sign up via the website of the Social Security Administration. You should do this in the seven months around your 65th birthday. Otherwise, you may be subject to penalties. Moreover, if you want Medigap or Medicare Advantage supplemental coverages, you also need to sign up in this seven-month window. Providers are required to accept you in this window, but they can turn you down outside this window.

Is Medicare Free in Colorado?

If you or your spouse paid Medicare taxes for a decade or more, you won’t have to pay for Medicare Part A. If not, eligible individuals pay monthly premiums of up to $437. Other aspects of Medicare, such as prescription drugs and doctor visits, require separate monthly premiums.

What Doesn't Medicare Cover?
  • Long-term care
  • Overseas medical care
  • Hearing aids and exams
  • Glasses and eye exams
  • Most dental care
  • Massage therapy
  • Cosmetic surgery procedures
What Is Medigap?
Medicare supplement insurance or “Medigap” is an additional policy offered by private insurance companies which can pay some costs which Medicare Part A and B don’t cover. This includes care for foreign travel but doesn’t cover long-term care, dental, vision, hearing aids, private nursing care, or prescription drugs. Plan F is the most popular and full-coverage form of Medigap. The premium price depends on factors like gender, location, and whether you smoke or not. The cost can run from around $120 to $400+ per month and you need Medicare Part A and B before you can buy a policy.

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