What is Medicare and who is Eligible?

Medicare is the US Federal Government Health Insurance Program for:

  • People 65 years of age and older
  • Some people with disabilities under age 65
  • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant)

Generally, you are eligible for Medicare if you, or your spouse, worked for at least 10 years in Medicare-covered employment and you are 65 years old and a citizen or permanent resident of the United States. You might also qualify for coverage if you are a younger person with a disability or with End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant).

Medicare has four parts:

  • Part A (Hospital Insurance)
    Most people do not have to pay for Part A.
  • Part B (Medical Insurance)
    Most people pay monthly for Part B.
  • Part C (Medical Advantage Plans)
    Medicare Advantage plans are offered by private insurance companies as an alternative to Original Medicare; plans are government subsidized and regulated.
  • Part D (Medical Prescription Drug Coverage)
    Part D Plans are offered by private insurance companies to provide coverage for prescription drug costs; plans are government subsidized and regulated.

You have several options for how to take your Medicare benefits, depending on where you live. In most cases when you first get Medicare, you are in Original Medicare. You may want to consider a Medicare Prescription Drug Plan to add drug coverage. Or, you may want to consider a Medicare Advantage Plan (like an HMO or PPO) that provides all your Part A, Part B, and often Part D coverage. Or, you can choose to enroll in Original Medicare and purchase a Medicare Supplement Insurance Plan to pay for any gaps in your coverage.