WHAT IS MEDICARE?
• Medicare is a federal health insurance program
for people age 65 or older, younger than age 65
with certain disabilities and any age with
permanent kidney failure, also called End-
Stage Renal Disease (ESRD).
• To qualify for Medicare, you must be a legal
citizen and have been in the United States for
at least ve years.
• Like other insurance plans, there are maximum
benets, exclusions and other requirements.
You pay monthly premiums and are sometimes
responsible for out-of-pocket deductibles and
co-payments.
THERE ARE TWO TYPES OF MEDICARE
COVERAGE.
1. ORIGINAL MEDICARE: is coverage under
which the government pays your healthcare
providers directly. Original Medicare has two
parts:
• MEDICARE PART A IS HOSPITAL
INSURANCE. It helps cover costs if you
are in the hospital, a skilled nursing facility,
hospice or home healthcare.
• MEDICARE PART B IS MEDICAL
INSURANCE. It helps cover services from
doctors and other healthcare providers,
as well as the cost of hospital outpatient
care, durable medical equipment, home
healthcare and preventive services.
Enrollment in Medicare Part A and Part B
You may be automatically enrolled in Medicare
Part A, but if you are not, sign up as soon as you are
eligible. Be sure to also sign up for Part B as soon
as you are eligible. Otherwise, you may face late
enrollment penalties. Parts A and B work together,
so you need to be enrolled in both.
You will need to sign up for Part A and Part B
on your own if:
• Are not receiving Social Security or
Railroad Retirement Board (RRB) benets.
• Qualify for Medicare because you have ESRD.
You should apply three months before your 65th
birthday. You can apply:
• Online at www.socialsecurity.gov/
medicareonly
• In person at your local Social Security
oce.
• By phone at 1-800-772-1213 ( if you worked
for a railroad, call the RRB at 1-877-772-5772.
2. MEDICARE ADVANTAGE: plans are
Medicare-approved health plans run by
private insurance companies. They combine
both the hospital (Part A) and medical
(Part B) components of coverage into one
plan. Medicare Advantage Plans are called
Medicare Part C.
Medicare Part D is prescription drug coverage.
Some Medicare Advantage Plans include Medicare
Part D. If you are covered by Original Medicare,
you may purchase Part D coverage through a
Medicare-approved prescription drug plan (PDP).
Medicare Part A is hospital insurance. Medicare Part B is medical insurance.
Medicare Part C is a Medicare Advantage Plan. Medicare Part D is prescription drug coverage.
For more information on Medicare, please visit www.Medicare.gov.
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