If you are looking for information about Medicare; what it is, who is eligible for Medicare, what it covers, how to sign up, the different types of plans available, see below:
What is Medicare?
Medicare is a federal health insurance program only for people who are either:
- 65 or older,
- Some disabled younger people and
- People with End-Stage Renal Disease (ESRD).
For most people, the Part A insurance is free, although you may have co-pays and deductibles.
What are the Medicare “Parts”?
Medicare is broken up in to separate “parts” to cover specific services:
- Medicare Part A (Hospital Insurance) – Free for most eligible people. Part A covers
inpatient hospital stays,
care in a skilled nursing facility,
hospice care, and
some home health care.
- Medicare Part B (Medical Insurance) – Part B covers
certain doctors’ services,
medical supplies, and
This plan does cost a monthly premium. Most people pay $134/month. If you have very high income, you could pay $187 or more.
If your yearly income in 2015 (for what you pay in 2017) was You pay each month (in 2017) File individual tax return File joint tax return File married & separate tax return $85,000 or less $170,000 or less $85,000 or less $134 above $85,000 up to $107,000 above $170,000 up to $214,000 Not applicable $187.50 above $107,000 up to $160,000 above $214,000 up to $320,000 Not applicable $267.90 above $160,000 up to $214,000 above $320,000 up to $428,000 above $85,000 and up to $129,000 $348.30 above $214,000 above $428,000 above $129,000 $428.60
Medicare Part B also requires you to pay a yearly deductible ($183 in 2017). Once you’ve met the deductible, you pay a coinsurance of 20% of the Medicare-approved amount charged by your providers. And many preventive services are provided at no cost to you, without requiring you to first meet your deductible.
- Medicare Part C (Medicare Advantage Plans) – These are type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Medicare Advantage Plans are an alternative way to get your Medicare Part A and B coverage and, in some cases, provide additional benefits. Some plans may also offer vision, dental, hearing and/or health and wellness programs at an extra cost.
Health Maintenance Organizations,
Preferred Provider Organizations,
Private Fee-for-Service Plans,
Special Needs Plans, and
Medicare Medical Savings Account Plans.
If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
- Medicare Part D (prescription drug coverage) – Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans. There is a monthly premium for Part D coverage.
If your filing status and yearly income in 2015 was File individual tax return File joint tax return File married & separate tax return You pay (in 2017) $85,000 or less $170,000 or less $85,000 or less your plan premium above $85,000 up to $107,000 above $170,000 up to $214,000 not applicable $13.30 + your plan premium above $107,000 up to $160,000 above $214,000 up to $320,000 not applicable $34.20 + your plan premium above $160,000 up to $214,000 above $320,000 up to $428,000 above $85,000 up to $129,000 $55.20 + your plan premium above $214,000 above $428,000 above $129,000 $76.20 + your plan premium
Add it up: total monthly costs
For most people who are not earning a substantial income (in other words, you earn less than $85k as an individual or $170k joint) your monthly costs are:
- Part A: $0
- Part B: $134
- Part D: $13.30
- And any deductibles co-pays or excesses, if you actually have medical needs during a given month.
This means your monthly premiums are about $150/ month.
But, as noted above you could still have co-pays, deductibles and excesses. So let’s look at what isn’t covered and supplemental coverage.
What Doesn’t Part A & Part B Cover?
Medicare doesn’t cover everything. If you need certain services Medicare doesn’t cover, you’ll have to pay for them yourself unless you have other insurance or you’re in a Medicare health plan that covers them. And even if Medicare covers a service or item, you generally have to pay your deductible, coinsurance, and copayments.
Some of the items and services that Medicare doesn’t cover include:
- Long-term care (also called custodial care)
- Most dental care
- Eye examinations related to prescribing glasses
- Cosmetic surgery
- Hearing aids and exams for fitting them
- Routine foot care
Supplemental Insurance plans Also called MediGap Plans
Medicare Supplement Insurance (Medigap) policies are sold by private companies, can help pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. See this page for detailed information about the benefits and costs of MediGap plans.
How to verify the coverage you have?
There are several methods:
- Check your red, white, and blue Medicare card.
- Check all the other insurance cards that you use. Call the phone number on the cards to get more information about the coverage.
- Check your Medicare health or drug plan enrollment documents.
- Call Medicare at 1-800-MEDICARE (1-800-633-4227).
How to Sign up for Medicare or Change plans
You can enroll three months before the month you turn 65, the month of your birthday or three months after your birth month. Eligibility requirements include:
- You or your spouse have worked for at least 10 years in Medicare-covered employment, and
- You’re a U.S. citizen or permanent resident for at least five years.
Even if you’re not collecting Social Security yet, you’re eligible to join at age 65 or later.
Click on the links below for more information about each topic
- Getting started with Medicare
- Your Medicare coverage choices (Original Medicare or a Medicare Advantage Plan (Part C) )
- How to sign up for Part A & Part B
- How to apply online for Medicare on Social Security’s website.
- How to get prescription drug coverage
- Changing health or drug plan
- Find out more about different types of Medicare health plans (such as Medicare Advantage, Medicare Savings Accounts, Cost Plans, demonstration/pilot programs, PACE, and Medication Therapy Management)
- Find and compare drug plans, health plans, and Medicare Supplement Insurance (Medigap) policies.