Medicare is the government’s health coverage for people 65 years of age or older, or younger people with disabilities and those with end-stage renal disease. Today Medicare provides health insurance for some 48 million Americans, a number that will grow in coming years. 

New government health care policies affecting coverage – and worries about the future budget impact of the program – are part of an ongoing debate about Medicare’s future. You may have many questions about Medicare, from what coverage is best for you to what costs you may incur.

How Do I Sign Up for Medicare?
The Centers for Medicare and Medicaid Services (CMS) administers Medicare, and the Social Security Administration determines eligibility and issues payments. To enroll, you may file online when you apply for Social Security retirement or disability benefits (www.socialsecurity.gov), or call 1-800-772-1213. You may apply for just Medicare if you don’t want to receive your Social Security benefits yet. Some people are automatically enrolled in Medicare, and receive an insurance card in the mail three months before their 65th birthday or on their 25th month of disability.

What Are Medicare Parts?
Medicare has four components, or parts: A, B, C and D. Parts A and B are also called traditional Medicare, an open-network, single-payer coverage for basic health care needs.

Part A covers basic in-patient hospital stays, tests, treatments, semiprivate room and meals. Part A also covers in-patient mental health treatment costs and treatment in skilled nursing facilities.

Part B covers outpatient medical care, including doctor’s office visits, outpatient hospital treatment, tests, diagnostic services, blood transfusions, limited ambulance services, and durable medical equipment like crutches, canes, walkers or scooters.

Part C formerly called Medicare+Choice, is an option to purchase an approved private insurance policy called a Medicare Advantage plan. About 22 percent of Medicare members have a Medicare Advantage plan. Medicare Advantage plans include health-maintenance organization (HMO) and preferred-provider organization (PPO) policies. Medicare Advantage is not supplemental insurance, but offers more extensive coverage for services not included in traditional Medicare, such as vision, hearing or dental treatments. Many offer prescription drug coverage too. If you have more extensive medical needs, or want more choice in what doctor you see or services you use, Medicare Advantage may be right for you. Medicare pays a set amount each month toward your Medicare Advantage premiums. Plans vary, so researching benefits of each policy or consulting an agent may help.

Part D is Medicare’s prescription drug coverage plan, added in 2006. Everyone on Medicare is eligible for prescription drug coverage through two avenues:

  • Enroll in traditional Medicare (Parts A and B only) and add Part D coverage
  • Enroll in a Medicare Advantage plan with drug coverage