What is Medicare?

Medicare is a health insurance program that provides coverage for individuals age 65 and older and for certain persons under age 65 with disabilities. “Original Medicare,” administered by the Federal Government, consists of two main parts; Part A and Part B. The other two parts of Medicare, Part C and Part D, are administered by private insurance companies.

Original Medicare (Federal Government)

Medicare Part A:

Inpatient Hospital, Skilled nursing facility, Home Health Care services, and Hospice – Most people do not have to pay for Part A.

Medicare Part B:

Physician and Outpatient Services, Durable Medical Equipment, Ambulance, Mental Health – most people pay a monthly premium for Part B.

Private Insurance Company

Medicare Part C:

Also called the Medicare Advantage Program, where private insurance companies provide Medicare Part A, Part B, and Part D benefits. May include extra services for an added cost, such as dental, vision and hearing.

Medicare Part D:

The outpatient prescription drug benefit, offered by private insurance companies.

When to Enroll?

Medicare Insurance Agent Grand Rapids MIIf you are already collecting Social Security benefits, then you will automatically be enrolled in Medicare Part A and Part B starting on the first day of the month that you turn 65. If you are not collecting social security benefits, you need to contact Social Security to make sure your Part A and Part B are effective.

If you choose to delay your Part B benefits because either you or your spouse are still working and covered by employer coverage, you can enroll in Part B with no penalty, anytime during the year when either you or your spouse retires and loses that employer coverage.

Enrollment Options

When you first enroll in Medicare, you will have Original Medicare Part A and Part B. You can choose to stay in Original Medicare and decide if you want to purchase:

Medicare Supplement Insurance – to help pay medical costs that Original Medicare doesn’t cover AND Part D, Outpatient Prescription drug coverage.

OR

Enroll in a Medicare Advantage plan and use a private insurance company to get all your Medicare benefits.

You cannot have both a Medicare Supplement and a Medicare Advantage plan.

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