What is the eligibility for medicare?

You are eligible for medicare if you are aged 65 years or above and you are also a citizen of the US or have been a legal resident for at least 5 years. Besides, you are eligible to receive Medicare at no charge if you are 65 or older and receiving retirement benefits from social security or railroad retirement board or you had medicare covered government job or you have received disability benefits for 24 months or have amyotrophic lateral sclerosis or kidney transplant.

Do I automatically get Medicare when I turn 65?

If you are 65 and already receive social security, then you will be automatically enrolled for Medicare (part A & Part B). But if you don't receive social security then you have to sign up for Medicare with the social security administration.

What will happen if I don’t sign up for Medicare at the age of 65?

If you don’t sign up at 65 then you will be subjected to late penalties. You will be subjected to two late penalties that are Part B late enrolment penalty which can increase your monthly premium by 10% each year you delay your enrolment and the second penalty is Part D late enrolment penalty which can increase your monthly premium by 1% each month you delay your medicare coverage.

When should I sign up for Medicare?

Ideally, you should sign up for Medicare 3 months earlier before you turn 65, even though the medicare benefits cannot be availed or begin before 65. You will receive your Medicare card two months before age 65.

What is the difference between Original Medicare and Medicare Advantage plans?

Medicare Part A & Part B are considered Original Medicare, which is a federal government program. Under this, you can go to any doctor or hospital which accepts medicare. However, Medicare advantage plans which are also known as Medicare Part C, are administered by private insurance companies that contract with the Federal Medicare program. Under this, you may have to pay more or pay the full cost out of your own pocket if you go to the providers outside the network but these plans may provide additional coverage which is not included in Medicare Part A and Part B such as hearing, vision, dental and prescription drug coverage.

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Let's Break Down Medicare

Medicare is our country’s health insurance program for people age 65 or older and younger people receiving Social Security disability benefits. The program helps with the cost of health care, but it doesn’t cover all medical expenses or the cost of most long-term care.

Lets Break Down The Basics

What is Original Medicare?

Original Medicare is a fee-for-service health plan that has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance).

Part A helps cover:

• Inpatient care in hospitals

• Skilled nursing facility care

• Hospice care

• Home health care

You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working for a certain amount of time. This is sometimes called premium-free Part A. If you aren’t eligible for premium-free Part A, you may be able to buy Part A.

Part B helps cover:

• Services from doctors and other health care providers

• Outpatient care

• Home health care

• Durable medical equipment (DME) (like wheelchairs, walkers, hospital beds, and other equipment)

• Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)

Most people pay the standard Part B premium amount.

What is Medicare Advantage?

Medicare Advantage (also known as Part C):

• An “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.

• Plans may have lower out-of-pocket costs than Original Medicare.

• Most plans offer extra benefits that Original Medicare doesn’t cover— like vision, hearing, and dental services.

What is Medicare Part D?

Part D (prescription drug coverage):

• Helps cover the cost of prescription drugs (including many recommended shots or vaccines)

• Run by private insurance companies that follow rules set by Medicare

• May help lower your drug costs and help protect against higher costs in the future

What is Medicaid?

Medicaid is a joint federal and state program that helps pay medical costs if you have limited income and/or resources and meet other requirements. People with Medicaid may get coverage for services that Medicare doesn’t cover or only partially covers, like nursing home care, personal care, transportation to medical services, home- and community-based services, and dental, vision, and hearing services.

Medicare Facts

Standard Part B Premium Amount*

Is Medicare Required?

Percent of US Citizens over 65 with Medicare

$ 0 *

(*Or higher depending on your income)

No, while Medicare isn’t necessarily mandatory, it is automatically offered in some situations and may take some effort to opt out of.

US Citizens Over 65 With Medicare

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