Medicare Basics

What is Medicare?

Medicare is a federal health insurance program for people 65 and older (and some people under 65 who qualify) to help pay for hospital and medical services. While Original Medicare covers a lot, it doesn’t pay for everything. You may want to consider adding additional coverage so that more of your healthcare needs in retirement are met. This is where Medicare Advantage, Medicare Supplement and prescription drug coverage come in, and why we’re here to help.

Medicare coverage includes four key components:

Part A

Hospital
Insurance

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Part B

Medical
Insurance

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Part C

Medicare
Advantage

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Part D

Prescription Drug
Coverage

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Am I Eligible?

Medicare is available to U.S. citizens and people who have been legal residents for at least five years. For most Americans, Medicare eligibility begins at age 65. You can start receiving Medicare Part A (Hospital Insurance) with no premium at 65 if you or your spouse worked and paid Medicare tax for at least 10 years.

In some cases, people under 65 can also receive Medicare if they:

receive Social Security disability benefits for at least 24 months (can be nonconsecutive)
receive disability pension benefits from the Railroad Retirement Board
have amyotrophic lateral sclerosis (ALS), also called Lou Gehrig’s disease
have End-Stage Renal Disease (ESRD), or kidney failure.

You can receive Medicare Part B (Medical Insurance) if you are eligible for Medicare Part A, but you must pay for it. If you are still working at age 65 and are covered by an employer-sponsored plan, you can delay starting your Part B coverage.

You can receive Medicare even if you never worked, though you will need to pay a premium for Medicare Part A.

How do I enroll?

If you are already receiving Social Security, you will be automatically enrolled in Medicare three months before you turn 65. If you are not yet receiving Social Security, but are of Medicare age (65), you will have to sign up for your Medicare benefits separately. To avoid penalties that may apply if you miss your initial Medicare enrollment window, please call us to discuss your Medicare options.

You have a 7-month Initial Enrollment Period to sign up.

This 7-month period:

begins three months before the month you turn 65
includes the month you turn 65
ends three months after the month you turn 65

If you fail to observe these Medicare timeframes, you risk late enrollment penalty surcharge on your Medicare Part B premiums for each year-long period you go without coverage. However, if you’re still working at age 65 for an employer with 20 or more employees and are covered under a qualified health plan, you can delay your Medicare enrollment without penalty.

You can sign up for Medicare online, by phone or in-person at a Social Security office starting at three months before turning 65.