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Medicare is a federal health insurance program primarily for individuals aged 65 and older, but it also covers certain younger people with disabilities and those with End-Stage Renal Disease. You are eligible for Medicare if you are 65 or older, have been receiving Social Security Disability Insurance (SSDI) for at least 24 months, or have a qualifying medical condition.
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Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
Part B (Medical Insurance) covers doctor visits, outpatient care, preventive services, and durable medical equipment.
Part C (Medicare Advantage) plans are offered by private insurance companies and include all benefits of Parts A and B, often with additional coverage such as prescription drugs and dental services.
Part D provides prescription drug coverage through private insurance plans.
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If you are already receiving Social Security benefits, you will be automatically enrolled in Parts A and B when you turn 65. If you are not receiving Social Security benefits, you will need to sign up for Medicare through the Social Security Administration either online, by phone, or in person.
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Original Medicare consists of Part A and Part B and is managed by the federal government. It allows you to visit any doctor or hospital that accepts Medicare. Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare offered by private insurance companies. These plans often include additional benefits like vision, dental, and hearing coverage, as well as Part D prescription drug coverage, but may have network restrictions.
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Initial Enrollment Period (IEP): A seven-month period that includes the three months before your 65th birthday month, the month of your 65th birthday, and the three months after your 65th birthday month.
Qualified Disabilities, or those with End-Stage Renal Disease: You may be eligible for Medicare at any age if you have qualifying medical condition or have been receiving Social Security Disability Insurance (SSDI) for at least 24 months.
Annual Enrollment Period (AEP): From October 15 to December 7 each year, you can change your Medicare Advantage or Part D plan for the following year.
Medicare Advantage Open Enrollment Period: From January 1 to March 31 each year, if you are enrolled in a Medicare Advantage plan, you can switch to a different Medicare Advantage plan or revert to Original Medicare and join a Part D plan.
Special Enrollment Periods (SEP): Certain circumstances, such as moving to a new area or losing other insurance coverage, may qualify you for a Special Enrollment Period to change your plan outside of the regular enrollment periods.