Medicare Explained

Medicare is the federally administered health insurance program for people sixty-five years of age and older, certain disabled people under sixty-five years of age, and people with end-stage renal disease. Medicare is divided into four parts, known simply as Part A, Part B, Part C and Part D. The benefits associated with Part A are free and automatic once an individual turns sixty-five. Part B is an add-on that requires a monthly premium. Below are the benefits associated with each plan.

Part A-Hospital Insurance

• Inpatient hospital care
• Skilled nursing care
• Hospice care
• Home health care (with certain restrictions)

Part B-Medical Insurance

• Doctors
• Services
• Outpatient hospital care
• Durable medical equipment such as wheelchairs and hospital beds
• Additional medical services not covered by Part A

Part C-Medicare Advantage

Medical savings accounts
• Coordinated care plans—private health care plans provided by preferred HMOs, POSs, PPOs and PSOs

Part D-Prescription Drug Coverage

• Individual plans are available through Medicare-contracted insurance companies

Eligibility and Qualifications

Medicare is provided when Social Security benefits begin, unless the individual is under sixty-five years of age and disabled or has end-stage renal disease, in which case it is provided at that time. Individuals who are entitled to Part A and enrolled in Part B are eligible to switch to Part C.