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Medicare

Comprehensive health insurance for people ages 65 and older and individuals with qualifying disabilities or permanent kidney failure

Learn more about Medicare coverage options.Contact us to speak with a licensed insurance agent now.Call (855) 914-1497
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Learn more about Medicare coverage options.Contact us to speak with a licensed insurance agent now.Call (855) 914-1497

Comprehensive health insurance for people ages 65 and older and individuals with qualifying disabilities or permanent kidney failure

what is original medicare

What is Original Medicare?

No one should have to worry about being able to pay for after they retire. Created in 1965, this federal health insurance program covers hospital and medical care for individuals age 65 and up and for people who have received qualifying disability benefits, amyotrophic lateral sclerosis (ALS), or End State Renal Disease (ESRD).

The four “parts” of Medicare help provide a variety of care. An eligible individual enrolls in each part separately.

  • Medicare Part A: Hospital Coverage
  • Medicare Part B: Medical Coverage (outpatient and physician services)
  • Medicare Part C: Medicare Advantage (An alternative to Part A and Part B, offered by an independent health insurance company, which can also include prescription drug coverage and additional benefits)
  • Medicare Part D: Prescription Drug Coverage

Together, Medicare Part A and Part B are known as Original Medicare. You can choose to be enrolled in Original Medicare or a Medicare Advantage plan (Part C), but not both. For prescription drug coverage, you can also enroll in a Medicare Part D prescription drug plan. If you choose a Medicare Advantage Plan that includes Medicare Part D prescription drug coverage (most do), you will not need to buy a separate stand-alone Medicare Part D prescription drug plan.

What do Medicare plans cover?

Medicare plans only cover services and supplies deemed to be medically necessary. Each of Medicare Part A, Medicare Part B, and Medicare Part D prescription drug plans covers a different type of service or supply. Original Medicare generally does not cover routine dental, hearing, or vision care, although these types of coverage may be offered as additional benefits with some Medicare Advantage Plans.

Medicare Part A

  • Inpatient hospital stays
  • Inpatient surgeries
  • Home health services
  • Hospice care
  • Skilled nursing facility stays after an inpatient hospitalization

Medicare Part B

  • Ambulatory surgeries and procedures
  • Diabetic supplies
  • Durable medical equipment
  • Emergency care
  • Healthcare provider visits
  • Imaging studies
  • Laboratory studies
  • Limited outpatient medications and vaccines
  • Mental healthcare and substance abuse treatment
  • Preventive screening tests
  • Therapy (e.g., physical therapy, occupational therapy, speech and language pathology)
  • Wellness exams

Medicare Part C

  • All services covered by Medicare Part A and Part B
  • Medicare Part D prescription drug plans (available with most plans)
  • Additional (benefits will vary based on the plan you choose)

Medicare Part D

  • Prescription drugs
  • Vaccines not covered by Medicare Part B

For more information about Original Medicare, visit Medicare.gov.

Are you eligible for Medicare?

Even when you feel well, accidents happen and unexpected illnesses can sideline your health. You also may be more likely to need medical care as you get older. About 95% of people 60 and older have one or more chronic medical conditions.

are you eligible for medicare

Original Medicare is a widely available option. It offers health coverage individuals can use to maintain their health and help manage medical conditions.

Anyone who has amyotrophic lateral sclerosis (ALS) is eligible for Medicare without having to wait through a five-month Social Security Disability benefits waiting period. As a result of new legislation enacted in late 2020, eligibility for Medicare is triggered immediately upon collecting Social Security Disability benefits for ALS. Anyone who has end-stage renal disease (ESRD), i.e., kidney disease that requires dialysis or a kidney transplant, is eligible for Medicare generally three months after starting dialysis (i.e., on the first day of the fourth month of dialysis). For other qualifying disabilities, you are eligible for Medicare 24 months after your Social Security Disability Insurance (SSDI) or certain Railroad Retirement Board benefits start.

Most people enrolled in Medicare, however, qualified for Medicare when turning 65. You can enroll starting three months before the month you turn 65, during your birthday month, or within three months after your birthday month. Be sure to keep an eye on your calendar. Signing up after the Initial Enrollment Period could result in late enrollment penalties.

Frequently Asked Questions Regarding Medicare

Is there help for me if I can’t afford Original Medicare’s premiums? open Is there help for me if I can’t afford Original Medicare’s premiums?
Do I need to sign up for a Medicare plan at age 65 if I’m still working? open Do I need to sign up for a Medicare plan at age 65 if I’m still working?
Does Original Medicare cover dental or vision? open Does Original Medicare cover dental or vision?
Does a Medicare plan replace my current insurance? open Does a Medicare plan replace my current insurance?
Can I keep my doctors when I enroll in Original Medicare? open Can I keep my doctors when I enroll in Original Medicare?
Medicare vs Medicaid: What’s the difference between Medicare and Original Medicaid? open Medicare vs Medicaid: What’s the difference between Medicare and Original Medicaid?

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