What is Medicare?

Medicare is a federal health insurance program that provides benefits to those 65 and older and to some younger individuals with disabilities. To understand how Medicare works, it helps to explore the different types of Medicare and the coverage they provide.

What are the 4 types of Medicare?

Medicare Part A covers hospital expenses (Original Medicare)
Medicare Part B is your general medical insurance for outpatient medical needs (Original Medicare)
Medicare Part C (Medicare Advantage) includes coverage benefits Original Medicare does not cover
Medicare Part D solely covers prescription drugs

What does Medicare Part A cover?

Any inpatient care falls under Medicare Part A coverage. That includes:

Hospital stays (semi-private rooms) up to 60 days
Nursing services
Intensive care services
Drugs, medical supplies, and equipment used on the premises
Lab tests and X-rays taken while hospitalized
Surgery and recovery costs
Rehabilitation and therapy services
Part-time home nursing care

What does Medicare Part B cover?

Medicare Part B covers outpatient needs, including:

Doctor visits
Tests, screenings and X-rays
Flu shots and other vaccinations
Necessary medical supplies
Outpatient mental health care
Medically necessary preventive care

What does Medicare Part C cover?

More Medicare coverage can mean more peace of mind. That's why many people choose Part C, called a Medicare Advantage plan, which you can select from private insurers like Empire. Medicare Part C plans include Part A and Part B (Original Medicare).

Many Medicare Advantage plans include prescription drug coverage (Part D) along with other benefits Original Medicare does not cover.

Medicare Advantage plans may include:

Routine dental care including cleanings, X-rays and dentures
Routine vision care including eye exams, glasses, and contacts
Routine hearing care including hearing aids
Fitness benefits including exercise classes

What does Medicare Part D cover?

Original Medicare doesn't cover prescription medications. For that, you can either choose a Medicare Advantage plan that combines with Part D to include prescription drug coverage, or a standalone Part D plan that just covers prescription drugs.

When are you eligible for Medicare?

You have a seven-month window to apply for Medicare:

Three months before you turn 65
The month you turn 65
Three months after you turn 65

It's good to know your Medicare enrollment dates. These are times when you can add, switch or drop coverage so you have a plan that fits your needs.

Apply for the first time: Medicare Initial Enrollment Period

Your Initial Enrollment Period is that seven-month window we just mentioned. It is your first chance to apply for Original Medicare. Try to sign up during this time to avoid penalties and delayed coverage.

Make changes to coverage: Medicare Annual Enrollment Period

If you already applied for Original Medicare but find you need to make changes, you can do that during the Annual Enrollment Period.

The Annual Enrollment Period (also known as the Annual Election Period) is from October 15 to December 7 each year, and is your opportunity to add, drop or change your benefits.

Annual Enrollment is also a good time to sign up for a Medicare Advantage plan if you need more coverage. Or if you have one already, you can make changes to a Medicare Advantage plan or Part D plan. You also have a chance to change your Medicare Advantage plan from January 1 to March 31 during the Medicare Advantage Open Enrollment Period.

How to Apply for Medicare

Visit your local Social Security office to sign up for Medicare, or sign up with Social Security online in about 10 minutes. You may need the following documents:

Your Social Security card
Your original birth certificate
Proof of U.S. citizenship or legal citizenship status documentation if you were not born in the U.S.
A copy of your W-2 form

What is the best Medicare plan?

Choose the best Medicare plan for you by reviewing your coverage needs and budget. Compare plans to find the right fit.