Who Is Medicare For?
People can qualify for Medicare coverage at age 65 (or older) if they are a U.S citizen or a permanent resident and they have lived here continuously for 5 years or more.
People under age 65 with certain disabilities for 24 months.
People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).
People with ALS (amyotrophic lateral sclerosis).
Medicare Parts and Plans
Medicare Part A (Hospital Insurance) – Part A helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits. Most people do not pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Click here for more detail on Medicare Part A.
Medicare Part B (Medical Insurance) – Part B helps cover doctors’ services and outpatient care. It also covers some other medical services that Part A does not cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary. Most people pay a monthly premium for Part B. Click here for more detail on Medicare Part B.
These two ‘Parts’ of Medicare (Part A and Part B) are called ‘Original Medicare’ and you will be sent a new Medicare Card (Red/White/Blue) a couple of weeks after approved enrollment.
Medicare Part C ( Medicare Advantage) – Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans are offered by private companies and their coverage must be deemed as good or better that Original Medicare coverage. Most Medicare Advantage Plans include drug coverage (Part D). In many cases, you will need to use health care providers who participate in the plan’s network and service area for the lowest costs. These plans set a limit on what you will have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs. Some plans offer out-of-network coverage, but sometimes at a higher cost. Click here for more detail on Medicare Part C.
Medicare Part D (Prescription Drug Coverage) – Medicare prescription drug coverage is available to everyone with Medicare. To get Medicare prescription drug coverage, people must join a plan approved by Medicare that offers Medicare drug coverage. Most people pay a monthly premium for Part D. Click here for more detail on Medicare Part D.
Supplements (Medigap) – Medigap is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like Copayments, Coinsurance, and Deductibles. Click here for more detail on Medicare Supplements.
What Should I Do First?
Generally, you need to apply and get approved for ‘Original Medicare’ (Part A & Part B) first. We suggest that you review the ‘Parts of Medicare’, ‘Eligibility’, ‘Enrollment Periods’, ‘Costs’, ‘Penalties’ and ‘How To Sign Up for Medicare’ sections under the ‘New To Medicare’ menu on our Sannes Insurance Website above.
Once you have signed up for Original Medicare, you can decide to:
1. Keep Original Medicare and add Supplement (Medigap) and Prescription Drug Plans… or
2. Move to a Medicare Advantage Plan.
There are Pros and Cons for each option and Sannes Insurance will help you determine which plans are best for your health, financial and lifestyle needs.
