A Complete Guide to Medicare Basics

Complete Overview of Medicare Essentials

Learn the fundamentals of Medicare
Medicare provides financial assistance for medical expenses. Whether you're about to turn 65 or qualifying through other means, understanding Medicare is crucial before selecting a plan.

An overview of Medicare and its components
Before exploring plan options, it’s important to grasp the basics of Medicare.

What is Medicare?
Medicare is a federal health insurance program for individuals aged 65 and above. It also covers younger people under specific conditions.

When are you eligible for Medicare?
Eligibility begins at age 65. Younger individuals may qualify if they:

Have Amyotrophic Lateral Sclerosis (ALS)

Have End-Stage Renal Disease requiring dialysis or a transplant

Receive disability benefits from the Railroad Retirement Board or Social Security Administration

The segments of Medicare
Medicare is divided into four parts: A, B, C, and D, each covering different benefits, with Part C functioning as an alternative plan.

Part A offers hospital insurance coverage.

Part B covers outpatient services and doctor visits.

Part C, known as Medicare Advantage, provides an alternative way to receive Medicare benefits.

Part D includes prescription drug coverage.

What does Part A include?

Hospital insurance covering inpatient care costs

Initial 60 days of hospital stay costs

Requires a deductible

Beyond 60 days, costs increase

Possible coverage for skilled nursing and hospice in some cases

What does Part B include?

Outpatient services, doctor visits, and diagnostic tests

Medical equipment and prosthetics

Covers approximately 80% of eligible costs

Requires a premium, adjusted by income

What is Medicare Part C?

An alternative plan to Original Medicare

Known as Medicare Advantage plans

Some include drug coverage (Part D)

What does Part D offer?

Prescription drug coverage

Lower-cost access to medications

Plans offered through private providers in partnership with Medicare

Premiums required, with plan variations in drug coverage

Medicare costs overview

Part A is free for enrolled members; no premium required

Hospital stay deductibles apply

Part B and D involve monthly premiums

2018 Medicare fee details

Part A deductible was $1340

Part B premium was $134 for low-income beneficiaries

Average Part D premium was around $34/month

Private plans like Advantage or Medigap require continued Part B payments

Difference between Medicare Advantage and Medigap

Advantage plans may add extra benefits, including drug coverage

Medigap covers out-of-pocket costs and fills the coverage gap but does not replace Original Medicare

We hope this guide clarifies Medicare's structure and coverage options.