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Medicare Can Be Confusing; Don't Let It Be!

Read below to find out more about your 2 main options for Medicare.

Contact you local Agent at Landmark Insurance & Financial Group Today to Learn More!

<b>What Is Medicare?</b>

What Is Medicare?

Medicare is the country's federal health insurance program that covers several health care costs for people aged 65 and older and younger people with certain approved medical conditions or qualifying permanent disabilities.

<b>Who Can Get Medicare?</b>

Who Can Get Medicare?

Medicare initially covered US senior citizens aged over 65 years. In 1972, Medicare extended its services to people with some debilitating chronic conditions such as ESRD (end-stage renal disease) or amyotrophic lateral sclerosis (ALS), and people living with disabilities.

Eligible Medicare beneficiaries

You qualify for full Medicare benefits if:

You're 65 or older:

  • Must be a U.S citizen or a permanent legal resident who has lived in the U.S for a minimum of 5 years
  • You or your spouse are entitled to Social Security benefits or Railroad Retirement benefits or have worked long enough to start receiving these benefits even if you're not yet collecting them.
  • You or your spouse are federal employees or retiree who have not paid into Social Security but has paid into Medicare payroll taxes

Younger than 65:

  • You have received Social Security disability benefits for 24 months. (The months need not be consecutive)
  • You're entitled to a disability pension from the Railroad Retirement Board and meet certain requirements
  • You have end-stage renal failure requiring a kidney transplant and regular dialysis or have ALS. You, your spouse or your parent will be required to have paid social security taxes for a specified period, depending on your age.

What are the different Medicare plans?

Medicare plans consist of four different programs, namely:

Medicare Benefits

Part A

Part A is a hospital insurance program covering inpatient care. It pays for inpatient hospital care, skilled nursing facility care, hospice care, and limited home health services. Most qualifying Part A beneficiaries don't pay monthly premiums. To enjoy "premium-free Part A," you must have worked for at least 10 years, and paid Medicare taxes while working. Otherwise, you pay monthly premiums. Medicare Part A does not cover full hospital bills and so you'll be responsible for some part of it.

Part B

Part B is a medical insurance program covering certain non-hospital medical bills expenses like doctor consultation fees, tests, x-rays, outpatient hospital care among others. You pay monthly premiums for this Medicare program and, in some cases, the monthly premium may be higher for people with a higher income bracket. Part B beneficiaries are responsible for a portion of their medical care total bills as well.

Part C

Also known as Medicare Advantage, Part C often combines all types of Medicare coverage under one plan. It's offered by private insurance companies contracted via CMS. It's optional to enroll in Part C, but to qualify for this private insurance program, you must have the original Medicare package—Part A and Part B. Depending on your insurance, this program can cover prescription drugs, hearing aids, eye exams, dental care, among other benefits not available to Part A and Part B Plans.

Part D

This plan is an optional prescription drug plan that uses private insurance firms. The monthly fee differs across individual insurance companies. Depending on the specific plan that you've enrolled with, you may have to share some part of the expenses.

If you don’t enroll, or enroll late, you could incur a penalty. To fully understand and discover what each plan's benefits and limitations are, it's important to consult with your insurance agent.

Medicare FAQs

Q: When should I apply for Medicare?

It's typically advisable to apply for Medicare 3 months prior to age 65. However, you will not enjoy these benefits until the first of the month that you turn 65.

Q: How can I apply for Medicare 

  1. You can apply online to enroll for Medicare at By dialing the Social Security office number on 1-800-772-1213. Available 7 a.m. to 7 p.m. on Monday to Friday.
  2. Visiting the local Social Security office to apply in person.

Q: Do you automatically become enrolled in Medicare when you turn 65?

It depends. If you receive Social Security benefits or federal retirement benefits then you become auto-enrolled in Medicare on the first of the month when you turn. Otherwise, you must sign up for Medicare manually.

Q: What is Medicare Supplement/Medigap?

Medigap fills the gaps left by Medicare coverage. Medigap covers both the expected and unforeseen out-of-pocket expenses such as consultation and prescription drugs.

Finally, you don't have to navigate this difficult process alone. Work with a professional that can review your options with you for the best possible outcome.

Want to Know More?

Read here to compare Original Medicare with Advantage Plans:

Still Have Questions?  Contact your local Landmark Insurance & Financial Group Agent today with questions!


(This information is from the 2021 Medicare and You Handbook)