Medicare is one of the most important health insurance programs in the United States and provides coverage for millions of seniors and people with disabilities. It can be complex to understand, but it doesn’t have to be. This guide gives a comprehensive overview of Medicare — what it is, how it works, who qualifies, what costs are associated with it, and more — so readers can make informed decisions about their healthcare coverage.## How Does Medicare Work?Medicare is a federal health insurance program that provides coverage for people who are 65 and older, certain individuals with disabilities, and those with End-Stage Renal Disease. It helps cover the cost of medically necessary services like hospital stays, doctor visits, preventive care, and prescription drugs. Medicare also offers optional coverage options such as extra vision and dental benefits.Medicare is broken into four parts - A, B, C and D
- Medicare Part A is a type of Medicare health insurance that helps cover inpatient care, such as hospital stays and skilled nursing facility visits. It also covers hospice and home health care. The Part A deductible applies to each benefit period, and there is no premium for those who qualify for premium-free Part A. Other expenses associated with Part A include coinsurance amounts and copayments that are typically the responsibility of the recipient.
- Medicare Part B is a type of health insurance that helps cover services and supplies related to medically necessary care, such as doctor visits, lab work and x-rays. It also helps with preventive care like vaccines and screenings. The cost of Part B is based on income and includes a monthly premium, an annual deductible, coinsurance amounts and copayment fees. In most cases, the Part B deductible must be met before Medicare covers any services or supplies.
- Medicare Part C also known as Medicare Advantage, is an alternative to traditional Medicare that allows private insurers to offer coverage. It typically includes Part A and Part B benefits, as well as additional services such as prescription drug coverage and vision and dental care. Most plans also include a network of doctors and other healthcare providers. The cost of Part C depends on the plan you choose; some require a premium in addition to the regular Part B premium.
- Medicare Part D is the prescription drug coverage of Medicare. It helps to cover the cost of most prescription drugs, including some over-the-counter medications. The cost of Part D depends on the plan you choose and may include a monthly premium, an annual deductible and co-payments for each medication filled. You can get Part D as part of a Medicare Advantage plan or purchase it as a stand-alone policy.
## The Differences Between Original Medicare And Medicare Advantage Original Medicare is made up of two parts, Part A and Part B. Part A covers hospital care, while Part B covers medical services and supplies from doctors, clinics, hospitals, and other providers. Medicare Advantage plans are an alternative to traditional Medicare that bundle both Parts A and B benefits into a single plan offered by private insurers. These plans may include additional benefits such as prescription drug coverage, vision and dental care; however, premiums for these plans may be higher than those associated with original Medicare.The following chart compares and contrasts Original Medicare and Medicare Advantage plans:| Original Medicare | Medicare Advantage ||----------------------------------------------------------|--------------------------------------------------------------------------------------------------------------|| Parts A and B only | Bundle Parts A & B along with additional benefits such as prescription drug coverage, vision and dental care || Monthly premiums for each part may be different | Fixed premium for all services || Choose any medical provider who accepts Medicare payment | Choice of providers may be limited to in-network services only || Annual deductible on Part A & B varies by plan | Deductible may be combined and lower than original medicare plans. Out-of-pocket maximums vary by plan. |## [Medicare Eligibility](https://coverageguru.com/medicare/basics/medicare-eligibility-how-old-do-you-have-to-be)It typically depends on the beneficiary's age and/or qualifying disability. Generally, anyone over 65 years old is eligible for Medicare Part A and B, whereas those below 65 may only qualify if they have a qualifying disability. Those receiving disability benefits from Social Security or Railroad Retirement Board (RRB) are automatically enrolled in Part A and B of Medicare. Additionally, beneficiaries under 65 who receive SSI benefits may also qualify for Medicare.Medicare eligibility depends on the beneficiary's age and/or qualifying disability. Generally, anyone over 65 years old is eligible for Medicare Part A and B, whereas those below 65 may only qualify if they have a qualifying disability. Those receiving disability benefits from Social Security or Railroad Retirement Board (RRB) are automatically enrolled in Part A and B of Medicare. Additionally, beneficiaries under 65 who receive SSI benefits may also qualify for Medicare.## What is [Medicare Supplement](https://coverageguru.com/medicare/plan-types/what-is-medigap)?Medicare Supplement plans, also known as Medigap, are private insurance policies that help fill the gaps in Original Medicare by providing coverage for some – or in some instances all – of the co-payments, coinsurance, and deductible expenses incurred under Medicare Part A and Part B. Depending on the plan you select, Medigap policies may cover services such as skilled nursing care and foreign travel emergency care. You must be enrolled in Original Medicare to be eligible for a Medicare Supplement plan.## Can I Combine Different Types of Medicare Plans?Combining Original Medicare with a Medicare Supplement plan and Part C or D can provide you with the best coverage available. With Original Medicare, you are able to receive services from any provider that accepts Medicare, while a Medicare Supplement plan helps fill the gaps in what original Medicare does not cover. When it comes to Part C or D, you are able to receive additional coverage for prescription drugs or get extra benefits like vision, hearing and dental services depending on the type of plan selected. You should compare the different types of plans available to find one that suits your needs.## How Do I Sign Up For Medicare?If you are eligible for Medicare, you can enroll through the [Social Security Administration](https://www.ssa.gov/policy/docs/ssb/v68n2/v68n2p41.html) or [Railroad Retirement Board (RRB)](https://rrb.gov) online, by phone, or in person. You should also contact your [State Health Insurance Assistance Program (SHIP)](https://www.shiphelp.org) which provides free health insurance counseling to those who qualify. To get started with the enrollment process, you will need to provide information such as your Social Security number and date of birth. Once you have submitted your application and provided all the necessary documentation, you will be notified when your coverage is approved.## Get Medicare Quotes Through Coverage GuruCoverage Guru is an online resource that helps you [get the best Medicare quotes](https://coverageguru.com/find-plans) for your needs. We can connect you with licensed agents so that you can quickly compare Medicare options and get tailored quotes from providers. The service includes quotes from competing insurance companies, allowing you to make an informed decision about what plan is right for you. Through Coverage Guru, you can also receive helpful guidance from experienced medical professionals who understand the details of Medicare and Medicare Supplement plans. Whether you are looking for basic coverage or more comprehensive benefits, we can help you find the right plan to meet your healthcare needs.