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Medicare 101

10 facts about Medicare

Christian Worstell

by Christian Worstell | Published December 16, 2020 | Reviewed by John Krahnert

Medicare can be overwhelming, so it is important to start with the basics. Listed below are 10 facts you should know about Medicare.

Fact 1: Medicare is for seniors and the disabled

Medicare is a federally-funded health insurance program for people age 65 or older and some younger people who have qualifying disabilities or who have end-stage renal disease (ESRD).

Medicare is administered by the Centers for Medicare & Medicaid Services and is an entitlement program similar to Social Security. This means that most U.S. citizens earn Medicare health insurance eligibility by paying taxes for a set period of time.

Fact 2: Medicare covers more than 61 million people

Medicare had over 61 million enrollees in the United States in November 2019, according to statistics from the Centers for Medicare & Medicaid Services (CMS).1

Fact 3: Medicare has 4 parts

The 4 parts of Medicare are:

  • Part A

  • Part B

  • Part C

  • Part D

Each part provides different health care benefits.

  • Medicare Part A provides hospital insurance. Medicare Part B provides coverage for preventative and medically necessary health care services.

    Part A and Part B combined are known as “Original Medicare,” and both are provided by the federal government.

  • Medicare Part C, known as Medicare Advantage, provides at least the same benefits as Original Medicare but is offered by private insurance companies and may include additional benefits.

  • Medicare Part D is optional prescription drug coverage that is also provided by private insurance companies. Both Part C and Part D are regulated by the federal government.

    You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Fact 4: Some seniors are enrolled in Part A automatically

Some seniors will be enrolled in Medicare Part A automatically around their 65th birthday.

If you are not automatically enrolled, you can enroll in Medicare Parts A and B during certain enrollment periods.

Fact 5: Many people receive Medicare Part A for free

Most people that qualify for Medicare do not pay the Part A premium.

If you or your spouse paid Medicare taxes for 10 or more years while working, you are eligible for premium-free Medicare Part A coverage.

If you are under 65, you may also qualify for premium-free Part A coverage. All Medicare beneficiaries may still be responsible for Part A costs, such as deductibles, co-insurance, and co-payments.

Fact 6: You can get Original Medicare benefits through a Medicare Advantage plan

Medicare Advantage plans (also known as Medicare Part C) cover the same benefits as Original Medicare but are provided by private insurance companies. Medicare Advantage plans must provide the same benefits as Medicare Part A and Part B.

Some of these plans offer additional benefits, such as prescription drug coverage, dental, vision, wellness programs, and other incentives.

You cannot be enrolled in a Medicare Advantage plan and have a Medicare Supplement insurance policy at the same time.

Fact 7: Medicare Part D provides prescription drug coverage

Medicare prescription drug plans (also known as Medicare Part D) provide prescription drug coverage through private insurance companies.

You can enroll in a Part D plan if you have Original Medicare. In most cases, you can enroll in a Part D plan even if you have a Medigap policy or a Medicare Advantage policy.

You can enroll in a Medicare prescription drug plan online by visiting MyRxPlans.com.

Enroll in Medicare Part D at MyRxPlans.com.

Vist MyRxPlans.com

Fact 8: You can change your Medicare coverage during the annual Medicare Open Enrollment Period

Each year, you can change some of your Medicare coverage options during the Medicare Open Enrollment Period.

The Medicare Open Enrollment Period for Medicare Advantage plans and Medicare Part D prescription drug plans runs from October 15 to December 7.

During this time, you can make several changes such as joining a Medicare Advantage plan or a Medicare prescription drug plan.

Fact 9: Medicare Supplement insurance can help reduce Medicare out-of-pocket costs

Medicare Supplement insurance is a private form of health insurance that covers some of Medicare’s out-of-pocket costs.

A policy can help cover some Medicare deductibles, co-payments, co-insurance, and other costs. There are 10 standardized plans options available in most states. Each plan option has a different combination of benefits.

You cannot be enrolled in a Medicare Advantage plan and a Medicare Supplement insurance plan at the same time.

Fact 10: Many beneficiaries enroll in optional Medicare coverage plans

Millions of beneficiaries choose to get extra coverage through Medicare Supplement insurance policies, Medicare prescription drug plans, and Medicare Advantage plans.

A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.

 

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1 https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Dashboard/Medicare-Enrollment/Enrollment%20Dashboard.html


 

Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.

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