A Basic Explanation

Medicare is a health insurance program offered by the federal government that covers many Americans as soon as they celebrate their 65th birthday. It was founded as a healthcare safety net for people who are no longer part of the workforce.

But Medicare isn’t just for seniors. Younger people with certain disabilities, and those with end-stage renal disease – permanent kidney failure requiring dialysis or a transplant – may also qualify for Medicare.

Expert Advice About Medicare

There are four parts to the Medicare program, and each one offers a different set of healthcare services and benefits.

Part A (Hospital Insurance)

This part of Medicare helps cover your inpatient hospital stays, and offers some assistance for skilled nursing (e.g., a stay in a nursing home). It also helps cover hospice and at-home healthcare. You won’t need to pay a premium for this coverage if you (or your spouse) paid Medicare taxes while you were working.

If you’re eligible for Medicare Part A, you’ll likely be enrolled automatically three months before your 65th birthday assuming you’ve signed up for social security benefits. (If you plan to delay collecting social security but still want to enroll in Medicare, visit socialsecurity.gov or visit your local social security office for information about how to apply.) If you aren’t 65 but think you might be eligible for Medicare, visit Medicare.gov.

Part B (Medical Insurance)

Part B covers doctors’ services; outpatient services (including when you go to the hospital but don’t have to stay overnight); diagnostic tests like X-rays; medical supplies; and preventive services like checkups, screenings, and vaccines. You pay a monthly premium for this coverage. Together, Part A and B are known as Original Medicare.

Part C (typically referred to as Medicare Advantage)

Part C plans provide Part A and B benefits as well as some additional coverage options: for example, dental, vision, hearing, and prescription medications. Unlike Original Medicare, which is administered by the government, Medicare Advantage plans are offered by private insurance companies that are contracted by the government. On occasion, they partner with an HMO or PPO to provide some of the services they cover.

Part D (Prescription Drug Coverage)

Part D Medicare plans provide prescription drug coverage. As with Medicare Advantage, Part D coverage is only offered through private insurance companies. You can buy a Part D prescription drug plan separately if you don’t have drug coverage; for example, if you have Original Medicare. If you have a Medicare Advantage plan that includes prescription drug coverage, you won’t need to buy a separate Part D plan.