What is Medicare? Medicare is a form of health insurance designed for those with specific disabilities, those with End-Stage Renal Disease (ESRD), and those who are 65 and over. Medicare has four parts:

Part A—hospital insurance. Part A covers in-patient hospital care, hospice, some home health care, and skilled nursing facility care.

Part B—medical insurance. Part B pertains to doctors’ services, out-patient care, and some preventive services to help you maintain health.

Part C—Medicare Advantage Plans such as HMOs (Health Maintenance Organizations) or PPOs (Preferred Provider Organizations). Part C refers to private company health coverage approved by the Medicare program.

Part D—Medicare prescription drug coverage. Part D covers prescription drug cost, helping lower the cost of prescription drugs as well as preventing costs from rising in the future.

Original Medicare, directed by the federal government, provides coverage for Parts A and B.  It also allows you to purchase Medicare Part C and D coverage which is provided by private insurance companies.

Medicare Advantage Plans relate to HMOs or PPOs, and are run by Medicare-approved private companies. You pay a monthly premium for these plans (Part C coverage).  When you visit the doctor, the plan pays an amount to the doctor.  If you have tests or procedures done by the doctor, the plan would pay various amounts for those services as well. Prescription drug coverage, Part D, can usually be added to one of these plans for an additional cost or it can be purchased as a stand alone policy from a different insurance company than the one being utilized for Part C coverage.

Costs for the Four Parts of Medicare.
Part A is typically free to people who are 65 or older and are U. S. citizens or residents.

Part B’s standard premium cost is $96.40, but may be higher if you are single, and your yearly modified adjusted gross income was more than $85,000; or if you are married, and your adjusted gross income was more than $170,000.

As for Part C, this will depend on the insurance company and plan that you choose.

Part D also depends on the insurance company and the plan (many companies offer multiple plans) that you choose.

How Do You  Enroll in Medicare? You should sign up for Medicare coverage (Part A) about three months prior to your 65 birthday. You can sign up for Medicare even if you do not plan to retire at age 65. Once you are eligible for Part A coverage, you have a seven-month period (your initial enrollment period) in which to sign up for Part B. A delay on your part will cause a delay in coverage and will result in higher premiums. Your initial enrollment period begins three months before your 65th birthday, includes the month in which you turn 65, and ends three months after that birthday. There is a substantial penalty for not enrolling in Part B within the initial enrollment period (a 10 percent increase in your premium for each 12-month period you were eligible for, but did not enroll in, Part B). For more information, or to enroll in Medicare, visit www.medicare.gov site, call your local Social Security center, or call 1-800-MEDICARE. Part C and D coverage can be obtained through private insurance companies.  Contact these companies directly for pricing information.

What Don’t Medicare Programs Cover? Medicare will not cover items such as hearing aids, eye exams, cosmetic surgery, and dental care/dentures. Medicare will not cover long term nursing home care or dementia care.