Medicare has Four Parts: Part A
Medicare Part A (hospital insurance) helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay). Part A also pays for some home health care, and hospice care.
People age 65 or older, who are citizens or permanent residents of the United States, are eligible for Medicare Part A. You’re eligible for “Part A” at no cost at age 65 if:
| Social Security Beneficiary |
You receive or are eligible to receive Social Security benefits. |
| Railroad Retiree |
You receive or are eligible to receive railroad retirement benefits. |
| Spouse has Benefits |
Your spouse (living or deceased, including divorced spouses) receives or is eligible to receive Social Security or railroad retirement benefits; |
| Government Retiree |
You or your spouse worked long enough in a government job through which you paid Medicare taxes. |
| Dependent Parent |
You are the dependent parent of a fully insured deceased child. |
| Paid Exception |
If you don’t meet these requirements, you may be able to get Medicare Part A by paying a monthly premium. Usually, you can purchase this coverage only during designated enrollment periods. Contact us for details. |
Medicare has Four Parts: Part B
Medicare Part B: Anyone who’s eligible for Medicare Part A at no cost can enroll in Medicare Part B by paying a monthly premium. Some people with higher incomes will pay a higher monthly Part B premium.
If you’re not eligible for Part A at no cost, you can buy Part B, without having to buy Part A, if you’re age 65 or older and you’re:
| US Citizen |
A U.S. citizen. |
| 5 Years a Resident |
lawfully admitted noncitizen, who has lived in the United States for at least five years. |
| Late Enrollment Penalty |
You can only sign up for Part B during designated enrollment periods. If you don’t enroll in Part B when you’re first eligible for it, you may have to pay a late enrollment penalty for as long as you have Part B coverage. |
Medicare has Four Parts: Part C
Medicare Part C (Medicare Advantage plans) If you receive your Part A and Part B benefits directly from the government, you have original Medicare. If you receive your benefits from a Medicare Advantage organization or other private company approved by Medicare, you have a Medicare Advantage plan. Many of these plans provide extra coverage and can lower your out-of-pocket costs.
If you have Medicare Parts A and B, you can join a Medicare Advantage plan. With these plans, you can’t have a Medigap policy, because Medicare Advantage plans cover many of the same benefits a Medigap policy covers. This includes benefits like extra days in the hospital after you’ve used days that Medicare covers.
Medicare Advantage plans include:
| Medicare coordinated-care plans |
| Medicare preferred provider organization plans |
| Medicare private fee-for-service plans |
| Medicare specialty plans |
Medicare has Four Parts: Part D
Medicare Part D (Medicare prescription drug coverage) Anyone who has Medicare Part A or Part B is eligible for Part D (Medicare prescription drug coverage). Part D benefits are available as a stand-alone plan or built into Medicare Advantage. The drug benefits work the same in either plan. Joining a Medicare prescription drug plan is voluntary, and you pay an extra monthly premium for the coverage. Some beneficiaries with higher incomes will pay a higher monthly Part D premium.
If you don’t enroll in a Medicare drug plan when you’re first eligible, you may pay a late enrollment penalty if you join a plan later. You’ll have to pay this penalty for as long as you have Medicare prescription drug coverage. However, you won’t pay a penalty if you have Extra Help, or another creditable prescription drug plan. To be creditable the coverage must pay, on average, at least as much as Medicare’s standard prescription coverage.
You may also be able to get Extra Help paying for the annual deductibles, monthly premiums, and prescription co-payments related to the Medicare prescription drug program (Part D). You may qualify for Extra Help if you have limited income (tied to the federal poverty level) and limited resources. These income and resource limits usually change each year, and you can contact us for the current numbers.
You automatically qualify and don’t need to apply for Extra Help if you have Medicare and meet one of the following conditions:
| Have full Medicaid coverage |
| Have Supplemental Security Income (SSI) |
| Take part in a state program that pays your Medicare premiums |
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