Medicare is a federal health insurance program primarily for people aged 65 and older, but it also covers certain younger individuals with disabilities or specific medical conditions. It’s divided into four parts—A, B, C, and D—each covering different healthcare services.
Here’s a comprehensive breakdown:
🧓 Who Is Eligible?
- Age 65 or older and a U.S. citizen or permanent legal resident.
- Under 65 with certain disabilities (after receiving Social Security Disability Insurance for 24 months).
- Any age with End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig’s disease).
🧩 The Four Parts of Medicare
🛣️ Two Main Ways to Get Medicare
- Original Medicare (Parts A & B)
- Run by the federal government.
- You can add:
- Part D for drug coverage.
- Medigap (Medicare Supplement) to help with out-of-pocket costs like deductibles and coinsurance.
- Medicare Advantage (Part C)
- Offered by private insurers approved by Medicare.
- Combines Parts A, B, and usually D.
- May include extra benefits like dental, vision, and hearing.
- Often has lower out-of-pocket costs but limited provider networks.
💡 Key Considerations
- Enrollment Periods:
- Initial Enrollment: 7-month window around your 65th birthday.
- General Enrollment: Jan 1–Mar 31 annually (coverage starts July 1).
- Open Enrollment: Oct 15–Dec 7 to switch plans or add coverage.
- Late Enrollment Penalties: Delaying Part B or D without other coverage may result in permanent penalties.
- No Family Plans: Medicare is individual-only—spouses must enroll separately.
🧾 What Medicare Doesn’t Cover
- Long-term care (custodial care)
- Most dental care
- Eye exams for glasses
- Hearing aids
- Cosmetic surgery
- Routine foot care
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