Medicare 101

The FOUR Parts of Medicare

Original Medicare
Supplemental Addons
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PART A

  • Inpatient Hospital Care
  • Skilled Nursing Services
  • Hospice Care
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PART B

  • Doctor’s Visits
  • Outpatient Hospital Services
  • Durable Medical Equipment
  • Physician Administered Drugs
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PART C

  • Medicare Advantage Plans offered by private insurance companies
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PART D

  • Prescription Drug Coverage

“Hospital Insurance”

“Medical Insurance”

“Medicare Advantage”

“Prescription Drug Coverage”

What’s NOT covered by Medicare?

N
Long Term Care (also called custodial care)
N
Most dental care
N
Eye examinations related to prescribing glasses
N
Dentures
N
Cosmetic Surgery
N
Hearing aids and exams for fitting them
N
Most prescription drugs*
N
Routine foot care

*these are covered by private insurance companies in on of two ways 1) through a Medicare Advantage plan OR 2) a stand alone Part D plan

What does Medicare Cost?

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PART A

Generally, PREMIUM FREE if you or your spouse worked 10+ years and have been a US citizen or legal resident for at least 5 years.

If you don’t qualify for premium free Part A, it can be purchased for $471/mo. (2021)

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PART B

The standard premium is $148.50/mo. – if your income is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA).

Medicare uses modified adjusted gross income (MAGI) reported on your IRS tax return from 2 years prior.

Signing up for Medicare


> Part A and Part B

You are first eligible for Medicare typically at age 65. You can sign up for premium-free Part A (Hospital Insurance) or Medicare Part B during your Initial Enrollment or within a Special Enrollment Period (if applicable). If you miss either of these, you may have to pay a late enrollment penalty. If you didn’t sign up for Part A and/or Part B during your Initial Enrollment Period, and you don’t qualify for a Special Enrollment Period,

you can sign up during the General Enrollment Period between January 1 – March 31st each year, however, your coverage won’t start until July 1 of that year, and you may have to pay a higher Part A and/or Part B premium for late enrollment.

Initial Enrollment Period

Your Initial Enrollment Period is a 7-month period that begins 3 months before your 65th birthday and ends 3 months after your birth month. Your coverage can start as early as the first day of the month you turn 65, unless your birthday is on the first day of the month. In that case, it can start the first of the month prior to turning 65.

3 Months

65th Birthday Month

3 Months

7 months

If you sign up for Part A and/or Part B, during the first 3 months of your Initial Enrollment Period, coverage starts the 1st of your birthday month. If your birthday is on the 1st of the month, your coverage can start the 1st of the month prior.

If you sign up for Part A and/or Part B, during your birthday month or the 3 months after, your Part B coverage will start the 1st of the following month in which you signed up.

You can sign up for Part A (Hospital Insurance) and Part B (Medical Insurance) in three ways:

  1. Online at www.SocialSecurity.gov.
  2. By calling Social Security at
    1-800-772-1213 (TTY users 1-800-325-0778),
    Monday through Friday, from 7AM to 7PM
  3. or In person at your local Social Security Office

You’ll be automatically signed up for Medicare Part A and Part B if any one of the following apply:

  • You are already getting benefits from Social Security or the Railroad Retirement Board
  • You are younger than 65 and have a disability
  • You have Lou Gehrig’s disease, also called Amyotrophic Lateral Sclerosis, or ALS

Ready to get started?