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Know more about your Medicare coverage

Medicare eligible male patient with a male doctor discussing Medicare coverage

When you apply for Medicare, you’ll make the best coverage choices if you know more about Medicare. Knowing what each part of Medicare covers will also help you navigate the Medicare enrollment process more easily and get all the great benefits Medicare offers.

What does Original Medicare cover?

Original Medicare is two parts: Medicare Part A coverage and Medicare Part B coverage.

Medicare Part A covers hospital stays, skilled nursing and in-home medical care. Think of it as your inpatient care coverage for unexpected injury or illness.

Medicare Part B covers your everyday medical needs including doctor visits, medical tests, X-rays, medical supplies and long-term preventive care. Think of it as everyday medical coverage that keeps you healthy.

What does Original Medicare not cover?

Many people need more coverage than Original Medicare provides. For example, Part A and Part B of Medicare do not cover prescription drugs, dental, vision or hearing.

What is Part C or Medicare Advantage plans?

Medicare Advantage plans give you added coverage and act as comprehensive all-in-one plans with more benefits. They include Medicare Part A and Part B, plus more. Other plans have many additional benefits. They may include:

  • Dental care including cleanings, X-rays and dentures
  • Vision care including contacts and glasses
  • Hearing care including hearing aids and regular testing
  • Fitness benefits including exercise classes and gym access

What is Part D prescription drug coverage?

Part D is Medicare insurance that covers prescription medications. If prescription medicines are part of your ongoing health care, then you have the option to add a Part D plan to your Original Medicare coverage. Or you can choose a Medicare Advantage plan that includes prescription drug coverage.

Questions to ask when choosing Medicare coverage

What does the Medicare Advantage plan pay for?
Look at premiums and how much you pay when you need care. Does the plan have a deductible, copays or coinsurance? What is the maximum you will pay out of pocket for plan-covered care? Make sure you understand your costs for doctor visits and hospital stays.

Do you have enough Medicare coverage?
Know what kind of coverage you need. More coverage is always better. Look for gaps in coverage that a different plan can cover. If you need coverage for prescription drugs or other health services, you can review Part D plans or Medicare Advantage plans.

Not sure about Medicare coverage for certain health care needs?
Talk to your doctor. If it’s not clear whether your treatment, medication or any other procedure is covered, just ask.

When are you eligible for Medicare coverage?

You’re eligible for Medicare when you turn 65. Around the time of your 65th birthday, there’s a seven-month window called the Initial Enrollment Period (IEP), when you can apply for Medicare:

  • Three months before you turn 65
  • The month you turn 65
  • Three months after you turn 65

If you miss your IEP, you get another chance to enroll. You can sign up for Medicare Part A and Part B between January 1 and March 31 each year. Your Medicare coverage then begins on July 1 of the same year.

Change your mind, change your coverage

After you’ve enrolled in Medicare, if you need more coverage or a different plan, you can apply during the Annual Enrollment Period — also known as the Annual Election Period. This window, from October 15 to December 7 each year, allows you to add, drop or change your coverage. You also have a chance to change your Medicare Advantage plan from January 1 to March 31 during the Medicare Advantage Open Enrollment Period.  The most important thing is to find the Medicare coverage that works for you.

Find a Medicare plan that fits your coverage needs. Explore your plan options.

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