What Is Medicare?

How Does Medicare Work?


Medicare is a federal health insurance program that provides benefits to those 65 and older and to some younger individuals with disabilities.


To understand what Medicare is and how Medicare works, it helps to explore the different types of Medicare and the coverage they provide.

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What Are The 4 Types Of Medicare?


  • Medicare Part A covers hospital expenses (Original Medicare)

  • Medicare Part B is your general medical insurance for outpatient medical needs (Original Medicare)

  • Medicare Part C (Medicare Advantage) includes coverage for everything in Medicare Parts A and B plus additional coverage

  • Medicare Part D solely covers prescription drugs



What Does Medicare Part A Cover?


Any inpatient care falls underMedicare Part A coverage. That includes:

  • Hospital stays (semi-private rooms) up to 60 days

  • Nursing services

  • Intensive care services

  • Drugs, medical supplies, and equipment used on the premises

  • Lab tests and X-rays taken while hospitalized

  • Surgery and recovery costs

  • Rehabilitation and therapy services

  • Part-time home nursing care



What Does Medicare Part B Cover?


Medicare Part B  covers outpatient needs, including:

  • Doctor visits

  • Tests, screenings, and X-rays

  • Flu shots and other vaccinations

  • Necessary medical supplies

  • Outpatient mental healthcare

  • Medically necessary preventive care



What Does Medicare Part C Cover?


More Medicare coverage can mean more peace of mind. That's why many people choose Part C, called a Medicare Advantage plan, which you can select from private insurers like Anthem. Medicare Part C plans include Part A and Part B (Original Medicare).


Many Medicare Advantage plans include prescription drug coverage (Part D) along with other benefits Original Medicare does not cover.


Medicare Advantage plans may include:

  • Routine dental care including cleanings, X-rays, and dentures

  • Routine vision care including eye exams, glasses, and contacts

  • Routine hearing care including hearing aids

  • Fitness benefits including exercise classes



What Does Medicare Part D Cover?


Original Medicare doesn't cover prescription medications. For that, you can either choose a Medicare Advantage plan that combines with Part D to include prescription drug coverage, or a standalone Part D plan that just covers prescription drugs.



Estimating Medicare Costs


Your annual income determines what you pay for Original Medicare (Parts A and B). Medicare Advantage plans (Part C) and Medicare Part D plans can vary in price based on the coverage of the plan you select.


Estimating Medicare costs is the first step to making Medicare work within your personal budget. That means knowing the parts of Medicare — what they cover and what you pay.


When Are You Eligible For Medicare?


You have a seven-month window to apply for Medicare:

  • Three months before the month you turn 65

  • The month you turn 65

  • Three months after the month you turn 65

It's good to know your Medicare enrollment dates. These are times when you can add, switch, or drop coverage so you have a plan that fits your needs.



Apply For The First Time: Medicare Initial Enrollment Period


Your Initial Enrollment Period is that seven-month window described above. It is your first chance to apply for Original Medicare. Try to sign up during this time to avoid penalties and delayed coverage.



Make Changes To Coverage: Medicare Annual Enrollment Period


If you already applied for Original Medicare but find you need to make changes, you can do that during the Annual Enrollment Period.


The Annual Enrollment Period (also known as the Annual Election Period) is from October 15 to December 7 each year, and it is your opportunity to add, drop, or change your benefits.


Annual Enrollment is also a good time to sign up for a Medicare Advantage plan if you need more coverage. If you have a plan already, you can make changes to it or to a Part D plan. The Medicare Advantage Open Enrollment Period (January 1 to March 31) is another chance to change your Medicare Advantage plan, but you can only change or drop your plan once during this period. If you drop your Medicare Advantage plan, you will return to Original Medicare (Part A and Part B). If you return to Original Medicare, you will be given the opportunity to enroll in a Part D plan.




How To Apply For Medicare


Visit your local Social Security office to sign up for Medicare, or sign up with Social Security online in about 10 minutes. You may need the following documents:

  • Your Social Security card

  • Your original birth certificate

  • Proof of U.S. citizenship or legal citizenship status documentation if you were not born in the U.S.

  • A copy of your W-2 form



What Is The Best Medicare Plan?


Choose the best Medicare plan for you by reviewing your coverage needs and budget. Compare plans to find the right fit.

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Read Our Other Medicare Articles

Anthem Blue Cross and Blue Shield is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal.


Anthem Blue Cross and Blue Shield is a Medicare Advantage plan with a Medicare contract. Anthem Blue Cross and Blue Shield is a D-SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal.