Medicare Explained

Medicare is a federal government program that provides healthcare coverage to those who are 65 or older, or under 65 with certain disabilities. It can be very complex, but our agency has helped countless seniors find the right Medicare plan for their needs and budget. We’ll explain Medicare in the simplest way we know how. Then, you’ll know what to expect in the months surrounding your 65th birthday. 

What Is Medicare?

Medicare was enacted in 1965 as a new way to help vulnerable Americans get access to affordable health insurance. In particular, Medicare helps aging adults, while Medicaid helps those living in poverty. Medicare didn’t change much until the prescription drug benefit was implemented in 2006—a major breakthrough.

The government has poured a lot of money into health care every year. This has resulted in better care, but constant re-assessment is needed to make sure people can keep getting coverage.

Today, Medicare is administered by the Centers for Medicare & Medicaid Services (CMS), which is part of the Department of Health and Human Services (HHS).

Parts of Medicare

Medicare consists of four parts:

  • Part A – Hospital Insurance
  • Part B – Medical Insurance
  • Part C – Medicare Advantage
  • Part D – Prescription Drug Coverage

Parts A and B are known as Original Medicare.

There are also other plans associated with Medicare, like Medigap and Medicare Advantage. If you need help with your options or you’re searching for a policy with a lower cost, reach out to Carolina Senior Benefits.

What Is Supplemental Insurance?

Original Medicare generally covers 80% of your medical costs, and you’re responsible for paying the other 20%. That’s where a supplemental insurance plan can help. If you visit the doctor often, that 20% can result in high out-of-pocket costs for you.

Medicare Eligibility

There are a few different eligibility requirements that would qualify someone for some form of Medicare. Some of these factors could offer automatic eligibility and approval, which include certain disabilities. Those that are automatically eligible for Medicare could opt to start receiving it as soon as their other benefits start. Other eligibility requirements stretch to people that are over 65 years old that may not be collecting Social Security.

Medicare Enrollment Information

Enrolling in Medicare can be slightly different for some, depending on your age and the plan you select. If you weren’t automatically enrolled in Parts A and B, you’ll need to actively sign up. You can do this in one of three ways:

  • Online: On the Social Security website 
  • Via Phone: Call 1-800-633-4227, or
  • In-Person: Visit your local Social Security office

You’ll want to enroll as soon as you’re eligible to avoid any late penalties. Your Initial Enrollment Period—when you’re first eligible for Medicare—begins three months before your 65th birthday and ends the three months after.

As stated, Medicare is administered by the Centers for Medicare and Medicaid Services. However, you actually apply for Original Medicare through Social Security.

If you’re interested in Medicare Advantage, Medicare Supplements, or prescription drug plans, you can enroll through a broker like Carolina Senior Benefits or contact the carrier directly.

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Discover How We Can Help

Carolina Senior Benefits is located in the Charlotte area. We provide outstanding customer service and help our clients make informed decisions about their health insurance coverage.

Our agents represent the top-rated insurance companies in your area, presenting you with options so you can be confident in your choices! Medicare can be intimidating, but we’re here when you need us. Call us at (704) 765-4689 to get started.