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Medicare Coverage and Basics Overview

Medicare is a federal program, managed by the Centers for Medicare & Medicaid Services. It provides health insurance to eligible United States citizens and permanent residents of five or more years.

You’re eligible for Medicare if you’re 65 or older, or under 65 with certain disabilities. You may also qualify for Medicare, regardless of age, if you have end-stage renal disease requiring dialysis or a kidney transplant, or amyotrophic lateral sclerosis (also known as Lou Gehrig’s Disease).

Medicare overview

Medicare beneficiaries can generally get their health coverage in two ways: through Original Medicare, or through a private Medicare Advantage plan.

Original Medicare comes in two parts:

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  • Medicare Part A (hospital insurance):  This covers inpatient hospital, skilled nursing facility, hospice, and home health care.
  • Medicare Part B (medical insurance): This covers outpatient medical care, including (but not limited to) doctor visits, durable medical equipment, lab tests, and preventive services.

Certain types of Medicare coverage are only available through private insurance companies.

  • Medicare Part C (Medicare Advantage): Medicare Advantage plans provide Original Medicare benefits through private insurance companies. There are many types of Medicare Advantage plans, such as Preferred Provider Organization (PPO) plans and Health Maintenance Organization (HMO) plans. In addition to what’s covered under Original Medicare, some plans offer other benefits, such as routine dental and vision, health wellness programs, and prescription drug coverage.
  • Medicare Part D (prescription drug coverage): Original Medicare doesn’t include prescription drug benefits, except in certain situations. You can sign up for prescription drug coverage through a separate Medicare prescription drug plan, or through a Medicare Advantage Prescription Drug plan.
  • Medicare Supplement (Medigap): Medigap helps pay for out-of-pocket costs not covered in Original Medicare, such as copayments, coinsurance, deductibles, and overseas health coverage. These plans can only be used for Original Medicare and cannot be used with a Medicare Advantage plan.

If you’re enrolled in, or will soon be eligible for Medicare, and are considering whether one of the Medicare plans could be a good option for you, I can help you check those out. To learn more about who I am, click on the orange button underneath my photo below and check out my profile. I’m happy to walk you through your options by phone or email you information; you can request that using the links below. To compare your options right away, click the blue Find Your Plan button near the top-right side of this page and view the Medicare plan plans offered in your area. If you’d like to get personalized assistance, talk to me or another eHealth licensed insurance agent.

Call Medicare.com’s licensed insurance agents at 1-844-847-2659, TTY users 711; Monday through Friday, 8AM to 11PM ET, Saturday through Sunday, 8AM to 9PM ET.  You may receive a messaging service on weekends and holidays from February 15 through September 30. Please leave a message and your call will be returned the next business day.