Medicare is the federal health insurance program for people 65 and older (and some younger people with disabilities). Understanding the basics can save you money and prevent gaps in coverage.
Medicare Part A: Hospital Insurance
What it covers:- ✓Inpatient hospital stays
- ✓Skilled nursing facility care (after a hospital stay)
- ✓Hospice care
- ✓Some home health services
Medicare Part B: Medical Insurance
What it covers:- ✓Doctor visits and outpatient care
- ✓Preventive services (flu shots, screenings, wellness visits)
- ✓Medical equipment (wheelchairs, walkers)
- ✓Mental health services
- ✓Some home health services
Medicare Part C: Medicare Advantage
What it is: An alternative to Original Medicare (Parts A and B) offered through private insurance companies approved by Medicare.- ✓Includes everything Parts A and B cover
- ✓Often includes prescription drug coverage (Part D)
- ✓May include extra benefits like dental, vision, and hearing
- ✓Usually requires using network doctors and hospitals
- ✓Costs vary by plan — some have $0 premiums but higher copays
Medicare Part D: Prescription Drug Coverage
What it covers: Prescription medications through private insurance plans.- ✓Each plan has a formulary (list of covered drugs)
- ✓Costs include monthly premiums, annual deductibles, and copays
- ✓The "donut hole" coverage gap has been mostly closed but still affects costs
- ✓Important to compare plans each year during Open Enrollment (October 15 - December 7)
Common Mistakes to Avoid
- ✓Missing enrollment deadlines — Late enrollment can mean permanent penalty premiums
- ✓Assuming everything is covered — Original Medicare does not cover dental, vision, hearing, or long-term care
- ✓Not reviewing plans annually — Drug formularies and costs change every year
- ✓Ignoring Medigap options — Medicare Supplement Insurance can help cover out-of-pocket costs
Where to Get Help
- ✓Medicare.gov — Official information and plan comparison tools
- ✓1-800-MEDICARE (1-800-633-4227) — Free help by phone
- ✓State Health Insurance Assistance Program (SHIP) — Free local counseling
- ✓Your local Area Agency on Aging — Community-based support