Medicare was enacted in 1965 under President Lyndon B. Johnson. It is a federal health insurance program for U.S. citizens and permanent legal residents.
It is the largest healthcare payer in the United States, In fact, it covers over 60 million people. You become eligible for Medicare when you turn 65. You may also become eligible before you turn 65. This is usually due to having end-stage renal disease at any age, or also if you are under 65 with certain disabilities.
Medicare offers basic insurance coverage. Therefore, it helps pay for things like doctor and emergency room visits, outpatient procedures, and hospital stays. The Centers for Medicare & Medicaid Services or CMS governs both Medicare and Medicaid. CMS is a branch of the Department of Health and Human Services (HHS).
Medicare is made of two parts: Medicare Part A also known as hospital insurance, and Medicare Part B also known as medical insurance.
According to CMS, total medicare expenditures for 2017 totaled $705.9 billion. This is funded through two U.S. Treasury trust funds:
You become eligible for Medicare when you Turn 65, are not 65 yet but have a qualifying disability, or have end stage renal disease.
According to the 2020 Medicare & You Guidebook, the official U.S. Government Medicare Handbook, you will be automatically enrolled into Part A and Part B if:
For everyone else, you wil need to sign up in order to receive Original Medicare. You may sign up during one of the enrollment periods.
You may face a late enrollment penalty for Part B, or Part D if you are eligible and choose not to enroll during your initial enrollment period. Make sure you have creditable coverage if you are considering delaying enrollment for either parts.
If you sign up before the month of your birthday, then your coverage will usually begin on the 1st of the month that you turn 65. This also applies to you if you are auto-enrolled due to receiving benefits from social security or RRB. However, your coverage will begin on the 1st of the previous month of your birthday if your birthday is on the first of the month.
If you’re under 65 with a disability, your coverage will start after you receive Social Security disability benefits. This is also true if you receive some RRB disability benefits for at least 24 months.
If you have ALS (Lou Gehrig’s Disease), you’ll receive Medicare benefits the same month you start receiving Social Security disability benefits.
Choosing the right plan will be different for each person. Futhermore, it should be based on your individual financial and medical needs. It is not a one-size fits all approach.
However, there are two main options that you will choose from. You can choose to have Original Medicare, which you can pair with a Supplement plan or you can choose an Advantage plan also known as Part C.
If you choose Original Medicare, it will consist of Part A and Part B. This is also known as Traditional Medicare or Fee-for-Service (FFS) Medicare. It is governed by the Centers for Medicare and Medicaid Services (CMS). If you go this route, you will most likely need to choose a stand-alone Part D (Prescription Drug) plan.
If you have questions or need help with your enrollment, I am a phone call away! I am a licensed Independent Broker. Therefore, I am not loyal to any one specific insurance company. Above all, my loyalty is to my clients. Best of all, my services are 100% free of charge!