WHAT IS MEDICARE

Medicare is a federal health insurance program mainly for:

• People 65 and older
   
• People under 65 with certain disabilities
   
• People of any age with End-Stage Renal Disease (ESRD) or ALS
   

• Covers: Inpatient hospital care, skilled nursing facility, hospice, and some home health care
   
• Cost: Usually free if you or your spouse worked and paid Medicare taxes for 10+ years
   

• Covers: Doctor visits, outpatient care, preventive services, lab tests, durable medical equipment
   
• Cost: Monthly premium (standard in 2025 is around $174.70, but could be higher based on income)
   

• Private plans approved by Medicare that combine Parts A and B, and often include drug coverage (Part D) and extras like vision, dental, and hearing
   
• Cost & Coverage: Varies by plan and location
   

• Covers: Prescription medications
   
• Run by: Private insurance companies
   
• Premiums: Vary by plan and income
   

• Helps pay out-of-pocket costs not covered by Original Medicare (like copays, coinsurance, deductibles)
   
• Only works with Original Medicare (not Medicare Advantage)
   
• Sold by private insurance companies
   

• You can enroll:
   
  • Automatically at 65 if you're already getting Social Security
     
  • Manually during your Initial Enrollment Period (3 months before, the month of, and 3 months after your 65th birthday)
     
• Late enrollment penalties can apply if you miss certain deadlines
   

You can choose between:

1. Original Medicare (Parts A & B)
   Add a Part D plan for prescriptions
   Consider a Medigap plan for cost protection
    
2. Medicare Advantage (Part C)
   All-in-one plan (hospital, medical, often drugs)
   Must use network doctors/hospitals in many cases

For more information about Medicare