Medicare is health insurance that the United States government provides for people ages 65 and older. It also covers some people younger than 65 who have disabilities and people who have long-term (chronic) kidney failure who need dialysis or a transplant.
Medicare helps pay for most hospital services and doctor visits. It also helps pay for physical therapy, occupational therapy, and some other home health services.
But Medicare doesn't cover everything. It doesn't pay for:
Medicare services are offered in parts. Parts A and B are often called original Medicare.
Part A
Part B
Part C
These plans have different costs depending on the plan you choose. You may have monthly premiums, as well as deductibles and co-pays.
Part D
You pay a premium for the drug plan, which can vary based on what is covered in the plan.
Most people are automatically enrolled in Part A and Part B if they:
If you qualify for automatic enrollment, you will be sent your Medicare card 3 months before you turn 65 or your 25th month of disability.
You need to apply to get Part A and Part B benefits if you aren't getting Social Security or railroad benefits. (You're 65 or older but still working, for example.)
You also need to sign up if you have end-stage renal disease. Medicare covers dialysis treatment for people who have permanent kidney failure.
You can get more information and sign up for Medicare by calling the Social Security office at 1-800-772-1213 or by applying online at www.socialsecurity.gov/medicareonly.
Penalty for late enrollment
If you don't sign up for Parts A and B when you are first eligible—by the first day of the month you turn 65—you may pay a higher premium (for the rest of your life) than if you had signed up then. A penalty also may apply for late enrollment in Part D, depending on how long you went without drug coverage.
Medigap is an insurance policy that you can buy from a private company to cover costs that are not covered by original Medicare. These costs include co-payments and deductibles. The cost of a Medigap policy depends on what is covered. Some policies pay for health care costs when you travel outside the United States.
You pay a monthly premium to the insurer, as well as paying the Medicare premium for Part B.
A Medigap policy only covers one person, so you and your spouse would each need your own policy.
Medicaid is health insurance for adults who have low income and limited resources. It also covers people who have disabilities.
Medicaid and Medicare are run by the Centers for Medicare and Medicaid Services (CMS) of the U.S. government.
The health insurance marketplace is a way for people who don't have health insurance to get coverage. The marketplace is part of the Affordable Care Act. Here are some important things to know:
You can find out more about Medicare, whether you are eligible, and what it would cost you in your situation at www.medicare.gov. Or you can call 1-800-633-4227.
You can look at Medicare plans at www.medicare.gov/find-a-plan/questions/home.aspx.
The website www.cms.gov has information on both Medicare and Medicaid.
You also can get help to decide what plans might be best for you through your state's Health Insurance Assistance Program. For more information, see www.shiptalk.org/Public/home.aspx.
Current as of: October 6, 2021
Author: Healthwise Staff
Medical Review:Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine
This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.
To learn more about Healthwise, visit Healthwise.org.
© 1995-2022 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
Follow Us
Disclaimer
Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc., and Cigna HealthCare of North Carolina, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Group Universal Life (GUL) insurance plans are insured by CGLIC. Life (other than GUL), accident, critical illness, hospital indemnity, and disability plans are insured or administered by Life Insurance Company of North America, except in NY, where insured plans are offered by Cigna Life Insurance Company of New York (New York, NY). All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico.
Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna website. Cigna may not control the content or links of non-Cigna websites. Details