What is Medicare - Medicare Eligibility - Medicare Coverage

What Is Medicare?

Medicare is a senior-focused federal health insurance plan.

Medicare came into effect in 1965 under the social security act, with the purpose of providing health insurance to U.S. citizens over the age of 65, regardless of income or medical history.

All U.S. citizens are eligible to receive Original Medicare at the age of 65. Original Medicare consists of Part A (inpatient hospital services) and Part B (outpatient medical services). Prescription drug coverage may be purchased separately under Part D Medicare, and special plans covering Original Medicare, Part D Medicare and more health services, also known as Medicare Part C (Medicare Advantage plans), can be purchased from private insurance companies.

Once you know you qualify for Medicare, you can evaluate your coverage options.

Medicare Eligibility

To be eligible for Medicare, you first have to be a U.S. citizen or legal resident residing in the U.S. for at least 5 years. If you meet that criteria and have worked for at least 10 years, you automatically become enrolled in Medicare Part A at the age of 65, which will cover emergency hospital stays. You also become eligible to enroll in Medicare Part B, covering preventive care and doctor’s visits, for a monthly premium.

Special Circumstances

Certain younger people may qualify for Medicare coverage if they have certain disabilities or life-threatening diseases. If you are under the age of 65, you may qualify for Medicare if you have:

  • ALS (also known as “Lou Gehrig’s Disease”)
  • End Stage Renal Disease (ESRD)
  • Received Social Security Disability Income
    (SSDI) for 24 months

Turning 65 or new to Medicare? Let us guide you through the gauntlet.


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What’s Not Covered Under Medicare Parts A & B

While Original Medicare covers some necessary bases, it doesn’t cover all your costs. Services and expenses that are not covered under Original Medicare include:

  • Most dental care/dentures
  • Eye exams/prescription glasses
  • Prescription drugs
  • Hearing aids
  • Long-term care
  • Homeopathic care
  • Acupuncture
  • Foot care and orthopedic shoes
  • Certain routine or physical exams
  • Deductibles, coinsurance, or copayments for health services

Know all your options.

Find your best health coverage with a Medicare Advantage or Supplement plan.

Medicare Advantage Medicare Supplement
Hospital Insurance (Part A)

Yes

Yes

Medical Insurance (Part B)

Yes

Yes

Part B Premiums

Yes

Yes

Monthly Premiums $0 or low $0 – $000
$0 Hospital Copays

Yes

No

Network Limited Non-restricted
Prescription Drug Coverage

Yes

No