Medicare is a US federal government health insurance program. It’s designed for people aged 65 and older and for younger individuals living with certain disabilities or illnesses, like End-Stage Renal Disease.
Medicare has four parts that help cover different specific services and allows individuals to customize their coverage.
Eligibility
You are eligible for Medicare if you:
- Are 65 or older
- Have been getting Social Security Disability benefits for at least 24 months (even if younger than 65)
- Have End Stage Renal Disease (regardless of age)
- Have Amyotrophic Lateral Sclerosis (regardless of age)
Non-US citizens may qualify for Medicare, depending on the specific circumstances. For instance, non-US citizens who are lawfully present can qualify for Medicare if they are eligible for Social Security retirement benefits, Railroad Retirement Benefits, or Social Security Disability Insurance.
Non-US citizens and green card holders who haven’t paid Medicare taxes for 10 years may still be eligible for coverage but may have to meet other requirements and will have to buy into Medicare.
Coverage
Medicare is not like private insurance. It does not offer plans for families or couples. As a result, you and your spouse can make different choices.
Medicare’s four parts are:
- Part A — This hospital insurance covers inpatient hospital stays, hospice, some home health care, and care in a skilled nursing facility.
- Part B — This medical insurance covers some doctors’ services, preventive services, medical supplies, and outpatient care.
- Part C — It provides the benefits of Parts A and B but is through private insurers offered by Medicare-approved companies and may provide additional benefits like vision, hearing, and dental.
- Part D — This prescription drug coverage helps with the costs of prescription drugs, and many recommended shots or vaccines.
When you enroll in Medicare, you have two choices for coverage:
- Original Medicare — This plan includes Part A and Part B and is managed by the federal government. You may see any doctor that accepts Medicare. You also may join a separate Medicare drug plan for Part D coverage.
- Medicare Advantage — This plan, also called Medicare Part C, is provided by private companies. Coverage includes Parts A and B and may include Part D as well as other benefits, depending on the plan you select. Some aspects of Part A, like hospice, may not be covered.