The Basics of Medicare

The Medicare program is a federally funded system of health insurance for the elderly and the infirmed. Medicare is divided into two parts:

  • Part A covers costs related to inpatient care, whether in a hospital, nursing home facility or hospice center. It also provides coverage for home-health care services.
  • Part B allows participants to pay an additional monthly premium to obtain reimbursement of physician’s fees, as well as other medical services and supplies.

As a general rule, Medicare recipients may obtain medical services from doctors of their own choosing, or through health maintenance organizations (HMOs) or other medical plans that have agreements with Medicare. Coverage is generally limited to the costs of reasonable and necessary medical treatment.

Eligibility for Medicare

Eligibility for Medicare is tied to eligibility for Social Security retirement and disability benefits. Most persons who have reached the age of 65 are entitled to coverage. Persons under the age of 65 may qualify based on disability.

Enrolling in Medicare

You can enroll in Medicare as early as three months before your 65th birthday, but you must enroll within 90 days after your 65th birthday, or face significant penalties. You may delay enrollment without penalty if you are covered by an employer’s policy of health insurance.