New To Medicare

Medicare Explained

What Does Original Medicare include?

Original Medicare is a fee-for-service health plan that includes Part A and Part B.

  • Medicare Part A (Hospital Insurance)
    Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Medicare Part B (Medical Insurance)
    Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

Medicare Part A in Detail

What qualifies you to be eligible for Part A Medicare? First, you need to be either 65 or disable. You or your spouse will also have to of worked for 10 years and have paid your taxes. 

Does Medicare Part A have a premium? There is no premium for having Medicare Part A if you worked for 10 years or 40 quarters where you paid into Medicare.

How do you sign up for Medicare Part A? If you Qualify for Medicare Part A you will be automatically enrolled in Part  A when you turn 65  if you are collecting Social Security. If you are not collecting Social Security you need to actively enroll in parts A and B through Social Security. You will receive your “Welcome to Medicare” letter in the mail approximately 3 months prior to your effective date if you are receiving Social Security and are automatically enrolled. Your red white and blue Medicare card will be in this welcome package and will be needed if you wish to enroll in a Medigap or Medicare Advantage plan.


Medicare Part B in Detail

How do you qualify for Medicare Part B? To qualify for Medicare part B you must be of 65 years of age and have worked for the last 10 years and paid your taxes. You can qualify if you are disabled or have End-Stage Renal Disease.

Is there a premium for Part B Medicare? There is a premium for Part B Medicare. It could be automatically deducted from your benefit payments if you receive payments from one of these,

  • Social Security
  • Railroad Retirement Board
  • Office of Personnel Management

How much does Part B Medicare Cost in 2024? The standard Part B premium in 2023 will be $174.70 A majority of people will pay this amount. Below is a chart that explains how your Medicare Part B might be higher based off of your adjust gross income as reported to the IRS from 2 years prior to enrolling in Medicare.


What is Medicare part D?

Medicare Part D is drug coverage that will provide you the medications you need. Part D plans are provided by private Insurance companies that are regulated by federal programs. You can sign up for a Part D drug plan on basic Medicare A and B, While on a Supplemental Plan, or when enrolled in a Part C Medicare Advantage Plan. With a Part C Medicare Advantage plan, Part D is included in the plan. With a Supplemental plan, you will need to add a separate Part D plan.

Frequently Asked Questions About Medicare Part D.

How much does Medicare Part D cost? 

The Monthly Premiums for Part D can very by carrier and what plan is right for you will be determind by the plans formulary. This price could be less or more depending on multiple factors such as eligibility for Extra Help, your income, Plan quality, and if you have it included with a Medicare Part C Plan. 

Am I eligible for Medicare Part D?

If you are entitled to Medicare Part A and/or enrolled in Medicare Part B then you are eligible to sign up for a Medicare Part D plan.

Do I need to get a Medicare Part D Plan?

If you are eligible for a Medicare Part D plan you are highly encouraged to get a Plan. If you do not have credible prescription drug coverage while eligible for Medicare Part D you could later get a Late Enrollment Penalty added to your monthly premium.


How and When to Enroll in Medicare

Turning 65

If you are turning 65 you have a 7 month window to enroll in Medicare and either Pick a Medicare Advantage Plan or Medicare Supplement plan. Neither of these are the best and you should meet with a broker to find which is best for you.

To enroll in Original Medicare Parts A and B you will need to go through Social Security. If you are collecting Social Security 4 months before you turn 65 this will happen automatically and you should receive your card months before your birthday. If you are delaying the collection of Social Security you can enroll in Original Medicare alot of ways. 

The most efficient way is Enroll with the online Portal here. 

The second most efficient way to enroll is to go down to your local Social Security office.

The last would be to call your local Social Security office. Usually, this leads to scheduled appointments that could be weeks out. 

Turning 65 and Working

If you are Turning 65 and you are working for a company that has more than 20 employees or have other credible coverage you can Delay Part B. If you are collecting Social Security you will need to actively reach out to Social Security and have them Delay Part B. Most people will still Activate Part A as it is free if you have met the requirements. 

With that said if you feel like you are paying a fair amount for Employer coverage you should meet with a Medicare Broker before activating or delaying Part B. Medicare can often cost less than employer coverage and can offer better coverage with more benefits.