What is Medicare and Who is Eligible?

Medicare is a federal health insurance program that provides health care coverage primarily for people age 65 and older. It also covers certain younger individuals with disabilities and people with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). Understanding the basics of Medicare and who qualifies can help you prepare for enrollment and ensure you get the benefits you’re entitled to.

What is Medicare?
Medicare was established in 1965 and is administered by the Centers for Medicare & Medicaid Services (CMS). It is designed to help cover healthcare costs for eligible individuals, including hospital care, outpatient services, and prescription drugs.
Medicare is divided into four parts:

• Part A: Hospital insurance (covers inpatient hospital stays, skilled nursing facilities, hospice, and some home health care).

• Part B: Medical insurance (covers doctor visits, preventive services, outpatient care, and medical supplies).

• Part C: Medicare Advantage (an alternative to Original Medicare, offered through private insurance companies) or Medigap Supplement (extra insurance you can buy from a private company to fill "gaps" in your Original Medicare coverage).

• Part D: Prescription drug coverage (helps pay for medications).
Who is Eligible for Medicare?

You are generally eligible for Medicare if:

• You are age 65 or older and a U.S. citizen or permanent legal resident who has lived in the U.S. for at least 5 years.
• You are under 65 but qualify due to certain disabilities and have been receiving Social Security Disability Insurance (SSDI) benefits for at least 24 months.
• You have End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).
• You have Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease).

When Can You Enroll?
Most people enroll during their Initial Enrollment Period (IEP), which begins 3 months before the month you turn 65 and ends 3 months after. If you are still working with creditable health coverage, you may delay enrollment without facing late penalties.

Final Thoughts
Medicare provides essential health coverage to millions of Americans. Knowing whether you’re eligible and what’s included in each part can help you make informed decisions. For personalized guidance, please give us a call to schedule an appointment and we will  walk you through your options and help you choose the best coverage for your needs at no cost to you.