New to Medicare?

You’re in the right place! Becoming eligible for Medicare can be overwhelming, but don’t worry, we’re here to help. What we do is simple: we help you understand Medicare and find affordable, quality coverage that’s right for you.

Medicare is a federal program that pays for covered healthcare services of qualified beneficiaries. It was established in 1965 under Title XVIII of the Social Security Act to provide health insurance to individuals 65 and older, and has been expanded over the years to include permanently disabled individuals under the age of 65. Medicare, which consists of four parts (Medicare A-D), covers hospitalizations, physician services, prescription drugs, skilled nursing facility care, home health visits, and hospice care, among other services.

Generally, individuals are eligible for Medicare if they or their spouse worked for at least 40 quarters in Medicare-covered employment, are 65 years old, and are a citizen or permanent resident of the United States. Individuals may also qualify for coverage if they are a younger person who cannot work because they have a medical condition that is expected to last at least one year or result in death, or have end-stage renal disease (permanent kidney failure requiring dialysis or transplant). The program is administered by the Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS) and by private entities that contract with CMS to provide claims processing, auditing, and quality oversight services.

Medicare Insurance FAQs

1. When am I eligible to receive Medicare Benefits?
   Most people become eligible for Medicare when they turn 65 years old. The enrollment period for a beneficiary begins 3 months before their 65th birthday and continues for an additional 3 months after, giving an individual 7 months to sign up. If they sign up for Part A and/or Part B within the first 3 months of a person’s Initial Enrollment Period (IEP), then their coverage usually starts the first day of their birthday month.
   
   
2. What are the different parts of Medicare?
   There are four basic parts of Medicare:

• Part A – Referred to as hospital insurance, Part A covers inpatient and hospital care, skilled nursing facility, hospice, lab tests, surgery, and home health care.
• Part B – Referred to as medical insurance, Part B covers clinical research, ambulance service, outpatient, doctor services, and other non-hospital care.
• Part C – An alternative to Original Medicare offered by private companies is “Medicare Advantage” plans. These plans bundle everything Original Medicare (Part A + Part B) covers, usually with additional benefits that may include vision, hearing, dental, prescription drug coverage, fitness programs, etc.
• Part D – A prescription drug plan offered through a private insurer covering prescription drugs for additional monthly premiums.

3. How can I find out if my doctor accepts Medicare?
   Though most doctors accept Medicare, you can find out who in your area is taking Medicare and its required pricing for procedures by going to Medicare’s Physician Compare tool (www.medicare.gov/physiciancompare) and look to see if your doctor “Accepts Medicare Assignment.” You may also call 1-800-MEDICARE (1-800-633-4227, TTY users call 1-877-486-2048), or give your doctor a call before scheduling an appointment.
   
   Or simply come to us for help! We will make sure that the Medicare options you choose include your physician and specialists and prescription drugs.

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