What is Medicare?

What is Medicare?

Medicare is a federal health insurance program primarily for people aged 65 and older, although certain younger individuals with disabilities or specific conditions may also qualify. Understanding Medicare and its various parts can be complex, but at Medicare-Planning.com, we are here to simplify the process and ensure you get the best plan for your needs. Our services are free to you because we are compensated by the insurance companies.

History of Original Medicare

Original Medicare, established in 1965 under President Lyndon B. Johnson, consists of two main parts: Part A (Hospital Insurance) and Part B (Medical Insurance). These parts provide essential health coverage, including hospital stays, nursing facility care, hospice, doctor visits, outpatient services, and preventive services.

Key Dates:

  • 1965: Medicare is signed into law.
  • 1972: Medicare expands to cover younger individuals with long-term disabilities and end-stage renal disease (ESRD).
  • 2003: The Medicare Modernization Act introduces Medicare Part D (prescription drug coverage).

Medicare Supplement Plans

Medicare Supplement (Medigap) plans are additional policies sold by private companies to cover costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. These plans help reduce out-of-pocket expenses and provide additional peace of mind.

Key Facts:

  • Medigap policies are standardized and labeled A through N.
  • You must have Medicare Part A and Part B to purchase a Medigap policy.
  • Medigap plans do not cover prescription drugs (you need Part D for that).

Medicare Advantage Plans

Medicare Advantage (Part C) plans are offered by private insurance companies approved by Medicare. These plans bundle Part A, Part B, and usually Part D (prescription drug) coverage, often providing additional benefits such as vision, dental, and hearing care.

Key Dates:

  • 1997: Medicare+Choice (later renamed Medicare Advantage) is introduced under the Balanced Budget Act.
  • 2003: Medicare Advantage is officially named and expanded under the Medicare Modernization Act.

Key Facts:

  • You must be enrolled in Medicare Part A and Part B to join a Medicare Advantage plan.
  • Medicare Advantage plans often have networks of doctors and hospitals you need to use.

Medicare Part D Plans

Medicare Part D provides prescription drug coverage and is available through private insurance companies. Part D plans help cover the cost of prescription medications, offering relief from high out-of-pocket expenses.

Key Dates:

  • 2003: Medicare Part D is created under the Medicare Modernization Act.
  • 2006: Medicare Part D coverage begins.

Key Facts:

  • You can join a standalone Part D plan or get drug coverage through a Medicare Advantage plan that includes Part D.
  • Part D plans have formularies, or lists of covered drugs, which can vary by plan.

Important Dates and Deadlines

  • Initial Enrollment Period (IEP): Begins three months before you turn 65 and ends three months after the month you turn 65.
  • General Enrollment Period (GEP): January 1 to March 31 each year for those who didn’t sign up during their IEP.
  • Open Enrollment Period: October 15 to December 7 each year, when you can switch or join Medicare Advantage or Part D plans.
  • Medicare Advantage Open Enrollment Period: January 1 to March 31 each year for those already in a Medicare Advantage plan.

How Medicare-Planning.com Can Help

Navigating Medicare’s many options and deadlines can be overwhelming. At Medicare-Planning.com, we offer personalized assistance to help you understand your choices and select the best plan for your needs. Our experts provide:

  • Free consultations to assess your healthcare needs.
  • Guidance on enrolling in Medicare and choosing between Original Medicare, Medicare Supplement plans, Medicare Advantage plans, and Part D plans.
  • Assistance with understanding costs, coverage options, and plan benefits.

Our service is completely free because we are paid by the insurance companies, ensuring that you receive unbiased, expert advice without any cost to you. Contact us today at info@medicare-planning.com to get started on your Medicare journey.

For further assistance, visit us at www.medicare-planning.com or email us at info@medicare-planning.com.


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