In all states: Medicare is a health insurance program for:

• People age 65 or older
• People under age 65 with certain disabilities
• People of all ages with End-Stage Renai Disease (permanent kidney failure requiring dialysis or a transplant)

Medicare has Two Parts:

• Part A (Hospital Insurance) most people don’t have to pay for Part A
• Part B (Medicare Insurance) most people pay monthly for Part B insurance.

You can choose different ways to get the services covered by Medicare. Depending on where you live, you may have different choices. In most cases, when you first get Medicare, you are in Original Medicare. You may want to consider a Medicare Prescription Drug Plan to add drug coverage. Or, you may want to consider a Medicare Advantage Plan (like HMO or PPO) that provides all your Part A and Part B, and often Part D coverage. You make a choice when you are first eligible for Medicare. Each year you can review your health and prescription needs and switch to a different plan in the fall. As long as you have both Part A and Part B, items covered by Part A and Part B are covered whether you have Original Medicare, or you belong to a Medicare Advantage Plan (like HMO or PPO). If you have Medicare A&B, you are eligible to buy a Medicare Supplement or Medicare Advantage Plan.

In all states: You are generally eligible for Medicare if: You or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States. If you aren’t yet 65, you might also qualify for coverage if you have a disability or with End-Stage Renal Disease (permanent kidney failure requiring dialysis or transplant).

Here are some simple guidelines: you can get Part A Insurance at age 65 without having to pay premiums if:

• You already get retirement benefits from Social Security or the Railroad Retirement Board.
• You are eligible to get Social Security or Railroad benefits but haven’t yet filed for them.
• You or your spouse had Medicare-covered government employment.

If you are under 65, you can get Part A Insurance without having to pay premiums if you have:

• Received Social Security or Railroad Retirement Board disability benefits for 24 months
• Diagnosed with End-Stage Renal Disease and meet certain requirements.

While you don’t have to pay a premium for Part A Insurance if you meet one of those conditions, you must pay for Part B if you want it. The Part B Insurance monthly premium in 2017 is $134.00. If you have Medicare A&B, you are eligible to buy a Medicare Supplement or Medicare Advantage Plan.

In all states: Medicare offers prescription drug coverage (Part D) for everyone with Medicare. To get Medicare drug coverage, you must join a plan run by an Insurance company or other private company approved by and under contract with Medicare. Each plan can vary in cost and drug coverage. If you want Medicare drug coverage, you need to choose a plan that works with your health coverage.

There are two ways to get Medicare prescription drug coverage:

• Medicare Prescription Drug Plans. These plans (sometimes called PDP’s) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service Plans, and Medicare Medical Savings Account Plans.
• Medicare Advantage Plans (like HMO or PPO) or other Medicare health plans that have prescription drug coverage.

You will get all of your Part A and Part B Insurance coverage and prescription drug coverage (Part D) through these plans. Medicare Advantage Plans with prescription drug coverage are sometimes called MA-PD’s. If you have Medicare A&B, you are eligible to buy a Medicare Supplement or Medicare Advantage Plan. 

In all states: Many people automatically get Medicare Part A and Part B insurance; if you’re already collecting benefits from Social Security or the Railroad Retirement Board (RRB); you will automatically get Part A (Hospital Insurance) and Part B (Medical Insurance). If you get Part B automatically and you don’t want to keep it, you must follow Medicare’s directions to let Medicare know you don’t want it. Otherwise, you’ll be charged the Part B premium. Some people need to sign up for Part A and Part B Insurance: If you’re age 65 or older and you aren’t getting Social Security or RRB benefits yet (for instance, because you’re still working), you won’t get Part A and Part B automatically; you need to sign up for them. If you worked for a railroad, contact the RRB to sign up. Everyone else should contact Social Security to sign up for Part A and Part B.

Note about Part A Premiums: most people don’t pay a monthly premium for Part A coverage because they (or their spouse) paid Medicare taxes while they were working. This is called “premium-free Part A”. People who aren’t eligible for premium-free Part A may be able to buy Part A for a monthly premium. If you want to buy Part A this way, you must also have Part B, which means you’ll have to pay the monthly Part B premium too. If you have Medicare A&B, you are eligible to buy a Medicare Supplement or Medicare Advantage Plan.

In all states: If you didn’t sign up for Part A and/or Part B when you first become eligible, you can sign up during the following times: You can sign up for Part A and/or Part B during the General Enrollment Period between January 1st – March 31st each year, with coverage starting July 1st. (You may have to pay a higher premium for late enrollment). You can sign up for Part A and Part B without a penalty anytime that you or your spouse (or family member if you’re disabled) are working, and you’re covered by a group health plan through the employer or union based on that work. If that coverage ends, you can sign up during the 8-month period that begins the month after the employment ends or the group health plan coverage ends, whichever happens first. This is your Special Enrollment Period (SEP) If you have Medicare A&B you are eligible to buy a Medicare Supplement or Medicare Advantage Plan.