Medicare, A Simple Explanation

Social Security and Medicare are both programs that are household names, but do you know the true difference? Both programs help safeguard millions of Americans as well as improve the quality of life for their family and friends. While Social Security offers retirement, disability, and survivors benefits, Medicare provides health insurance.

Medicare is our country’s health insurance program for people age 65 or older and younger people receiving Social Security disability benefits. The program helps with the cost of health care, but it doesn’t cover all medical expenses or the cost of most long-term care.

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are 2 main ways to get Medicare:

Original Medicare

Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). If you want drug coverage, you can join a separate Part D plan. To help pay your out-of-pocket costs in Original Medicare (like your deductible and 20% coinsurance), you can also shop for and buy supplemental coverage. Examples include coverage from a Medicare Supplement Insurance (Medigap) policy, or from a former employer or union.

Medicare Advantage (also known as Part C)

Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.  Part C plans may have lower out-of-pocket costs than Original Medicare.  They also may offer extra benefits that Original Medicare doesn’t cover — like vision, hearing, dental, and more.

If you can’t afford to pay your Medicare premiums and other medical costs, you may be able to get help from your state. States offer programs for people eligible for or entitled to Medicare who have low income. Some programs may pay for Medicare premiums and some pay Medicare deductibles and coinsurance. To qualify, you must have limited income and resources.

You can learn more about Medicare, including how to apply for Medicare and get a replacement Medicare card on our website.


191 thoughts on “Medicare, A Simple Explanation

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  2. My mom is 88 years old and gets Supplemental Security Income but wants to cash surrender the value of her life insurance, but she would not want to loose her monthly SSI or Medicare or Medicaid benefits she currently receives. She receives 2,868 annual income from SSI. The life insurance policies she would like to surrender cash value, she would be receiving a total of 6,200. She is needing some home improvements and the monthly policy is something she doesn’t want to make any longer but she does NOT want her monthly income to decrease or to loose it. PLEASE help. Thank you.

    • Hi Rebecca, thank you for your question. Because SSI is a needs based program, a change in our mother’s income and assets could change her benefit amount. To inquire about the possible impact on your mother’s SSI benefits, call us at 1-800-772-1213 or your local Social Security office and speak to a representative. Please look for the general inquiry telephone number at the Social Security Office Locator. The number may appear under Show Additional Office Information. Please be aware that our call wait times are longer than normal. We hope this information helps.

  3. I have looked all over Sites that talk about
    Medicare ABD&C. And cannot find an answer to my question!

    Does Medicare A or B pay for Ambulance
    Cost to Emergency room visit for possible Heart Attack?

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