Medicare, A Simple Explanation
Reading Time: 2 MinutesLast Updated: July 16, 2021
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.
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Darlynda Bogle, Assistant Deputy Commissioner
Darlynda Bogle, Assistant Deputy Commissioner
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Kirti S.
I am Turing 65 June 2020 .
I am employed right now & have employer insurance .i would like to continue same insurance .
Do I have to inform Medicare or SSA regarding this ?
What should I do whenever I decide to get Medicare ?
Thanks
V.V.
Hi Kirti, thanks for using our blog. If you’re over age 65, and covered under a Group health plan based on current employment, you may be eligible to sign up for Medicare (Part A & B) during a Special Enrollment Period (SEP). We always suggest that individuals speak to their personnel office, health benefits advisor, or health plan representative to see what’s best for them, and to prevent any penalties or delayed enrollment in the future.
For specific questions about your case, call 1-800-772-1213 and ask a representative to assist you, or you can contact your local office directly. 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.
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Audrey F.
I receive 420.00 a month in social security, however,on June 8,I will turn 65..On june 8,I turn 65,where is the rest of my money?! Did Medicare automatically take money from my 420.00? If so,I am highly disturbed, because how in the world am I supposed to make it off of 170.00 a month? Please help! Thank you! Audrey Fisher 804 732 1511.
V.V.
Hi Audrey, thanks for using our blog. You may want to apply for Extra Help with Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $5,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia. In addition to the Extra Help, you may be able to get help from your State with other Medicare costs under the Medicare Savings Programs. By completing the Extra Help application, you will start your application process for a Medicare Savings Program. We will send information to your State who will contact you to help you apply for a Medicare Savings Program unless you tell us not to when you complete the application.
If you need information about Medicare Savings Programs, Medicare Prescription Drug plans or how to enroll in a plan, call 1-800-MEDICARE (TTY 1-877-486-2048) or visit http://www.medicare.gov. You also can request information about how to contact your State Health Insurance Counseling and Assistance Program (SHIP). The SHIP offers help with your Medicare questions. We hope this helps.
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Cheryl C.
Does any medicare plan cover dental?
A.C.
Hi, Cheryl. Thanks for your question. Medicare will pay for dental services in specific cases. To learn more, go here. To get additional information on Medicare benefits, check out http://www.medicare.gov/. You may also wish to contact your local Medicare SHIP (State Health Insurance Program Coordinator) to discuss your options. We hope this helps. We hope this helps!
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