Medicare

Medicare, A Simple Explanation

October 24, 2019 • By

Reading Time: 2 Minutes

Last 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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About the Author

Darlynda Bogle, Assistant Deputy Commissioner

Darlynda Bogle, Assistant Deputy Commissioner

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  3. Gladys R.

    What is the difference between Medicare part A and part B

    • A.C.

      Hi, Gladys. Thanks for your question. Medicare Part A (hospital insurance) helps pay for inpatient care in a hospital or limited time at a skilled nursing facility following a hospital stay). Part A also pays for some home health care and hospice care. Medicare Part B (medical insurance) helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services. For more information about the different parts of Medicare, visit here. We hope this helps.

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    I am 65 years June 2020. Presently working & have employer based (more than 20 employees) insurance . I have HSA both employer & employee contribution. Not signing for medicare this year . If I drop that insurance in January 2021 , my special enrollment period will be 9 months for Part A & Part B. How about part D. Do I have to sign immediately ? If I sign for medicare in March 2021 – I will have penalty for HSA . I would like to delay enrolling in part A & B till June 2021 , how about Part D ? Can I do same ?

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