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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  2. Alex W.

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  3. Priscilla O.

    I am in receipt of “Your New Benefit Amount” for 2020. My question is, does this reflect my new enrollment in Medicare Advantage Plan PPO through United Health Care? I was under the impression it would be billed by United Health Care rather than deducted from my benefit amount shown for 2020.

    • A.C.

      Hi, Priscilla. For your security, we do not have access to private information in this venue. We ask that members in our Blog community work with our offices with specific questions. You can call us at 1-800-772-1213, Monday through Friday, between 7:00 a.m. and 7:00 p.m., for assistance. Generally, you will have a shorter wait if you call later in the day. You can also contact your local Social Security office. We hope this helps.

  4. victor t.

    Hi, I’ll be 65 on March 4, 2020 and I have insurance with the company I work for. Do I have to register for medicare Part A only? If I have to sign up, what do I need to do? I do not see anything on medicare site to sign for Part A, only.
    Thank you!

    • L.A.

      Hi Victor. Thank you for your question. If you are age 65 and still working, you have the choice to delay enrolling in Medicare, if you are covered under a group health plan based on your employment. Please speak with your employer and health insurance plan to see what is best for you. You should also contact your local Medicare SHIP (State Health Insurance Program Coordinator) to discuss your health insurance options. You can read more about Medicare coverage on our internet page, and our publication titled “Medicare.” We hope this helps.

  5. Greta J.

    Thank you for your help in explaining that medicare helps to cover expenses like drug coverage with a Part D plan. However, it sounds like there is a good amount of gap in the insurance which could leave my mother paying a lot of money. My mother is getting up there in age and I am worried about how she would pay for any large medical bills. I wonder if she should look at supplement insurance plans to see if any of those would help her. https://medicaresupplementinsuranceexchangeus.com/

  6. James B.

    It is interesting that you can bundle part a, b and d together in Medicare Advantage. My mom is turning 65 next year and we’ve been discussing what she should plan for. We may consider consulting someone that does supplemental plans for advice. https://www.senior-advisors.com/

  7. James B.

    It is interesting that you cn bundle part a, b and d together in Medicare Advantage. My mom is turning 65 next year and we’ve been discussing what she should plan for. We may consider consulting someone that does supplemental plans for advice. https://www.senior-advisors.com/

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