What You Should Know About Medicare

If you’re approaching 65 and ready to enroll in Medicare, navigating your options can be confusing. Whether you’re still working or currently getting benefits from Social Security factors into when and how you’ll sign up for Medicare. Learn more about the basics of Medicare and supplemental programs to decide what works best for you.

Parts A & B

The Federal Medicare program offers health insurance for eligible individuals 65 or older. It’s also available for those under 65 who are currently on disability or have certain health conditions like end-stage renal disease or amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease). If you’re already getting Social Security benefits, when you turn 65 you will be automatically enrolled into Medicare. If you’re not already getting Social Security, you can sign up as early as three months before you turn 65. While Medicare helps with health care costs, it doesn’t cover all expenses, such as deductibles, coinsurance, and copays.

Original Medicare includes Part A and Part B coverage: Part A – Hospital Insurance and Part B – Medical Insurance. Part A helps cover inpatient care at hospitals, skilled nursing facilities, hospice, and some home health care. You may have to pay a Part A premium. Part B covers doctor visits, outpatient care, medical equipment, and preventative care. Enrolling in Part B is optional and does have a premium you will have to pay. If you do not sign up for Part B when you’re first eligible you may have to pay a late enrollment penalty.

Medicare Advantage

While Original Medicare is a federal program that offers Part A and Part B, private insurance offers other coverage options. The Medicare Advantage Plan includes the benefits of Parts A and B as well as prescription drug coverage under Part D. Some plans may include vision, hearing, and dental benefits. Medicare Advantage, also known as Part C, has different out-of-pocket costs than Original Medicare or supplemental coverage, and you may have an additional premium.

Medigap Policies

Medigap policies, also known as Medicare Supplement Insurance, cover out-of-pocket expenses not covered by original Medicare. Private insurance companies offer these policies to help with expenses like copayments, coinsurance, and deductibles. You must have Part A and Part B to enroll in a Medigap plan. You cannot have a Medigap policy and a Medicare Advantage Plan at the same time. Medigap plans generally do not cover long-term care, vision or dental services, hearing aids, or glasses. Medigap policies do not offer prescription drug coverage and you may need to enroll in a stand-alone prescription drug plan, or Part D. Medigap plans also follow state laws, and you can find what is available in your state at Medicare.gov.

Medicaid vs. Medicare

Medicaid is a joint federal and state program that provides health coverage for those with limited resources. Depending on which state you live in, it may offer nursing home care, personal care services, and assistance with Medicare premiums and other health care expenses. You can visit your local Health and Human Services Department or visit Medicaid.gov for more information on this program.

Questions about Medicare? Let us help.

Medicare can be complicated, but Texell Insurance¹ can help with our Medicare education program. Our goal is to equip you with tools and insight to make an informed decision between the insurance options available to you. Visit Texell.org/medicare to learn more. 

¹ Texell Financial, LLC is a wholly owned subsidiary of Texell Credit Union and does business as Texell Insurance. Insurance products are not issued, guaranteed, underwritten, or insured by Texell Credit Union or the National Credit Union Administration. 

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