Medicare Rules

Medicare is a health insurance program offered by the United States federal government. Medicare formerly consisted only of two parts, A and B. As of 2011, however, Medicare officially comes in four parts to include private Medicare Advantage plans and prescription drug plans. Several Medicare supplement plans include standardized benefits but are sold through insurance companies. Medicare does not come without rules and restrictions, however, even when you purchase it privately.

Eligibility

• Medicare is meant for people aged 65 and older, although there are some exceptions. To initially qualify for Medicare, you generally must meet the minimum age and be a United States citizen or permanent resident. You and/or your spouse must also have held a job which paid Medicare taxes for at least 10 years. If you have not done this but are 65 or older, you may still be eligible for Part A Medicare if you pay a monthly premium. People younger than 65 may also qualify for Medicare Part A if they have end-stage renal failure, or if they have already been receiving Railroad Retirement Board or Social Security benefits.

Premiums

• Medicare Part A can be premium-free if you meet certain conditions. Part B, however, must be paid for. As of 2011, the Part B premium is officially $110.50 per month. Citizens who began their coverage as of January 1, 2010, or those with higher incomes, pay this amount. However, if you enrolled before January 1, 2010 and the Part B premium is deducted straight from your Social Security benefits, you continue to pay $96.40 monthly.

Benefits

• Medicare Parts A and B offer benefits for inpatient and outpatient hospitalizations, preventive services, health screens, home health care and hospice. They do not, however, offer any benefits for dental care, prescription medications, eye exams, eyeglasses or foreign travel emergencies. For these benefits, you will have to buy either a Medicare Advantage policy, standalone Medicare Part D prescription drug plan, or one of the standardized Medicare supplement plans.

Enrollment

• People who are already receiving Social Security benefits are automatically enrolled in Medicare when they turn 65. If you are not already getting Social Security, you will have to enroll yourself. You can apply online or at a local Social Security office three months before your 65th birthday. Your initial enrollment period encompasses the three months before your birthday and the three months after the month of your birthday. You can sign up for any Medicare coverage you want during initial enrollment. If you do not sign up for Part B or Part D when you are first eligible, you may have to pay higher fees later on.