Medicare Coverage Questions

Medicare is the federally funded medical insurance program for seniors over age 65. Congress authorized the program with the Social Security Act of 1965, and it was signed into law by President Lyndon Johnson, along with Medicaid, as part of the "Great Society" programs. In its modern form, Medicare consists of four parts: Part A covers basic hospitalization; Part B covers physician services, diagnostic test and medical equipment; Part C, Medicare Advantage, provides for access to benefits through managed care organizations; and Part D covers prescription drugs.

When Am I Eligible?

• You are eligible for Medicare benefits as soon as you turn 65, provided you or your spouse have at least 10 years of Medicare-eligible employment. You may also be eligible prior to age 65 if you have end-stage renal disease or have received Social Security or Railroad Retirement disability benefits for at least 24 months.

How Do I Enroll?

• If you already receive Social Security benefits you are automatically enrolled in Part A and B. Begin the process three months prior to your 65th birthday by calling Medicare at 800-772-1213, or by using the enrollment tool on the Social Security link website (see Resources). You can enroll in Part A free of charge; Parts B, C and D are optional, and each requires a monthly premium. If you are enrolled automatically and don't want Part B, the Social Security Administration will send you paperwork to decline it.

Are There Enrollment Periods for Part B?

• Yes. If you didn't take Part B when you first became eligible, you can enroll during the open enrollment period for Part B, between Jan. 1 and March 31 of each year. Note that failure to enroll in Part B when you are first eligible may require you to pay higher premiums later, if you do choose to enroll.

How do I Enroll in Medicare Advantage?

• To enroll in Medicare Advantage (Part C), you must first be enrolled in Parts A and B. Because private insurance companies administer Medicare Advantage, enrollment options vary by state and region. To view your options, visit the Medicare Plan Finder site (see Resources).

How do I Enroll in Part D

• Medicare Part D, the optional prescription drug plan, is also administered by private insurance companies in your state. You can compare plans and providers in your area by using the online tool (see Resources). You must pay a premium to get prescription drug benefits. Specific premiums vary with each plan.