November 8, 2018

medicare-101

U.S. citizens and legal residents.

Legal residents must live in the U.S. for at least 5 years in a row, including the 5 years just before applying for Medicare.


You must also meet one of the following requirements:

  • Age 65 or older

  • Younger than 65 with a qualifying disability

  • Any age with a diagnosis of end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

Original Medicare

  • Part A covers inpatient hospital and skilled nursing care.

  • Part B covers doctor visits and outpatient care.


Private Medicare plans are optional and provide more coverage.

  • Medicare Advantage plans (Part C) combine Part A and Part B coverage. They often include drug coverage and other benefits you don’t get with Original Medicare.

  • Medicare prescription drug plans (Part D) help pay for medications. You can get a standalone Part D plan or get a Medicare Advantage plan that includes drug coverage.

  • Medicare supplement insurance (Medigap) helps pay some or all costs not paid by Original Medicare (deductibles, copays and coinsurance).

You can add coverage to Original Medicare or choose a Medicare Advantage plan instead.

Original Medicare

You may add a standalone Part D plan, a Medicare supplement plan or both to Original Medicare (Parts A & B).

  • Parts A + B

  • Parts A + B plus Part D prescription coverage

  • Parts A + B plus a Medicare supplement plan

  • Parts A + B plus both Part D prescription coverage and a Medicare supplement plan


Medicare Advantage

You may choose to get your benefits through a Medicare Advantage plan (Part C). Many plans come with built-in prescription drug coverage.

  • Part C with no drug coverage

  • Part C with built-in Part D prescription coverage

  • Part C plus a standalone Part D prescription coverage plan in limited circumstances

Medicare and many Medicare plans charge premiums—a fixed amount that you pay each month for your coverage.

You also pay a share of the cost for health care services you receive. There are three types of payments you may have:

  • Deductible: A set amount you pay out of pocket for covered services each year before Medicare or your plan begins to pay.

  • Copay: A fixed amount you pay at the time you receive a covered service. For example, you might pay $20 when you visit the doctor or $12 when you fill a prescription.

  • Coinsurance: A percentage of the cost for a covered service that you pay when you receive it. For example, Medicare might pay 80% of the covered service and the remaining 20% would be paid by you.

  • Your Initial Enrollment Period (IEP) is 7 months long. It includes your 65th birthday month plus the 3 months before and the 3 months after.

  • Your IEP begins and ends one month earlier if your birthday is on the first of the month.

  • Your IEP is based on your 25th month of receiving benefits if you become eligible for Medicare due to a qualifying disability.

  • You should be enrolled in Part A and Part B automatically at age 65 if you are receiving social security or Railroad Retirement Board benefits. Medicare will mail your card to you.

  • Think about your needs so you can see how different coverage options might work for you.

    Your health

    • How often do you go to the doctor?

    • What health problems do you have?

    • What medications do you take regularly?


    Your budget

    • What are you able to pay each month in premiums?

    • How comfortable are you covering copays or coinsurance for services?

    • How willing are you to accept the risk of high out-of-pocket costs?


    Your preferences

    • Which doctors, hospitals and pharmacies do you like to go to?

    • How important is it for you to have access to health care while traveling?

    • What other coverage do you have, such as an employer or retiree plan?

Is Medicare Advantage Right for You?

Original Medicare doesn’t cover everything—so it’s a great idea to learn about how a Medicare Advantage plan can help.

Get a Personalized Estimate

If you know what type of coverage you need, we can help you estimate your costs based on a few simple questions.

Compare Plans and Choose

Go straight to our wide array of coverage options and find one that matches your must-haves.

Stay Connected.

Receive helpful Medicare updates, enrollment reminders, educational materials or other information from HelloMedicare.

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©2018 Hello Medicare Last updated 10.11.2018 at 12:01 AM CST |MULTIPLAN_180926_105735 Accepted

HelloMedicare™, a web- and phone-based insurance portal, is provided by Golden Outlook, a California resident licensed insurance agency (license #0E97515), also licensed as a nonresident insurance agency, or otherwise authorized to transact business as an insurance agency, in all 50 states and the District of Columbia. Golden Outlook works with Medicare enrollees to explain Medicare Advantage, Medicare Supplement Insurance, and Prescription Drug Plan options.

Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

Out-of-network/non-contracted providers are under no obligation to treat Plan/Part D Sponsor members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.

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ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-436-9292 TTY:711 Monday-Saturday 7am-10pm CST.

注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-888-436-9292 TTY:711 Monday-Saturday 7am-10pm CST.

This information is available for free in other languages. Please call our customer service number at 1-888-436-9292 TTY:711 Monday-Saturday 7am-10pm CST. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

This information is not a complete description of benefits. Call 1-888-436-9292 TTY:711 Monday-Saturday 7am-10pm CST for more information.

Medicare beneficiaries may also enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.

Every year, Medicare evaluates plans based on a 5-star rating system.

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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Use of the Anthem websites constitutes your agreement with our Terms of Use.

Rates are reviewed periodically and are subject to change in your state.