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What is Medicare and Who is Eligible?

Medicare is a federal health insurance program primarily designed for individuals aged 65 and older. Additionally, it serves younger individuals with disabilities and those with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). The program consists of several parts that cover various healthcare services.

Medicare Parts Overview

  • Part A: Hospital Insurance - Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Part B: Medical Insurance - Covers certain doctors' services, outpatient hospital care, and some home health care.
  • Part C: Medicare Advantage - A plan offered by private insurance companies that includes coverage from both Part A and Part B and often includes additional benefits.
  • Part D: Prescription Drug Coverage - Helps cover the cost of prescription drugs.

Eligibility Criteria

Individuals are generally eligible for Medicare if they fall into one of these categories:

  • Age 65 or older
  • People under 65 with disabilities (after receiving Social Security Disability Insurance for 24 months)
  • Individuals with ESRD or ALS

Enrollment typically begins three months before the individual's 65th birthday and lasts for seven months. It is essential to understand the different parts of Medicare to choose the coverage that best fits your healthcare needs.

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