Getting Started with Medicare

Eligibility Team
Researcher & Writer
December 10, 2019

If you’re getting ready to retire or about to turn 65 years old, you will need to make some important decisions about your healthcare in the near future.  The best way to educate yourself about what choices you have is to start early and do your homework.  The choices you make will have a material impact on your life going forward.  You will want to decide what kind of coverage you want, know when to enroll to avoid late enrollment penalties, as well as make many other key choices.

Several months before you turn 65, you should begin to familiarize yourself with an overview of Medicare, and understand Parts A, B, C, and D, and implications of choosing whether or not to initiate coverage.  You should also ask questions about how Medicare will dovetail into your existing healthcare coverage.  With too little coverage, you could get stuck with some large expenditures. With too much coverage, you could be paying unnecessary premiums in the future.

Understanding the different parts of Medicare

Medicare is broken into four parts; A, B, C and D.

  • Medicare Part A provides hospital insurance in the form of inpatient hospital stays, care in skilled nursing facilities, hospice, and some home health care situations.
  • Medicare Part B covers many doctors’ services, outpatient care and services, medical supplies, and an array of preventative services.
  • When you turn 65, you'll need to enroll in Part A and Part B through the Social Security Administration.  Most people will pay the standard Part B premium amount of $144.60 in 2020 (up from $135.50 in 2019). Few people pay a premium for Part A.
  • Medicare Part C is also known as Medicare Advantage.  These are private health plans that contract with Medicare to provide both Part A and Part B coverage. These plans typically include HMOs and PPOs.  Medicare Part C plans must cover all the same services as Parts A and B, but they may also cover added services such as eye exams, hearing aids, and other types of add-on services.  Some plans also include prescription drug coverage as well.  Because Part C is optional, you will end up paying a premium if you choose to go this route.
  • Medicare Part D provides prescription drug coverage.  Under Part D, the Federal government subsidizes the cost of prescription drugs and drug insurance premiums.  You can get Part D coverage as a standalone benefit, or it can be included in Part C coverage.

What to know about enrolling

The first time you can enroll in Medicare is called your Initial Enrollment Period.  This 7-month period includes the three months before you turn 65, the month you turn 65, and the three months after you turn 65.  If you don’t enroll during this time period and want to enroll later on, you may have to pay a late enrollment penalty for Part B.

For more information

Here, you'll a wealth of information for you to better understand your options and the timeframes you should be concerned with as you approach becoming a member of Medicare.

Check out our guide to Medicare. It'll help you get started.


Content on this site has not been reviewed or endorsed by the Centers for Medicare & Medicaid Services, the United States Government, any state Medicare agency, or any private insurance agency (collectively "Medicare System Providers"). Eligibility.com is a DBA of Clear Link Technologies, LLC and is not affiliated with any Medicare System Providers.

Eligibility Team
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Eligibility Team
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