What Is Medicare?
Medicare is a federally sponsored health insurance program designed for seniors and individuals with disabilities. Established in 1966, Medicare is available regardless of health status, income, or location. It is divided into four parts—A, B, C, and D—each addressing different healthcare needs.
When Do I Qualify For Medicare?
Medicare is available to individuals aged 65 or older, younger individuals with qualifying disabilities, and those with End Stage Renal Disease. Most people qualify for Part A at age 65, while Part B requires a monthly premium. Parts C and D are offered by private insurance companies and require enrollment in both Parts A and B.
The Four Parts of Medicare
Medicare Part A is often referred to as hospital insurance, though it primarily covers nursing care services rather than all hospital-related expenses. Doctor services received during a hospital stay are billed separately under Part B.
- Skilled nursing services
- Semi-private hospital or nursing facility rooms
- Meals provided by medical facilities
- Facility-provided labs, drugs, and supplies
- Home health services when eligible
- Hospice care services
Most individuals do not pay a premium for Part A, as it is funded through Medicare payroll taxes. Those without sufficient work credits may be required to pay a premium.
Medicare Part B covers a wide range of outpatient and preventative medical services.
- Doctor and surgical services
- Outpatient diagnostic tests and labs
- Preventative care such as flu shots and screenings
- Medical equipment (wheelchairs, oxygen, diabetic supplies)
- Emergency room and outpatient clinic services
- Mental health and therapy services
- Ambulance services
Part B requires a monthly premium and typically includes a 20% coinsurance. Because these costs can add up, many individuals choose to supplement their coverage.
Medicare Part C, also known as Medicare Advantage, is offered through private insurers and often includes Parts A, B, and sometimes D. These plans may provide additional benefits such as dental, vision, transportation, and wellness programs.
Medicare Part D provides outpatient prescription drug coverage. Plans vary by carrier and may require prior authorization for certain medications.
- Coverage progresses through four annual phases
- Plans differ in drug coverage and copays
- No plan covers all medications
- Annual changes to pricing and benefits are allowed
Decisions, Decisions
Medicare is not a one-size-fits-all program. Choosing the right plan requires understanding enrollment periods, plan differences, and your personal healthcare needs.
- Enroll at the right time — Missing deadlines can result in lifelong penalties.
- Research your options — Understand the difference between Original Medicare and Medicare Advantage.
- Get expert help — Work with an advisor who represents a wide range of plans.
Amerus Financial Group offers access to over 40 Medicare plans nationwide. Our experienced agents take the time to understand your situation and guide you toward the best coverage for your needs.
This Medicare resource was provided by Amerus Insurance Group, a nationwide independent agency that helps seniors confidently compare plan options, control out-of-pocket costs, and enroll with the right coverage for their doctors, prescriptions, and lifestyle. Whether you’re new to Medicare or reviewing your current plan, speak with an Amerus advisor for a free, personalized consultation.
