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.

Medicare Advantage 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 Health 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.
  • If you’re getting these benefits, in most cases, you’ll automatically get Part A and Part B starting the first day of the month you turn 65. If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.

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?

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