You probably know that Medicare is a federal health insurance program for people age 65 and older and for others with certain disabilities. Now that you’re eligible or will become eligible in the near future, it’s time to learn how Medicare works, what the different plans or “parts” are and how they fit into your current situation.

• Medicare Part A and Part B together are called Original Medicare.
• Medicare Part A pays for inpatient
  Care you receive in a hospital when you are admitted for an inpatient stay.
  hospital care, and Medicare Part B pays for doctor visits and outpatient
  Care you receive as a hospital patient if you are not admitted for an inpatient stay, or care you receive in a freestanding clinic or surgery center as an outpatient. 
  care.

Original Medicare doesn't cover everything.

Original Medicare helps you get the coverage you need, but you should expect to pay some of the costs. Many people enroll in a Medicare Advantage (Medicare Part C) plan, a Medicare Part D prescription drug plan and/or a Medicare supplement insurance (Medigap) plan to help pay for some of the costs and benefits that aren’t paid by Original Medicare.

• Medicare Advantage (Medicare Part C) plans cover all the services that Original Medicare covers and may also include prescription drug coverage, vision, hearing and dental coverage, and preventive services.
• Medicare Part D plans help with prescription drug costs.
• Medicare supplement insurance (Medigap) plans help pay for some of the hospital and medical costs that Original Medicare doesn’t cover.

What’s not covered by Original Medicare

Here are some benefits Original Medicare doesn’t cover:

It’s easy to determine if you’re eligible for Medicare.

If you’re turning 65, you have an opportunity to enroll in a Medicare plan. You can enroll three months before the month you turn 65, the month of your birthday and three months after your birth month. If you are eligible for Medicare due to disability, you also have a seven-month Initial Enrollment Period (IEP), starting three months before your eligibility month and lasting three months after your eligibility month.

Important: If you wait to enroll in a plan, there’s a chance you’ll have fewer plan choices, and you may have to pay more.

When are you eligible for Medicare?

You are eligible for Medicare when:

• You’re 65 or older, or you are under age 65 and have a qualifying disability or special situation.
• You’re a U.S. citizen or legal resident for at least five consecutive years.

Here are some things to know if you’re nearing eligibility because of your age:

• Even if you’re already collecting Social Security, you must wait until you’re 65 to join Medicare.
• You must be 65 to join Medicare. Your spouse’s age doesn’t count.
• You may join Medicare at age 65 or later even if you’re not collecting Social Security yet.

If you have questions about when you will be eligible for Medicare, visit Medicare.gov, or call Social Security at 1-800-772-1213, TTY 1-800-325-0778, 7 a.m. to 7 p.m. local time, Monday through Friday. Or contact Medicare Made Clear at 1-877-619-5582, TTY 711. Representatives are available 8 a.m. to 8 p.m. local time, 7 days a week.

Your Medicare plan choices don’t have to be forever.

Your needs may change over time, and you may find that your selection no longer provides the coverage you need. That’s OK. With Medicare, you’re not locked into one plan permanently. You’ll have an opportunity to change plans at least once a year during Medicare’s Annual Enrollment Period (AEP).

How to apply for Medicare: Who does the paperwork?

The Social Security Administration handles most of the Medicare application forms and paperwork for applying for Medicare.

The first Medicare letter you get in the mail will probably come from Social Security. If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), in most cases you will be automatically enrolled in Original Medicare (Parts A and B).

Social Security can also help you find out if you’re eligible for financial help with the cost of a Medicare plan.

What happens to the health care coverage you have now?

As you make your decisions about Medicare, keep your current health care coverage in mind.

• If you’re retired, this could include retiree health coverage from your former employer or your union.
• If you’re still working, you may have health coverage from your current job. Or you may have purchased your own health insurance.

Find out how Original Medicare works with any coverage you have today, and whether or not it makes sense to enroll in another Medicare plan. In some cases, it’s beneficial to keep your current coverage for as long as you can. In other cases, it makes more sense to add Original Medicare or enroll in another Medicare plan. Depending on your situation, you may have more options available to you than the standard choices.

Explore your health insurance options with someone who’s familiar with the details of the coverage you have now. If it’s coverage from an employer or a union, you can start with a human resources manager or a benefits administrator. Or talk to customer service at the health care insurance company that provides the plan.

Important: In some cases, if you keep your current coverage and wait until later to join Medicare, you may have fewer choices and pay more. It's important to review your health care needs and finances to be sure you're getting the coverage you need at a price you can afford.