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What is Medicare

What is Medicare

What it is ─ What it’s not.

• Medicare is health insurance for older and disabled Americans.

Medicare is health insurance for people 65 and older and those who have qualifying disabilities. The program gets its money from the federal payroll tax ─ FICA.

• Another important thing about Medicare is individual insurance, not a family health plan.

Medicare is INDIVIDUAL insurance, which may be confusing if you’re used to getting coverage for yourself, your spouse, and your children through an employer plan. Unlike group health insurance plans offered by employers, individual members must meet eligibility requirements for participation, enroll independently, and select their own health plan. One spouse may enroll in Medicare while the other is not yet qualified. This can differ from what you’re used to if you’ve had a family health plan through an employer.

• Medicare isn’t free.

Few things in life are entirely free, and that includes Medicare. You’ll have some costs to pay, which we’ll talk about.

• And lastly, don’t confuse Medicare with Social Security or Medicaid.

  • Social Security provides financial support.
  • Medicaid helps with healthcare for people who don’t have a lot of money or resources.

Understanding the Differences: Medicare vs Medicaid

If you’ve ever wondered about the differences between Medicare and Medicaid, you’re not alone.

• Medicaid is a state government program that helps cover health care needs for individuals, families, and children when your income and resources are on the leaner side.

It provides doctor visits, hospital care, long-term care services, prescription drugs, and preventive care, among other things.

• Medicaid is like a cozy partnership between the federal and state governments. Uncle Sam chips in a matching percentage of funds based on each state’s per capita income.

• Medicaid programs and eligibility vary by state, but they all follow federal guidelines.

• Medicaid and Medicare can work together ─ some people have both. These people are called “dual eligible.”

In a nutshell, Medicare focuses on older adults and those with disabilities, while Medicaid supports low-income individuals and families. Medicare’s coverage is determined by age and health conditions, whereas Medicaid’s coverage is income-based and varies by state.

Who can get Medicare?

No surprise ─ Medicare has eligibility requirements.

• You need to be a United States citizen or legal resident. Medicare also asks for at least five years of continuous residence in the country, including the five years leading up to your enrollment.

• You must also meet one of the following requirements:

  • You’re at least 65 years old.
  • You’re younger than 65 but have a qualifying disability and have been receiving disability benefits for 24 months.
  • You’ve been diagnosed with end-stage renal disease or ALS (Lou Gehrig’s Disease).

Each enrolled person gets their own Medicare card with a unique number. It’s like your ticket to a new world of health coverage.

Not sure where to begin

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    We do not offer every plan available in your area. Currently we represent six organizations offering thirty products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

    Not connected with or endorsed by the United States government or the federal Medicare program.

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