Medicare Basics

Understanding Medicare Basics

Here’s some basic information on the U.S. Government’s Medicare Program – What it is, and what it is not.
Continue reading this page for more info…

Medicare Basics: What is Medicare?

The U.S. government’s largest health insurance program serving more than 62 million people.

MEDICARE IS

A federal health insurance program
For U.S. citizens and legal residents
Individual health insurance

MEDICARE IS NOT

Medicaid
Social security
Family plans

Medicare Basics: Who Can get Medicare

You can qualify for Medicare if you meet one of the following requirements:

● Within three months of turning 65 or older, even if you still work
● Younger than 65 with a qualifying disability
● Have end-stage renal disease (ESRD)

Note: you also may be eligible for Medicare Part A through your spouse, though you must meet the age or disability requirement

Medicare Basics: What does Original Medicare cover?

Original Medicare consists of Part A and Part B

Part A
HOSPITAL INSURANCE

Hospital room & meals
Intensive care
Skilled nursing facility care
Operating room services
Hospice care
Rehabilitation services
Some home health care

Part B
MEDICAL INSURANCE

Doctor visits
Annual wellness visits & preventive services
Outpatient care
Mental health care
Clinical lab services
Durable medical equipment
Ambulance services
Occupational physical therapy

Medicare Basics: What does it cost?

Original Medicare consists of Part A and part B
→ but NO out of pocket maximum

*Note: premium free if you or your spouse worked and paid taxes for 10+ years. If you don’t get premium-free Part A, you pay up to $506 each month.

**If you are an above average income earner, you will have to pay a higher Part B premium.
DEDUCTIBLE

Part A
HOSPITAL INSURANCE

Premium

Deductible

$1,632 Per benefit period

Other Costs

$408
Per day (days 61-90)

$816
Per day (after 90)

Part B
MEDICAL INSURANCE

Premium

$174.70* Per month**

Deductible

$240 Per year

Other Costs

20%
Of costs, plus any
excess changes

Not affiliated with the U.S. government or federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800 MEDICARE to get information on all of your options

Beyond the Basics…

I hope these Medicare Basics have been helpful to you.

To learn about supplemental plans and if they’re right for you, I’d love to help you understand your options.

Please call me at 808-479-6350 from Hawaiʻi, or 831-889-9699 from California. You can also fill out our short contact form.

Together we can find the right solution for you!