Medicare is a government health insurance program for people 65 and older and for some younger individuals with disabilities or certain health conditions.

Think of it as a way to help cover your medical costs, like doctor visits, hospital stays, and prescription drugs.

It’s divided into parts, like Part A (hospital insurance) and Part B (medical insurance). You can also add options like Part D for prescription drugs. Some even choose Medicare Advantage plans (Part C), which bundle everything together.

If you’re turning 65 soon, you’ll want to sign up, even if you’re healthy. It’s here to give you peace of mind for future medical needs.

• Individuals are typically eligible for Medicare if they are 65 or older.
• Those under 65 may also qualify if they have a qualifying disability, such as end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). Reach out to us to see if your condition qualifies.
• Individuals who have received Social Security Disability benefits for at least two years may also be eligible for Medicare coverage.

You can apply for Medicare through several convenient methods:

1.Online (Recommended):  

Visit the official Social Security Administration (SSA) website at [www.ssa.gov/medicare](https://www.ssa.gov/medicare). Follow the step-by-step instructions to submit your application.  

2.By Phone:  

Call Social Security at 1-800-772-1213 (TTY users can call 1-800-325-0778). Representatives can assist you with the application process.  

3.In Person:

Visit your local Social Security office. You can find one near you using the office locator tool on their website.  

Note: If you already receive Social Security benefits, you may automatically enroll in Medicare Part A and Part B when you turn 65.  

Medicare is divided into two main parts to help cover different healthcare needs:

• Part A includes coverage for inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health services.
• Part B focuses on outpatient care, such as doctor visits, preventive services, lab tests, and medical equipment.

Together, these parts address your hospital and outpatient healthcare needs.

Medicare Part C, also known as Medicare Advantage, is an alternative to Original Medicare (Parts A and B) offered by private insurance companies approved by Medicare.

These plans provide all the benefits of Original Medicare and often include additional coverage for vision, dental, hearing, and prescription drugs.

Medicare Advantage (Part C) plans typically operate through managed care models like HMOs or PPOs, offering a more comprehensive and coordinated approach to healthcare.

However, coverage details, costs, and provider networks can vary by plan, making it essential to review options carefully to find the best fit for your medical and financial needs.

Your county determines Medicare plans, not your proximity to a particular city. For example, if you live in Broken Arrow and your physical address is in Wagoner County, you might not qualify for some plans available in Tulsa County.

No, you’re not required to enroll in Medicare when you turn 65 if you still work and have health insurance through your employer. However, it’s a good idea to check with your employer’s benefits administrator to see how your current coverage works with Medicare. If your employer has fewer than 20 employees, you may need to enroll in Medicare Part A and B to avoid penalties later.

A limited number of Medicare plans often pay many companies that advertise Medicare assistance on television. This means they may not provide you with a complete list of all the plans available in your county.

Many Medicare Advantage plans also have networks that include specific doctors and hospital systems. National organizations promoting these plans may not always consider whether your preferred doctors or hospitals are included, so it is important to review your options carefully.

Specific plans, such as those tailored for individuals with specific income levels, chronic conditions, Veterans, or Native Americans, and some HMO options, may reimburse you for part of your monthly Medicare Part B premium.

We can review these options to help you understand what might work best for your situation.

You can sign up for a plan during annual enrollment (October 15 to December 7); coverage starts January 1. However, you’ll face a penalty if you didn’t enroll in a drug plan during your initial enrollment. The penalty is about $5 per year of delay, calculated monthly and permanently added to your plan cost.

Consider enrolling in a Medicare Advantage Plan with drug coverage, which may cost little. Even with these plans, penalties for late enrollment still apply. Planning ahead can save you from higher prescription costs in the future. Speak with one of our licensed Medicare advisors for assistance.

You can’t avoid the penalty if you don’t have drug coverage when eligible for Medicare. However, exceptions apply if you have Veteran or Native American healthcare—be sure to inform Medicare.

We often recommend plans with Medicare Part B payback to offset the penalty. For example, if your plan reimburses $75 monthly and your penalty is $25, you’d still save $50 on Part B. Plus, these plans include drug coverage to stop the penalty from increasing.

We offer a glossary of insurance terms to help you understand key concepts easily.

https://content.naic.org/glossary-insurance-terms