Search Menu GoHealth CALL US MEDICARE GUIDE Introduction Original Medicare Overview Costs Coverage Enrollment Medicare Part A Medicare Part B Medicare Part C (Advantage) Medicare Supplement Medicare Part D Medicaid & Medicare What Is & Isn't Covered? Medicare Costs & Enrollment Medicare Changes 2021 Medicare & COVID-19 MedicareMedicare Part A & B Medicare Part A & B All about Medicare Part A & B, or Original Medicare Reviewed by: Ed McClane, Licensed Insurance Agent. Written by: Aaron Garcia. SHARE ON FACEBOOK SHARE ON TWITTER SHARE ON LINKEDIN EMAIL THIS PAGE PRINT THIS PAGE Key Takeaways The Plan Original Medicare has two parts: Medicare Part A and Medicare Part B. How it Works Part A and Part B combine to cover medical and hospital insurance for individuals 65 years of age and older. The Value Medicare customers can see any doctor in the country that accepts Medicare. How to Enroll You have a seven-month window when you turn 65 called your Initial Enrollment Period (IEP) to enroll in Original Medicare–the month of your birthday plus 3 months before your birthday and 3 months after your birthday. If you miss your IEP, you’ll need to wait for the annual General Enrollment Period. ON THIS PAGE What Is Medicare? What's Covered? What Costs Should I Consider? How Do I Enroll? When Can I Enroll? Is It Right for Me? FAQs What is Medicare? With 67.7 million Medicare enrollees [1] in 2020, you, or someone you know, receive Medicare benefits. If you or a loved one will soon be eligible for Medicare, and have questions, we have answers. Medicare: The Basics Medicare is public health insurance for Americans that: are 65 years of age or older. are under 65 years of age but have qualifying disabilities. The Medicare insurance program is run by The Centers for Medicare and Medicaid Services (CMS). The program is funded partially by the federal budget, income taxes paid to Social Security and Medicare, and premiums paid by Medicare beneficiaries. Original Medicare (Part A and Part B) insurance can be used at any doctor or hospital in the U.S. that accepts it. The most popular form of Medicare is Original Medicare, which is Parts A and B only. That’s why it’s the best place to start. What’s Covered by Medicare? Medicare Part A and Medicare Part B cover most standard medical services. Part A and Part B cover facility costs and Medicare-approved services you receive inside. You may hear Part A called “hospital insurance,” and Part B called “medical insurance.” Part A (Hospital Insurance) Part B (Medical Insurance) Inpatient Doctors & other care providers Skilled nursing facility care Outpatient Care Hospice Care Home health care Home health care Medical equipment (like walkers, wheelchairs, or beds) Preventive & screening services Between Parts A and B, Original Medicare covers a wide range of services. For a deeper look into what you can expect from your Medicare policy, check out our information on Original Medicare Parts A and B coverage. GoHealth can also help you with options like Medicare Supplement Insurance (Medigap) and Medicare Advantage. How Much Do Medicare Part A and B Cost? For most people, their budget is front and center when considering which health insurance to choose. Here’s a starting point when working out your budget: Medicare Part A costs for 2021 [2] Deductible: $1,484 Premium: $0 (for most people) Keep in mind: You’ll want to know if you’re responsible for paying a premium. Most individuals don’t have a Part A premium, but it can vary from person to person based on employment and tax history. You’ll be responsible for your Part A deductible. Medicare Part B costs for 2021 Deductible: $203 Premium: $148.50 Keep in mind: Medicare Part B has a standard yearly deductible cost. Medicare Part B has a standard monthly premium cost. The standard premium for Medicare Part B is income-based. For both Part A and Part B, after you meet your deductible, your cost for care will be approximately 20%, and Medicare will pay about 80% for the remainder of your benefit calendar year. There are plenty of other factors to consider, including copayments, co-insurance, and when to enroll. Learn more about what goes into Original Medicare costs. How Do I Get Original Medicare? You know what’s included in Original Medicare and what it covers. How do you enroll in Original Medicare? Most Americans are automatically enrolled in Part A when they reach 65 years of age. You must contact the Social Security Administration to enroll in Part B if you’re already enrolled in Part A. You can enroll online [3] if you actively sign up for both Parts A and B at the same time. Because you pay a premium for Part B coverage, you can turn down the coverage. If you turn down Part B coverage but choose to enroll later, you may have to pay a higher monthly premium. When Can I Add Part D Coverage? Understanding that you will need to add Medicare Prescription Drug Plan (Part D) coverage is essential. Medicare Prescription Drug coverage (Part D) is added to Original Medicare. What does that mean? Here are two important details to help explain: Part D is an optional Medicare benefit. It’s recommended if you think you’ll need prescription medication in the future or currently depend on prescriptions to manage your health. Private health insurance companies administer Part D. The federal government sets specific requirements, but private health insurance companies decide which drugs to cover. To join Part D, you can choose a Prescription Drug Plan (PDP) or a Medicare Advantage plan that includes drug coverage (MA-PD). You can add Part D coverage during any of the Medicare enrollment periods. When Am I Eligible to Enroll in Medicare? The majority of Americans that choose Medicare health insurance plans are 65 years of age or older. If that’s you, you’ll want to remember the seven-month rule, which says that you have seven months to enroll in Medicare during the year you turn 65. For example, if you turn 65 in August: Three months before your birth month: May, June, July Your birth month: August Three months after your birth month: September, October, November For some people with specific disabilities and illnesses, Medicare is available before they reach 65 years of age. If you’re an American citizen, or have lived in the U.S. legally for five or more years, you’re eligible for Medicare if any of the following apply to you: You’re 65 years of age or older. You’ve received Social Security disability benefits for more than 24 consecutive months. You’ve received disability benefits from the Railroad Retirement Board for more than 24 consecutive months. You have kidney failure, also known as end-stage renal disease, requiring permanent dialysis or need a kidney transplant. You’re living with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease. Is Medicare the Right Choice for You? Here’s a recap of Original Medicare, its costs, how to enroll, and what it covers: Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). If you want prescription drug coverage, you can join a separate Part D plan with a private health insurance provider. To help pay your out-of-pocket costs in Original Medicare (like 20% co-insurance), you can also explore supplemental coverage. You can use any doctor or hospital that accepts Medicare, anywhere in the U.S. Original Medicare is one way to get Medicare. The other way is Medicare Advantage. We recommend you also take time to learn about Medicare Advantage, Medigap, and Out-of-pocket costs. These are all important pieces of making the best decision for your care. You can always contact a GoHealth licensed insurance agent to get answers. GoHealth works for you, not insurance companies, and will take time to discuss all your options. FAQs Do I Sign Up for Medicare Online? You can enroll in Medicare over the phone, in person, or online. If you have questions about Medicare policies, a partner like GoHealth can help you get started. It’s important to note that your initial enrollment window spans seven months, starting three months before the month of your 65 birthday and the three months that follow your birthday month. For example, if you turn 65 on May 1, 2021, you are eligible to enroll: February to April 2021 May 2021 And, June to August 2021 To enroll, you will need some basic information: Name, address, phone number Social Security number Identification documents, such as a birth certificate, driver’s license, or proof of U.S. citizenship. Do I Need Medicare If I’m Still Working and Have Health Insurance? Can I Switch From Original Medicare to a Medicare Advantage plan? Can I use a Health Savings Account with Medicare? What's Next? Medicare Part A & B Costs 1-855-792-0088 TTY:711 Mon-Fri, 7am-9pm CT, Sat-Sun, 9am-6pm CT And, We’ll Call You. Sources A Dozen Facts About Medicare Advantage in 2020. KFF.org Medicare costs at a glance. Medicare.gov. Medicare Benefits. SSA.gov How Medicare Works With Other Insurance. Medicare.gov This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money. If you’re looking for the government’s Medicare site, please navigate to www.medicare.gov. 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