Welcome to Medicare Information!

For many, health insurance is so expensive you simply can't afford it. As you grow older, the need for medical care usually increases and that can be a financial strain, especially if you are on a limited income. Medicare was created to provide health insurance for people that have worked and paid into the Medicare system.

Where do you start? First you need to know if and when you are eligible for Medicare. You will need to know about the different Medicare Part Plans and what those plans cover. Finally, you will need to know how you can get additional Medicare Supplemental insurance coverage if you need it.

Additional common questions include Medicare terms and definitions, what is MyMedicare, Medicare prevention services, Medicare fraud, the different Medicare Plans (Part A, Part B, Part C, and Part D), the Medicare rates for 2010, and when is Medicare open enrollment. The Medicare articles on the upper left hand side of this site provide you with additional information and links.

We also provide you with an overview of several of the most popular Medicare approved private insurance companies that provide Medicare supplemental health insurance. Companies like Humana, AARP Health Care, and SecureHorizons offer Medicare Advantage plans, Medicare prescription drug plans, and Medicare Supplement insurance plans (also known as Medigap plans).

Please feel free to explore the links and Medicare information that we have provided  to help you determine when you are eligible for Medicare and which Medicare Plans will benefit you the most.

Remember that Medicare is a different program than Medicaid. If you want to learn more about the Medicaid program please visit the Medicaid Information site.

What is Medicare?

Medicare is a United States Federal Government health insurance program that was established for people age 65 or older, people under the age of 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (ESRD - permanent kidney failure requiring dialysis or a transplant) or Lou Gehrig's disease.

There are four parts to Medicare:

Medicare Part A (Hospital Insurance)

Medicare Part B (Medical Insurance)

Medicare Part C (Medicare Advantage)

Medicare Part D (Medicare Prescription Drug Plan)

What is the Original Medicare Plan?

The Original Medicare plan is managed by the U.S. Government and is a fee-based service that includes Medicare Part A and Medicare Part B. Everyone that qualifies for Medicare is covered by the Original Medicare Plan. This plan covers most of your health care needs and certain drugs.

While the Original Medicare Plan pays for several of your health care supplies and services, there are additional costs that you must pay like deductibles, copayments, and coinsurance. These additional costs to you are called "gaps" in your Medicare coverage. To help cover these Medicare "gaps" you may want to consider purchasing Medigap policies from private health insurance companies.

Coverage gaps, also known as the "doughnut hole", are gaps in the Medicare Prescription Drug Plan. The new health care reform law works toward closing the coverage gap by 2020.

What is Medicare Advantage?

Medicare Advantage (Medicare Part C) - This plan was formerly known as "Medicare + Choice". Medicare Advantage plans are offered by private health insurance companies and must provide at least the same coverage as Original Medicare. The health insurance companies often provide additional benefits and coverage.

Medicare Advantage insurance providers like SecureHorizons and Humana Medicare offer a variety of Medicare approved insurance plans. These plans are usually Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-For-Service (PFFS), and Special Needs Plan (SNP).

Humana Medicare is one of the private insurance companies that offers you a wide range of Medicare Advantage plans that include Humana Gold Choice PFFS, Humana Gold Plus HMO, HumanaChoicePPO, and Humana Special Needs Plans.

What is Medigap and Medicare Supplement?

Medigap and Medicare Supplement policies are the same thing. Medigap policies are not part of the Medicare program. Medicare supplement insurance plans are offered by private insurance companies. These additional plans can help cover the costs of "gaps", copayments and treatments, in health services that Medicare does not cover.

Did you know that insurance companies must sell you a Medigap Plan during certain time periods? These time periods are known as open enrollment periods and guaranteed issue periods.

What is Medicaid?

Medicaid is a separate government program than Medicare. Medicaid helps provide medical care for individuals and families with low incomes and limited financial resources. Medicaid is an entitlement program that is jointly funded by the states and the federal government, and is jointly managed by the states.  To learn more about the differences between Medicare and Medicaid please visit the Medicare and Medicaid Website.

What Does Medicare & Medicaid Dual Eligibles Mean?

Dual eligibles refers to people who are entitled to Medicare Part A and/or Part B and are eligible for some form of Medicaid benefit. To determine if you are Medicare and Medicaid dual eligible read the Medicare & Medicaid dual eligibles article.

Who Is Eligible for Medicare?

Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years (40 quarters) in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States.

If you are not yet age 65, you may qualify for Medicare coverage if you have a disability or you have End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant).

 You will be eligible for Medicare when you turn 65 even if you are not eligible for Social Security retirement benefits. Medicare Part B will cover a one-time initial preventive physical exam.

Enrollment Overview:

Medicare open enrollment is from November 15 - December 31. If you have Medicare, it is during this open enrollment period that you can add, drop, or change your Medicare prescription drug coverage.

Please note that Social Security will make the final decision on your eligibility and enrollment status.  If you are not a U.S. citizen or a lawfully admitted alien who has lived in the U.S. continuously for a five-year period, you will need to contact Social Security for your Medicare enrollment and eligibility.

The Centers for Medicare and Medicaid Services (CMS), a component of the Department of Health and Human Services (HHS), administers Medicare, Medicaid and the State Children's Heath Insurance Program (SCHIP).  The Social Security Administration is responsible for determining Medicare eligibility and processing premium payments for the Medicare program.

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Medicare Fraud

In recent years, Medicare fraud has become a criminal enterprise estimated to be about $60 billion that is stolen from the American taxpayers every year. Unfortunately, Medicare fraud is easy, the criminals have become more sophisticated, and the Medicare system doesn't have enough auditors and personnel to adequately address Medicare fraud.