Common Questions from Newcomers to Medicare

By Lois Thomson

What do I need to know about Medicare? Medicare is a complex program and can sometimes be confusing. The best way to start is by familiarizing yourself with the different parts, what they cover, and when you are eligible to sign up.

What are the four parts of Medicare?

  • Part A provides inpatient/hospital coverage

  • Part B provides outpatient/medical coverage

  • Part C offers an alternative to the way to receive your Medicare benefits

  • Part D provides prescription drug coverage

Am I eligible for Medicare? To qualify, you must be a citizen of or lawfully present in the United States. You must also: (a) Be age 65 or older, (b) Be under age 65 but have certain disabilities, or (c) Have permanent kidney failure that requires dialysis. Your age and retirement date also determine whether you are eligible for Medicare.

When can I enroll in Medicare? You can enroll in the month of your 65th birthday, as well as three months before or three months after. If you currently receive health care benefits through your employer, your employer can help you understand what you need to do before you retire.

What are my coverage options? Everyone is different and therefore has different health care needs; the coverage that is right for your friends or family may not be right for you. For example, you might choose to enroll in Original Medicare, or decide that you prefer a Medicare Advantage Plan. If you are currently covered by employer insurance, you may decide not to enroll in Medicare until you have retired. Review the differences between available plans and determine which one best suits your needs.

Does Medicare cover dental and vision expenses? Medicare does not consider dental and vision care to be medically necessary, so it does not cover exams, procedures, supplies, or related services.

Where can I get more information? The following sources may be able to help with additional questions:

  • 1-800-MEDICARE

  • Social Security Administration

  • State Health Insurance Assistance Program (SHIP)

  • Medicare Rights Center