Medicare Education
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).
Original Medicare is health coverage managed by the federal government. Generally, there is a cost for each service. In most cases, you can go to any doctor, other health care provider, hospital, or another facility that is enrolled in Medicare and is accepting new Medicare patients.
If you are receiving Social Security benefits before turning 65, you should automatically receive notification of your enrollment in Medicare shortly before your 65th birthday or your 25th month of disability. Other individuals must apply by calling or visiting their Social Security office to receive Medicare.
The way Medicare pays is, you generally pay a set amount for your health care (deductible) before Medicare pays its share. Then, Medicare pays its share, and you pay your share (coinsurance / copayment) for covered services and supplies.
Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services.
Medicare enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket medical expenses from Medicaid (e.g. MSPs, QMBs, SLBs, and QIs).
Do you have to pay for Medicare? Yes, most people will pay Medicare premiums. Fortunately, it’s fairly easy to get together a Medicare cost estimate so that you can plan ahead.