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Medicare Explained

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Medicare is a U.S. federal health insurance program.

The U.S. government created Medicare in 1966 for retired Americans. Over the years, Medicare has expanded its coverage and eligibility requirements.1

What age does Medicare start?

You can get Medicare if you are 65 or older. Medicare is also for:

  • Younger people with disabilities
  • People with End-Stage Renal Disease (ESRD)2
  • People with ALS (amyotrophic lateral sclerosis, also called Lou Gehrig’s disease)

What is Original Medicare?

Original Medicare started with hospital and medical coverage. These are Medicare Part A and Medicare Part B. The member has to pay for additional costs like prescription drugs. To help, private insurance companies like Capital Blue Cross created Medicare Advantage plans. Medicare Advantage plans include Parts A and B with other benefits.

Do I need Medicare if I have Private Health Insurance?

There are many answers to this question, depending on your circumstances. As long as you have private insurance through a company with 20 or more employees, you can delay signing up for Medicare beyond age 65 until you retire. That private insurance gives you “credible coverage” to delay signing up for Medicare A and B without a penalty for late enrollment. If your company has less than 20 employees, you will need to sign up for Medicare as soon as you are eligible to avoid penalties.

Even with private insurance, you can choose to enroll in Medicare Part A, when you are eligible, without paying an additional premium, and still get the additional benefits that will complement your private health insurance. With the “credible coverage” private insurance, you can delay enrolling in Medicare Part B, which has a monthly premium cost.

You can also compare the cost of your private health coverage against what the original Medicare and/or a Medicare Advantage plan premium would be. If choosing a Medicare plan is a better option for you, then you can make Medicare your primary insurance and cancel your employer coverage. Our Medicare Customer Care staff is available to talk through this decision with you. Please call them toll-free at 1.888.234.5707.

What are the parts of Medicare?

The Four Parts of Medicare

Simply put:

Part A

Part B 

Part C 

Part D 

Hospital Coverage

Medical Coverage

Medicare Advantage Plans

Prescription Drug Plans

Your coverage options

We know it’s confusing to choose a Medicare plan. It’s important to pick a plan that meets your health needs. Don’t forget, Original Medicare doesn’t cover everything. We have your options spelled out here.

Your Options How Do you Enroll?

1Medicare is a separate program from Medicaid. Medicaid helps lower-income people with healthcare.

2This is a disease that causes permanent kidney failure. People with this disease require dialysis or a transplant.

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Updated October 1, 2022


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