Understanding Medicare is easy once you learn some basic concepts. When you’re informed, you can make smart decisions about your healthcare and what plan is best for you. Here is some basic information to help you better understand Medicare and how it works.

What Is Medicare?

Medicare is a government-sponsored health insurance program, which means part of your taxes, such as Social Security, goes to fund Medicare expenses. It’s designed to provide health insurance for people ages 65 and older and people under 65 with certain disabilities.

There are different types of Medicare plans, which are broken into “Parts.” Medicare Parts A, B, C and D are the most common Medicare programs.

  • Medicare Part A covers care you receive in a hospital
  • Medicare Part B covers doctor services, medical supplies and other preventive services
  • Medicare Part C is known as Medicare Advantage and combines Part A and B under one plan.  This plan is administered by a private healthcare company like Medical Mutual and often includes additional benefits
  • Medicare Part D is a prescription drug plan also administered by a private healthcare company and is often included in many Medicare Advantage plans.

Learn more about what each part of Medicare covers.

Parts of Medicare

Understanding Medicare Costs

If you’ve paid Social Security and Medicare payroll taxes for about 10 years and meet other eligibility requirements, you won’t have premiums for Medicare Part A coverage. If you don’t have enough payroll tax history, you may also qualify for no premium Part A based on your spouse’s work history. You can also buy Medicare Part A with a monthly premium. Parts B and D require premium payments regardless of work history. Part C, Medicare Advantage, plans often require a monthly premium based on the level of coverage you select.  Some insurers, including Medical Mutual, also offer Medicare Advantage $0 premium plan options.

Depending on the Medicare coverage you choose, all of the costs may not be covered and you could be responsible for copays, coinsurance and deductibles. You can purchase Medicare Part C (Medicare Advantage) or Medicare Supplement Insurance (also known as Medigap) to help cover the expenses Medicare doesn’t.

If you and your spouse are both enrolled in Medicare, you are separately responsible to pay any premiums, deductibles and/or copays the coverage requires.

If you have questions about your Medicare eligibility or have not received an enrollment notice prior to your 65th birthday, call Social Security Administration at 800.772.1213 (TTY users call 800.325.0778) or visit the Social Security website.

Have Questions? We Can Help.

Speak with a Medical Mutual licensed insurance agent or call your insurance agent.

Call 1-866-406-8777 (TTY 711 for hearing impaired)

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Page last updated on 9/29/2021
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