Medicare

What is Medicare?

Medicare is a federal health insurance program. It helps pay for doctor visits, hospital stays, prescription drugs, and other medical care. Medicare is run by the Centers for Medicare & Medicaid Services.

Who qualifies for Medicare

You qualify for Medicare if you meet one of these conditions:

• You are 65 or older
• You are under 65 and have been getting Social Security Disability Insurance (SSDI) for at least 24 months
• You have end-stage renal disease (permanent kidney failure that needs dialysis or a transplant)
• You have amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease

U.S. citizenship or legal residency is required.

What Medicare covers

Medicare has different parts that cover different services:

• Part A covers hospital stays, skilled nursing facility care, hospice care, and some home health services
• Part B covers doctor visits, outpatient care, medical equipment, and preventive services
• Part D covers prescription drugs
• Part C (also called Medicare Advantage) is an alternative way to get Parts A and B coverage, often with Part D included

Medicare does not cover everything. Dental care, vision care, hearing aids, and long-term custodial care are usually not covered.

How much you pay

What you pay depends on which parts of Medicare you have and your income.

Part A: Most people pay nothing for Part A if they or their spouse paid Medicare taxes while working. If you don't qualify for free Part A, you may pay a monthly premium.

Part B: You usually pay a monthly premium. The amount depends on your income. If your income is higher, you may pay more.

Part D: You pay a monthly premium for prescription drug coverage. The amount varies by plan.

Deductibles and copays: You also pay deductibles (the amount you pay before insurance kicks in) and copayments or coinsurance (your share of the cost after insurance starts paying). These amounts vary by plan and service.

How to apply for Medicare

You don't need to do anything if you are already getting Social Security or Railroad Retirement Board benefits. Medicare will start automatically when you turn 65.

If you are not getting Social Security benefits, you need to apply. You can:

• Visit Medicare.gov
• Call Social Security at the number on the Medicare website
• Visit your local Social Security office
• Apply online through your Social Security account

When to apply

You should apply during your Initial Enrollment Period. This is a seven-month window:

• Three months before the month you turn 65
• The month you turn 65
• Three months after the month you turn 65

If you apply during this window, your coverage can start the month you turn 65.

If you miss this deadline, you may face a penalty. You can still apply after your Initial Enrollment Period, but your coverage will start later and you may pay more.

What to bring when you apply

Have these documents ready:

• Your Social Security card
• Proof of U.S. citizenship or legal residency (passport, birth certificate, green card, or naturalization papers)
• Proof of residency (utility bill, lease, or mortgage statement)

What happens after you apply

Social Security will review your application. If you qualify, you will get a Medicare card in the mail. This usually takes about 2-4 weeks.

Your Medicare card shows your Medicare number. You will need this number for doctor visits and prescriptions.

If you need to choose a Part D plan (for prescription drugs), you must choose one during your Initial Enrollment Period. If you don't choose, you may be automatically enrolled in a plan, or you may have to wait until the next enrollment period.

Renewing your coverage

Your Medicare coverage continues as long as you pay your premiums and stay eligible. You do not need to reapply each year.

You can change your coverage during the Annual Enrollment Period, which runs from October 15 to December 7 each year. During this time, you can switch Part C plans, change your Part D prescription drug plan, or make other changes to your coverage.

Related programs

If you have low income, you may qualify for programs that help pay your Medicare costs:

• Medicaid helps pay for Medicare premiums, deductibles, and copayments for people with low income
• Medicare Savings Program helps pay Part B and Part D premiums
• Extra Help helps pay prescription drug costs if you have limited income and resources

You can also use our screener tool to find out what other benefits you may qualify for.

Need more help?

Visit Medicare.gov for detailed information about coverage, plans, and enrollment. If you have questions, our help page has resources to guide you.