Medicare Basics and
Answers to Your Question

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What is Medicare?

Medicare is the largest health insurance program in the United States. It is run by the Centers for Medicare and Medicaid Services (CMS), a government agency. Whether you're new to Medicare or already have the basics covered and know what coverage you need, EmblemHealth is here to guide you with the right information so you can make the right choice.

You can join Medicare if you’re 65 or older and:

  • You are either a citizen or a permanent resident of the United States.
  • You or your spouse worked at least 10 years and paid Medicare taxes. 
  • You are under 65 with certain disabilities.

Medicare Basics

Original Medicare has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). It is a “fee-for-service” health plan. This means you pay for each service you receive. To better understand Original Medicare, let’s look at what each part cover

Part A | Hospital Insurance

Medicare Part A covers care you receive when you stay in a hospital (this is called “inpatient” care). It also covers care you get at skilled nursing facilities, home health care and hospice care. Read More.

Part C | Medicare Advantage Plans

Original Medicare coverage is good, but it can be hard to manage multiple plans, ID cards, bills and networks. With a Medicare Advantage plan from a private company like EmblemHealth, you can get what you need from a single plan. Read More.

Part B | Medical Insurance

Medicare Part B helps you pay for medical services. These are services like doctor visits, tests, outpatient hospital services and other like services. Read More.

Part D | Prescription Drug Coverage

Original Medicare coverage is good, but it can be hard to manage multiple plans, ID cards, bills and networks. With a Medicare Advantage plan from a private company like EmblemHealth, you can get what you need from a single plan. Read More.

How to Get Help Covering Costs

Medicare Savings Programs

If you have limited income and resources, you may be able to get help from your state to pay your Medicare costs. Some of the programs may help to pay your Medicare Part B premium, or some of your costs to get services, like deductibles, coinsurance or copays.

Medicaid

Medicaid is a health plan for low-income and disabled people. Each state runs its own program. The federal government and each state government share the costs of this program. “Dual eligibles” are those that have both Medicare and Medicaid and most health care expenses are covered

"Extra Help"

Extra Help is a Medicare program to help people with limited income and resources pay Part D drug plan costs. It can help pay monthly premium fees, deductibles, and coinsurance. Are you eligible for "Extra Help"? Read More.

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Moving from a Marketplace or SHOP plan to a Medicare Plan

Once you qualify for Medicare, you’ll have a limited time (an initial enrollment period) to sign up. For most people, the enrollment period starts three months before their 65th birthday and ends three months after their 65th birthday.

In most cases, it’s to your advantage to sign up for Medicare when you’re first eligible.

Medicare Resource

Brochures

EmblemHealth Medicare Made Simple Guide

Get our Medicare Made Simple Guide — An EmblemHealth guide to help you make the right Medicare decisions.

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CMS Medicare & You Brochure 

Helpful information for people eligible for Medicare and their caregivers.

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Helpful Links

Official U.S. Government website for people with Medicare General information and helpful tools.

Medicare Rights Center
A national not-for-profit consumer service organization dedicated to making sure that older adults and people with disabilities get affordable health care.

Administration for Community Living
The Administration for Community Living educates people and their caregivers about the benefits and services available to help them.

Phone Numbers

Social Security Administration
800-772-1213 (TTY: 800-325-0778), Monday through Friday, 7 am to 7 pm.

Elderly Pharmaceutical Insurance Coverage EPIC Help Line
800-332-3742, Monday through Friday, 8 am to 5 pm. (TTY: 800-421-1220).
This program helps income-eligible people 65+ to supplement their out-of-pocket Medicare Part D drug plan costs. The Administration for Community Living educates people and their caregivers about the benefits and services available to help them.

Last Updated 9/8/2021

Y0026_ 200570 Accepted 9/29/20