How Does Medicare Work for Older Adults?

How Does Medicare Work for Older Adults?

Medicare covers a portion of health care costs similar to traditional health insurance for adults 65 and older. Original Medicare includes Part A, which covers hospital expenses, and Part B, which covers outpatient and doctor visits.

Older adults enroll in Medicare when turning 65. The eligibility period starts three months before the month of the person's birthday and continues for three months after the birthday month. Adults who miss the enrollment period may pay more.

Seniors who make Social Security contributions for at least 10 years don't pay premiums for Part A. Others pay a small premium each month. Part B premiums depend on income. Both Part A and B have deductibles, copays and coinsurance like traditional health insurance.

Once enrolled in Medicare, the senior can seek medical care as she would with private insurance. The provider must be a qualified provider, and not all providers accept new Medicare patients at all times.

Because Medicare Part A and B don't cover all expenses, some seniors choose to purchase additional coverage called Medicare supplement insurance. Seniors also have the option of enrolling in a Medicare Part D plan to cover some prescription drug costs.

An alternative to Original Medicare is a Medicare Advantage Part C plan through a private insurance company. These plans are usually a hybrid of Part A and B coverage with some additional benefits, such as vision or hearing coverage.