1. Hospital insurance (Part A) helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care and hospice care.
2. Medical insurance (Part B) helps pay for doctors’ services and many other medical services and supplies that are not covered by hospital insurance.
3. Medicare Advantage (Part C) plans are available in many areas. People with Medicare Parts A and B can choose to receive all of their health care services through one of these provider organizations under Part C.
4. Prescription drug coverage (Part D) helps pay for medications doctors prescribe for treatment.

Most people age 65 or older who are citizens or permanent residents of the United States are eligible for free Medicare hospital insurance (Part A).
You are eligible at age 65 if:

• You receive or are eligible to receive Social Security benefits; or
• You receive or are eligible to receive railroad retirement benefits; or
• Your spouse is eligible; or
• You or your spouse (living or deceased, including divorced spouses) worked long enough in a government job where Medicare taxes were paid; or
• You are the dependent parent of a fully insured deceased child.

If you do not meet these requirements, you may be able to get Medicare hospital insurance by paying a monthly premium. Usually, you can sign up for this hospital insurance only during designated enrollment periods.
NOTE: Even though the full retirement age is no longer 65, you should sign up for Medicare three months before your 65th birthday.
There are ways to receive Medicare Part A before age 65. Listed below are a few of the more common ways to receive Medicare Part A early:

• You have been entitled to Social Security disability benefits for 24 months; or
• You receive a disability pension from the railroad retirement board and meet certain conditions; or
• If you receive Social Security disability benefits because you have Lou Gehrig’s disease (amyotrophic lateral sclerosis); or

Anyone who is eligible for free Medicare hospital insurance (Part A) can enroll in Medicare medical insurance (Part B) by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. Please see the chart below illustrating the 2012 Medicare Part B Premiums:

• A U.S. citizen; or
• A lawfully admitted non-citizen who has lived in the United States for at least five years.

If you have Medicare Parts A and B, you can join a Medicare Advantage plan. Medicare Advantage plans are offered by private companies and approved by Medicare. With one of these plans, you do not need a Medigap policy, because Medicare Advantage plans generally cover many of the same benefits that a Medigap policy would cover, such as extra days in the hospital after you have used the number of days that Medicare covers.
Medicare Advantage plans include:

• Medicare managed care plans;
• Medicare preferred provider organization (PPO) plans;
• Medicare private fee-for-service plans; and
• Medicare specialty plans.

If you decide to join a Medicare Advantage plan, you use the health card that you get from your Medicare Advantage plan provider for your health care. Also, you might have to pay a monthly premium for your Medicare Advantage plan because of the extra benefits it offers.

People who become newly entitled to Medicare should enroll during their initial enrollment period or during the annual coordinated election period from October 15 – December 7 each year. The effective date for the enrollment is January 1 of the upcoming year. There also will be special enrollment periods for some situations.

Anyone who has Medicare hospital insurance (Part A), medical insurance (Part B) or a Medicare Advantage plan (Part C) is eligible for prescription drug coverage (Part D). Joining a Medicare prescription drug plan is voluntary, and you pay an additional monthly premium for the coverage.

You can wait to enroll in a Medicare Part D plan if you have other creditable prescription drug coverage, but, if you don’t have prescription coverage that is, on average, at least as good as Medicare prescription drug coverage, you will pay a penalty if you wait to join later. You will have to pay this penalty for as long as you have Medicare prescription drug coverage.

People who become newly entitled to Medicare should enroll during their initial enrollment period. After the initial enrollment period, the annual coordinated election period to enroll or make provider changes will be October 15 – December 7 each year. The effective date for the enrollment is January 1 of the upcoming year. There also will be special enrollment periods for some situations.

If you are already getting Social Security retirement or disability benefits or railroad retirement checks, you will be contacted a few months before you become eligible for Medicare and given the information you need. If you live in one of the 50 states or Washington, D.C., you will be enrolled in Medicare Parts A and B automatically. However, because you must pay a premium for Part B coverage, you have the option of turning it down.

If you are not already getting retirement benefits, you should contact us about three months before your 65th birthday to sign up for Medicare. You can sign up for Medicare even if you do not plan to retire at age 65.

Once you are enrolled in Medicare, you will receive a red, white and blue Medicare card showing whether you have Part A, Part B or both. Keep your card in a safe place so you will have it when you need it. If your card is ever lost or stolen, you can apply for a replacement card on the Internet at www.socialsecurity.gov/medicarecard or call Social Security’s toll-free number.

When you first become eligible for hospital insurance (Part A), you have a seven-month period (your initial enrollment period) in which to sign up for medical insurance (Part B). A delay on your part will cause a delay in coverage and result in higher premiums. If you are eligible at age 65, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65 and ends three months after that birthday.

If you are eligible for Medicare based on disability or permanent kidney failure, your initial enrollment period depends on the date your disability or treatment began.

If you accept the automatic enrollment in Medicare Part B, or if you enroll in Medicare Part B during the first three months of your initial enrollment period, your medical insurance protection will start with the month you are first eligible. If you enroll during the last four months, your protection will start from one to three months after you enroll.

The following chart shows when your Medicare Part B becomes effective:

General Enrollment Period – Part B

If you do not enroll in Medicare Part B during your initial enrollment period, you have another chance each year to sign up during a “general enrollment period” from January 1 through March 31. Your coverage begins on July 1 of the year you enroll. However, your monthly premium increases 10 percent for each 12-month period you were eligible for, but did not enroll in, Medicare Part B.

If you don’t sign up for Part B during your Initial Enrollment Period because you are covered under a group health plan you qualify for a Special Enrollment Period (SEP). Your SEP is an 8 month period that begins the month after your employments end or your group health plan coverage ends.
For a complete chart on Part B Enrollment Options please see the chart below:

For both Parts A & B you may have to pay a penalty equal to 10% of the premium, unless you're eligble for a SEP

If you have a Medicare Advantage plan (Part C), you can leave your plan and switch to original Medicare from January 1 through February 14. If you use this option, you also have until February 14 to join a Medicare prescription drug plan. Your coverage begins the first day of the month after the plan gets your enrollment form.

If you are 65 or older and are covered under a group health plan either from your own or your spouse’s current employment, you have a “special enrollment period” in which to sign up for Medicare Part B. This means that you may delay enrolling in Medicare Part B without having to wait for a general enrollment period and paying the 10 percent premium surcharge for late enrollment. The rules allow you to:

• Enroll in Medicare Part B any time while you are covered under the group health plan based on current employment; or
• Enroll in Medicare Part B during the eight-month period that begins following the last month your group health coverage ends, or following the month employment ends—whichever comes first.

Special enrollment period rules do not apply if employment or employer-provided group health plan coverage ends during your initial enrollment period.

When you enroll in Medicare Part B while you are still in the group health plan or during the first full month when you are no longer in the plan, your coverage begins either:

• On the first day of the month you enroll; or
• At your option, on the first day of any of the following three months.

If you enroll during any of the remaining seven months of the “special enrollment period,” your Medicare Part B coverage begins on the first day of the following month.

If you do not enroll by the end of the eight-month period, you will have to wait until the next general enrollment period, which begins January 1 of the next year. You also may have to pay a higher premium, as described previously.