Medicare is a US federal health insurance program. It helps pay for medical healthcare for people aged 65 years and above, and for some younger people with certain disabilities or permanent kidney failure.
Medicare is run by the government through the Centers for Medicare and Medicaid Services (CMS).
There are parts to Medicare: Part A, Part B, Part C (called Medicare Advantage), and Part D (drug coverage).
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Purpose of Medicare
The purpose of Medicare is to make sure people aged 65 years and above (and certain younger people with specific health conditions) get access to healthcare.
Medicare coverage can also help individuals get recommended preventive care. Preventive care can help stop acute illnesses, chronic conditions, and other health problems before they develop or become serious. Preventive care covers vaccines, screenings, immunizations and annual wellness visits.
Who Is Medicare For
- People aged 65 years and above who are US citizens, or are legal residents long enough and have paid into Medicare through payroll taxes during their working years.
- Younger people with certain disabilities, after meeting specific requirements.
- People of any age who have End-Stage Renal Disease (kidney failure needing dialysis or transplant).
To join Medicare, many people sign up for Part A and Part B when they turn 65. Then they choose whether to use Original Medicare or Medicare Advantage.
What Does Medicare Cover
Medicare covers certain kinds of healthcare.
Here is a breakdown of what each part covers:
- Part A (hospital insurance): Pays for hospital stays (also called “inpatient care”), skilled nursing facility stays (after a hospital stay), hospice care, and some home healthcare.
- Part B (medical insurance): Covers doctors’ services, outpatient care (visits that do not require hospital stay), preventive services (like screenings and vaccines), durable medical equipment (e.g. walkers, wheelchairs), and sometimes home healthcare.
- Part D (prescription drug coverage): Helps cover many prescription drugs. You join a private company’s drug plan or get it through a Medicare Advantage plan.
Original Medicare (Parts A and B) does not cover everything. It usually does not pay for:
- Most dental care or dentures
- Hearing aids and exams to fit them
- Glasses or routine eye exams for correction
- Long‑term care or custodial care (help with daily living when you can’t do it yourself)
- Part C (Medicare Advantage): These are private plans approved by Medicare that bundle together Parts A and B. They also usually include Part D.
Medicare Advantage plans may also offer extra services that Original Medicare does not cover, like vision, dental, hearing, or wellness benefits. But these extra services vary by plan.
What Are Medicare Benefits
Medicare benefits refer to the services, help, and coverage you get and they vary by plan. Some key benefits for people aged 65 years and above are:
- Hospital benefits: when you must stay in hospital, Medicare covers much of the cost under Part A.
- Doctor and outpatient benefits: visits to doctors, specialists, outpatient clinics, lab tests, x‑rays, Part B services.
- Preventive care: vaccines (flu, pneumonia, shingles), health screenings (breast cancer, colon cancer, etc.), yearly wellness visits. These services are meant to find problems early.
- Drug coverage: prescriptions are often expensive. Medicare Part D helps reduce what you pay for medications. If you are in a Medicare Advantage plan that includes drug coverage, that benefit is usually built in.
- Home health and hospice: if you need care at home for certain conditions, or end‑of‑life care, Medicare offers that.
- Extra benefits via Medicare Advantage: Many Medicare Advantage plans provide extra benefits not offered by Original Medicare. These can include things like dental, vision, hearing (these vary by plan), sometimes wellness programs, and more.
Frequently Asked Questions about Medicare
- How do I sign up for Medicare?
You usually enroll when you turn 65. If you already get Social Security, you may be signed up automatically for Part A and Part B. Otherwise, you enroll through the Social Security Administration. - Is there a cost for Medicare?
Yes. Part A may be premium‑free if you or your spouse paid enough Medicare taxes. Part B has a monthly premium, deductible, and cost sharing. Part D and Advantage plans have their own costs. - Can Medicare cover prescription drugs?
Yes, with Part D, or if your Medicare Advantage plan includes drug coverage. - What preventive services are free under Medicare?
Many preventive services are fully covered: certain vaccines, cancer screenings, wellness visits. Refer to each plan’s specific benefits to find out what’s covered. - Can I get extra help with costs?
Yes, there are programs and insurance (like Medigap, Medicare Savings Programs) to help reduce out‑of‑pocket costs, premiums, coinsurance, and deductibles especially for those with limited income.
Your trusted partner in healthcare
At IntraCare Health Centers, we provide whole-person healthcare designed specifically for adults aged 65 years and above, putting your physical, emotional, and cognitive well-being first.
Our doctors don’t just treat problems; they help prevent them with early diagnoses, regular check-ups, medication reviews, and lifestyle support to keep you healthy and independent, especially if you’re managing multiple chronic conditions.
We help individuals in Texas and Arizona enrolled in Original Medicare (Parts A and B) or Medicare Advantage (Part C) plans stay strong, active, and in control of your health.