What is Medicare?

Section I.a. Explaining Medicare
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Medicare is the federal government program that gives you health care coverage (health insurance) if you are 65 or older or under 65 and have a disability, no matter your income. When you pay taxes on your income, part of the money goes toward Medicare.

The Centers for Medicare and Medicaid Services (CMS) is the federal agency that oversees Medicare.

Medicare is different from Medicaid, which is a state and federal program offering health care coverage to people of most ages in certain groups (children and pregnant women, single parents, people with disabilities, and people 65 and over), but generally only to those with low incomes.

Medicare has different parts that cover inpatient services, outpatient services and prescription drugs at the pharmacy.

Unless you make another choice for how to get your benefits when you become eligible for Medicare, you will have Original Medicare, the traditional fee-for-service program offered directly through the federal government. In Original Medicare, you are covered to go to just about any doctor or hospital in the country.

People can also choose to get their Medicare benefits instead through a Medicare Advantage plan (such as an HMO or PPO). These plans, which are also called Medicare private health plans, must offer at least the same benefits as Original Medicare but can have different rules, costs and coverage restrictions. They can also offer additional benefits. Some people who get health coverage from a union or current or former employer will automatically be enrolled in a Medicare Advantage plan when they become eligible for Medicare if their employer sponsors one. Everyone has a choice about how to get Medicare health benefits.

It is important to understand your Medicare coverage choices and to pick your coverage carefully. How you choose to get your benefits can affect your quality of care.

Everyone who has Medicare receives a red-white-and-blue Original Medicare card. If you have Original Medicare, you will show this card when you get services. If you choose to get your health benefits through a Medicare Advantage plan, you will still get an Original Medicare card but you will show your private plan card when you get services. No matter how your get your Medicare health benefits, keep the Original Medicare card as proof of your Medicare eligibility.

Medicare card

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Centers for Medicare and Medicaid Services (CMS)

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