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Medicare Fact Sheet

Medicare Coverage

  • Part A (Hospital Insurance) – Covers inpatient hospital care, skilled nursing facility, hospice, home health care, and blood work.

  • Part B (Medical Insurance) – Covers doctor’s visits, outpatient services, durable medical equipment, preventative care, mental health, and ambulance services.

  • Part C (Medicare Advantage Plan) – Alternative Medicare coverage offered through private companies. Incorporates Medicare Parts A and B and supplemental insurance in a single plan. This is an alternative to original Medicare. You must have Medicare Parts A and B to enroll in a Medicare Advantage plan. Your Medicare Advantage plan may or may not include Part D prescription drug coverage as well as include additional benefits, such as dental, hearing, or vision not covered with original Medicare.

  • Part D (Prescription Drug Coverage) – Prescription drug coverage offered through private companies or as part of a Medicare Advantage plan. You must be enrolled in Parts A and B to join a Part D plan.

  • Medigap Plan (Supplemental Insurance) – Supplemental Insurance policy that helps pay various expenses not covered under original Medicare, such as deductibles and co-pays. You must be enrolled in original Medicare (Parts A and B) in order to purchase a Medigap policy. Do not sign up for a Medigap policy if you are enrolled in a Medicare Advantage plan (Part C).

Enrollment

  • Initial Enrollment Period (Parts A, B, C, and D) – A seven-month window that begins three months before, includes the month of your birthday, and ends three months after you turn age 65.

  • Special Enrollment Period – If you did not sign up for benefits during the initial enrollment period because you are still covered under a group health plan, you can sign up for benefits for up to eight months after employment or your group health plan coverage ends.

  • General Enrollment Period – January 1 through March 31 – This is an opportunity to enroll if you did not enroll when first eligible or during a Special Enrollment Period. Penalties are typically assessed when you sign up during this period if this is not during your Initial Enrollment Period. Your coverage begins July 1.

  • Annual Enrollment Period – October 15 through December 7 – Anyone with Medicare can join, switch, or drop a Medicare Advantage or Part D prescription drug plan during this period. Your coverage begins January 1.

Medicare Monthly Premiums

  • Part A – $0 if you or your spouse have 40 Social Security credits. If you have to pay for Part A, the 2021 premiums are $259 or $471 each month, depending on how long you or your spouse worked and paid Medicare taxes.

  • Part B* – The Standard Part B premium for 2021 is $148.50.

  • Part C – $33.00 was the average monthly premium for 2020. Part C premiums vary because they are administered through private companies.

  • Part D* – $43.07 is the national average monthly bid for 2021. Part D premiums vary because they are administered through private companies.

* You may be required to pay a higher monthly premium based upon your modified adjusted gross income from two years ago if that amount is greater than $88,000 for single filers or $176,000 for a married couple filing jointly.

IMPORTANT NOTES

  • To sign up for Medicare, contact the Social Security Administration at ssa.gov or by calling (800) 772-1213.

  • For more information, go to medicare.gov, call (800) 633-4227 (800-MEDICARE), and/or contact your state’s department of insurance.

  • For more information, contact Health Plan One at (888) 404-1516 or visit their Stifel-dedicated website at: http://www.medicareusa.com/stifel 

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