Medicare 101 Part 1

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What is Medicare?

Medicare Defined: Medicare is a national social insurance program administered by the U.S. government which provides health insurance to individuals aged 65 or older (and other certain individuals).

CMS:  Centers for Medicare and Medicaid Services – Governing body over Medicare

CMS sets the marketing rules and regulation for Medicare Part C (Medicare Advantage) and Medicare Part D (Prescription Drug) plans

Social Security – Works with CMS for data and offers some services out of their offices such as Medicare enrollment and Part B premium information

Medicare’s 4 Parts

4 Parts of Medicare

Medicare Clients

The majority of your clients will be aging into Medicare (T65: Turning 65 years old) or will already have Medicare (older than 65).

Three months out they will receive their red, white, and blue Medicare card in the mail, which will enroll them into Medicare Part A and B.

Under Age 65: You may have clients who are under age 65.  Medicare is available to individuals who are disabled for a period of at least 24 consecutive months.  If you are helping an under 65-year-old and they do not have Medicare, they may apply through Social Security.

The Medicare Card

Medicare Card

Name according to Social Security:  Make sure your client’s application matches the name on their Medicare card, and not a nick name or middle name they may go by.  This will help streamline the application process

Medicare ID:  The Medicare ID is a Social Security number with a letter or letter and number at the beginning or the end of the number.  This may not be the applicant’s number depending on how they are receiving their Medicare benefits.

Part A and B effective dates:  These dates represent when your applicant received their Medicare benefits. They may not match if they delayed their Medicare Part B.