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Medicare insurance
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Medicare Insurance
What is Medicare and Who Is It For?
Medicare is a federal health insurance program primarily for people age 65 and older, as well as certain younger individuals with disabilities or specific medical conditions. It provides a strong foundation for healthcare coverage in retirement, but it doesn’t cover everything — which is where smart planning and the right supplemental coverage come in.
At a glance, Medicare:
Helps cover doctor visits, hospital stays, preventive care and more.
Is made up of different "parts": Part A, Part B, Part C and Part D.
May be paired with Medicare Supplement (Medigap) or Medicare Advantage plans.
Does not automatically include dental, vision, hearing aids or long-term custodial care.
Good News: You don't have to figure out Medicare out alone. As an independent Medicare broker, Atlas Benefits compares multiple companies and plan types so you can see the full picture before choosing.
Goal: Simple explanations, clear comparisons and a Medicare plan that fits your health and budget.
Because there are many moving pieces, it's easy to feel overwhelmed. Atlas Benefits helps you understand each part of medicare
and how your choices affect your costs and coverage.
Understanding the 4 Parts of Medicare
Medicare is divided into four parts, each covering different healthcare needs. Here's a simple breakdown to help you understand your options.
Part A
Hospital Insurance
Covers inpatient hospital stays, skilled nursing facility care, hospice, and limited home health services. Most people pay no monthly premium if they paid Medicare taxes while working.
Part B
Medical Insurance
Covers doctor visits, outpatient care, preventive services, lab work, and medical equipment. Includes a monthly premium and typically covers about 80% of approved services.
Part C
Medicare Advantage
Private insurance plans that combine Part A and Part B, often including extra benefits like drug coverage, dental, vision, and hearing. Plans may use provider networks.
Part D
Prescription Drug Coverage
Helps cover prescription medications through private insurance plans. Costs and covered drugs vary by plan and can be included with Medicare Advantage or purchased separately.
Part A: Hospital | Part B: Medical | Part C: Advantage Plans | Part D: Prescription Drugs
What Does Medicare Cover?
Medicare helps cover a wide range of healthcare services, but coverage is divided into different parts. Here's a simple breakdown of what is typically included.
Hospital & Inpatient Care
Includes inpatient hospital stays, skilled nursing facility care, hospice services, and some home health care under Medicare Part A.
Doctor Visits & Outpatient Care
Covers doctor appointments, specialist visits, outpatient procedures, preventive services, and lab testing under Medicare Part B.
Preventive Services
Includes screenings, vaccines, annual wellness visits, and other services designed to help detect or prevent illnesses early.
Prescription Drugs
Covered through Medicare Part D or many Medicare Advantage plans, helping reduce the cost of medications.
Additional Benefits
Many Medicare Advantage plans include extra benefits like dental, vision, hearing, transportation, and fitness programs.
Medical Equipment
Covers durable medical equipment such as wheelchairs, walkers, oxygen equipment, and more when medically necessary.
Medicare coverage can vary based on the plan you choose. Understanding your options is key to making sure your healthcare needs are fully covered.
What Medicare Does NOT Cover
While Medicare provides valuable health coverage, there are important gaps you should be aware of. Understanding what is not covered can help you avoid unexpected out-of-pocket costs.
Routine Dental Care
Medicare generally does not cover routine dental services such as cleanings, fillings, extractions, dentures, or most dental procedures.
Routine Vision Care
Eye exams for glasses, contact lenses, and most routine vision services are not covered under Original Medicare.
Hearing Aids
Medicare does not typically cover hearing aids or routine hearing exams, which can be a significant out-of-pocket expense.
Long-Term Care
Custodial care, such as assistance with bathing, dressing, and daily living activities, is not covered by Medicare in most situations.
Care Outside the U.S.
Medicare generally does not cover healthcare services received outside of the United States, with very limited exceptions.
Unlimited Out-of-Pocket Costs
Original Medicare does not include a maximum out-of-pocket limit, which means costs can add up without additional coverage.
These gaps are why many people choose additional coverage like Medicare Advantage plans or Medicare Supplement plans to help protect against unexpected costs.
Who Is Eligible for Medicare?
Medicare eligibility is based on age, certain disabilities, or specific medical conditions. Here’s a simple breakdown to help you understand if you qualify.
Age 65 or Older
Most people qualify for Medicare when they turn 65. You are eligible if you are a U.S. citizen or a legal resident who has lived in the U.S. for at least 5 consecutive years.
Under 65 with a Disability
Individuals under age 65 may qualify after receiving Social Security Disability Insurance (SSDI) benefits for 24 months.
End-Stage Renal Disease (ESRD)
People with permanent kidney failure requiring dialysis or a kidney transplant may qualify for Medicare regardless of age.
ALS (Lou Gehrig’s Disease)
Individuals diagnosed with ALS automatically qualify for Medicare as soon as they begin receiving Social Security Disability benefits, without a waiting period.
Timing matters. Enrolling at the right time can help you avoid penalties and ensure you have the coverage you need when you need it.
What Are The Costs of Medicare?
Get In Touch
We may not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.