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Medicare Basics

Basic Coverage

When you turn 65, have a qualifying disability, end-stage renal disease (ESRD) or amyotrophic lateral sclerosis
(ALS), you’re eligible for Part A and Part B — that’s Original Medicare.

Part A (Hospital Insurance) Coverage

Most people don’t pay a Part A premium because they paid Medicare taxes while working.
  • Inpatient care in a hospital
  • Limited stays in a skilled nursing facility
  • Some home health care
  • Hospice care

Part B (Medical Insurance) Coverage

Part B is optional and has a monthly premium. There is a penalty if you don’t enroll when you’re first eligible. In most cases, you can delay enrollment in Part B without penalty if you are actively at work and enrolled in an employer group health plan.
  • Doctor’s services
  • Outpatient care
  • Durable medical equipment
  • Some preventive services
  • Some prescription drugs

Out of Pocket Costs

Original Medicare doesn’t cover everything. If you need certain services that Medicare does not cover, you will
have to pay out–of-pocket unless you have other insurance to help cover the costs. Even if Medicare covers a
service or item, you’ll have to pay deductibles, coinsurance, and copayments.

Out-of-Pocket Costs you’ll pay with Parts A and B

  • Deductibles and copays for hospital stays
  • Part B annual deductible
  • Deductibles and 20% of the Medicare-approved amount for most care you get from doctors or other health care providers, outpatient therapy, Medicare Part B drugs and durable medical equipment

Out-Of-Pocket Costs you’ll pay outside of Parts A and B

  • Routine dental care
  • Routine vision care and eyewear
  • Routine hearing exam and hearing aids
  • Over-the-Counter (OTC) items such as vitamins or cold/allergy medicines

When Do I Become Eligible for Medicare?

You can sign up during these 7 months. If you plan to work past age 65, these times can differ for you:

3 Months

Before your birthday

65th Birthday

During your birthday month

3 Months

After your birthday

When Do I Become Eligible for Medicare?

You can sign up during these 7 months. If you plan to work past age 65, these times can differ for you:

3 Months

Before your birthday

65th Birthday

During your birthday month

3 Months

After your birthday

Get AMAC’s Free 2024 Medicare Guide

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Our Customer Reviews

“I would like to tell you what a terrific associate you have in Ed Babits. Every year he patiently walks me through my Medicare decisions and is always pleasant to talk with. He is a step above the crowd. Be proud you have him.”
Douglas W.
“I had just finished my Medicare sign-ups yesterday for 2023 with the help of Diana Jordan. I would like to convey my appreciation for the professional insurance services Diana provided. Diana was very knowledgeable, patient and pleasant with getting my Medicare program set up for next year. I will come back to AMAC next year for their wonderful services. Thank you very much.”
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Shelby W.
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Bob E.
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Frank & Sherree T.
“Elaine, just a short note to say thank-you for all your assistance to both Carol and I as we navigate towards Medicare. You have done a fabulous job of keeping us informed and helping us through all the information that is part of the process. We will continue to work with you in the future and please let us know if there is anything you need from us as you move forward.”
Scott M.
“Kyla, thank you, thank you, thank you! Thank you for your patience and for doing your best to help us…we appreciate those efforts. Please, by all means, forward this to your supervisor. AMAC management deserves - needs - to know when their team members make the extra effort to assist association members. Have a great day.”
Scott & Becky F
“Sabrinah is terrific and has the answers on her fingertips. You certainly have a gem with Sabrinah. Excellent customer service year after year. Outstanding job.”
Joan S.
“What an asset Lexi Breckenridge is to your company. I would not hesitate to reach back out to her for any of my Medicare needs. She deserves at least a pat on the back.”
“Mackensie Cromer is FANTASTIC…so lovely and patient. We’ve worked with her a couple of years now and she is so knowledgeable and helpful. We’ve given her name to our friends. We also love your phone system matching us to our agent—such a great feature!”
I want to thank Bethany for helping me. She was kind and explained things where I could understand them. Made the process easy for me. Easiest thing I have done for my retirement.”
I just got off the phone with your agent Ashley MacDonald. She was VERY patient with me .I'm turning 65 and needed help understanding all the different Medicare plans. She was very professional, knowledgeable, and friendly.
“ Marcus, thank you so much for taking the time to explain everything to me and making this process so easy for seniors! I appreciate AMAC and everything that they do for us seniors.! ”
Josephine, N.Y.
“ Angela is great at what she does and made this an easy as possible.”
James M.
“Theresa was very professional and was the first person that could answer all Medicare questions and made this process so easy!”
Elisabeth M.
“Edward Moneagle went above and beyond in helping me find a Medicare plan. He was a pleasure to work with and I will definitely be recommending him to anyone that needs Medicare insurance.”
Nancy B.

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