Welcome to Medicare 101
Plans. Coverages. Benefits. It all seems like a lot, but we can make it a lot simpler! Learn all about Medicare—and how to get the right Medicare plan for you—with help and advice from Baylor Scott & White Health Plan.
Medicare is a public health insurance program for people 65 and older or those with certain disabilities or diseases. It is run by the Centers for Medicare & Medicaid Services, an entity within the federal government. You can generally choose from among several types of Medicare…see below.
There are four different parts of the Medicare program (Parts A, B, C and D), each designed to cover a different aspect of your healthcare needs:
Part A Sometimes called “Original Medicare”
Covers hospital stays, nursing facility stays, and, in some circumstances, hospice care. If you or your spouse has been working and paying taxes to Medicare for 10 years, there is no monthly premium for Part A.
Part B Sometimes called “Original Medicare”
Covers medical care services like doctor visits and outpatient services and procedures. There is a premium for Part B, which is calculated based on your income tax returns from two years ago.
Part C Also known as “Medicare Advantage”
Covers everything from Parts A and B, plus offers other benefits such as coverage for dental, vision and hearing. There can be a monthly premium for these plans, but many insurers offer $0 premium options. Part C plans (Medicare Advantage) are offered through a private insurance company, like Baylor Scott & White Health Plan. Check out our plan options.
Part D
Provides coverage for prescription drugs. Offered through private insurance companies, Part D plans are included in many Medicare Advantage plans (Part C) or can be purchased separately if you have Original Medicare only or a Medicare Supplement (MediGap) plan. Baylor Scott & White Health Plan offers Medicare Advantage plans that include Part D prescription coverage and others that don’t—so you can choose what’s right for you.
Pro Tip:
If you choose a Medicare Advantage plan from Baylor Scott & White Health Plan, you’ll have all your “ABCDs” included!
Original Medicare provides coverage for hospital and doctor visits (see Parts A and B above), but doesn’t include coverage for extras such as prescriptions and dental.
Medicare Advantage (see Part C above) includes the same coverages offered under Medicare Parts A and B and will often have prescription drug coverage (Part D), plus dental, vision, hearing and other supplemental benefits. Medicare Advantage plans may offer more comprehensive coverage at a lower cost than a Medicare Supplement (MediGap) plan.
Medicare Supplement (MediGap) provides more coverage for hospital and doctor visits than Original Medicare (Parts A and B above), but it generally has a higher monthly premium. It doesn’t include coverage for prescriptions, dental, vision and hearing.
For most people, 65 is the magic number. You are eligible to join Medicare up to three months before your 65th birthday month and within three months after your birthday month. In fact, you must enroll in Original Medicare (Parts A or B) within that seven-month window unless you are covered by an employer’s health plan—or you may be subject to penalties from the government. Once you enroll and start paying Part B premiums, you can enroll in a Medicare Advantage plan (Part C), like one from our plan!
Lots of people work past age 65, and you can generally delay enrolling in Medicare until after you retire.
- If you (or your spouse) are covered through a qualified health insurance plan from your employer—and if you want to keep that coverage—you can choose to delay signing up for Parts A and B.
- Once you stop working (or lose or cancel your employer’s health insurance), you have an eight-month Special Enrollment Period (SEP) during which you can sign up for Medicare (or add Part B to existing Part A coverage), including a Medicare Advantage plan through Baylor Scott & White Health Plan.
Pro Tip:
Enroll in a Medicare Advantage or other Medicare plan 2-3 months before you retire to ensure you have health insurance immediately after your employer’s health coverage ends.
Questions? We’ve got you covered!
(And we can even help you enroll when the time comes.)
Call 833.975.0841833.975.0841 (TTY: 711) to speak with a licensed insurance agent.
October 1 – March 31: 7 days a week, 8:00 AM – 8:00 PM
April 1 – September 30: Monday – Friday, 8:00 AM – 5:00 PM
Closed on major holidays.
Para hablar con un representante en español, llame a 833.412.3320833.412.3320.
Already a member? Visit our Member Resources.
For additional information related to Medicare, you can access the CMS website at medicare.gov.
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