Medicare Overview
Medicare is a federal health insurance program administered by the U.S. government. It primarily serves people age 65 and older, though some younger individuals with certain disabilities or conditions also qualify. Medicare helps cover medical costs including hospital stays, doctor visits, preventive care, and prescription drugs.
To qualify for Medicare, you must be a U.S. citizen or permanent resident and be at least 65 years old. You can also qualify if you are younger than 65 and have received Social Security disability benefits for 24 months, or if you have End-Stage Renal Disease (ESRD) or ALS.
The Four Parts of Medicare
Part A — Hospital Insurance
Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes while working (at least 40 quarters). However, there are deductibles and coinsurance costs associated with hospital stays.
Part B — Medical Insurance
Medicare Part B covers outpatient care, doctor visits, preventive services, durable medical equipment, and some home health services. Part B has a monthly premium (which varies based on income), an annual deductible, and typically requires you to pay 20% of the Medicare-approved amount for most services.
Part C — Medicare Advantage
Medicare Advantage plans are offered by private insurance companies approved by Medicare. They include all Part A and Part B coverage, and most plans also include Part D drug coverage and extra benefits like dental, vision, and hearing. Learn more about Medicare Advantage.
Part D — Prescription Drug Coverage
Medicare Part D helps cover the cost of prescription drugs. These plans are offered by private insurance companies and are available as standalone plans (for those with Original Medicare) or as part of a Medicare Advantage plan. Each Part D plan has its own formulary (list of covered drugs) and cost structure.
Original Medicare vs. Medicare Advantage
When you first enroll in Medicare, you have a fundamental choice to make:
- Original Medicare (Parts A & B) — Government-run. You can see any provider that accepts Medicare. You may add a Medigap supplement plan and a standalone Part D drug plan. Learn about Medigap plans.
- Medicare Advantage (Part C) — Private insurance. Bundles A, B, and usually D together, often with extra benefits. Uses provider networks (HMO or PPO). Learn about Advantage plans.
Neither option is universally better — the right choice depends on your health needs, preferred doctors, medications, and budget. A licensed Medicare agent can help you compare your specific options.
Medicare in Southern Utah
Residents of St. George, Hurricane, Washington, Cedar City, and surrounding Southern Utah communities have access to several Medicare plan options. The specific plans available depend on your zip code and can change each year.
We provide free, no-obligation guidance to help you understand your options and enroll in the right plan.