Medicare Basics
Understanding Medicare doesn’t have to be confusing. We’ve gathered the things you need to know and resources to help you find plans that work for you.
What is Medicare
Medicare was established in 1965 to help people who are 65 and over or have certain disabilities or conditions pay for the rising costs of medical care. You are eligible if:
- You are age 65 or above.
- You already receive Social Security or Railroad Retirement Board (RRB) benefits
- You have been diagnosed with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS, “Lou Gehrig’s disease”)
- You are under age 65 and are permanently disabled and have received Social Security disability payments for at least 24 months.
Want to check your eligibility?
Parts of Medicare
Part A - Hospital
Hospital coverage including inpatient stays, care in a skilled nursing facility, and some home & hospice health care.
Part B - Medical
Medical coverage including doctor’s services/tests, outpatient care, durable medical equipment, some preventive services, and supplies not covered by Part A.
Part C – Medicare Advantage
Medicare Advantage includes Part A and Part B benefits, and some plans may offer extra benefits.
Part D – Prescription Drug Plan (PDP)
PDPs provide additional prescription coverage. Many Medicare Advantage plans include Part D coverage.
Deciding The Plan for You
Medicare Advantage
Medicare Advantage combines Original Medicare and sometimes Prescription Drug Plans (Part D) for an all-in-one solution with extra perks. These plans are good for:
- People who want to keep costs more predictable
- People who wish to see their established, in-network care team
- People who want extra benefits
Medicare Supplement
Medicare Supplement plans, or Medigap, provide extra insurance for the things Original Medicare doesn’t cover. These plans are typically good for:
- People who want coverage that travels with them
- People who want more flexibility and choice in providers
- People with budget flexibility
Grow your Medicare IQ
When is My Enrollment Period?
Your Initial Enrollment Period (IEP) is based on your birth month. Enrollment begins three months before you turn 65 and extends until three months after.
If you miss the IEP there is also the Special Enrollment Period (if you qualify) and the General Enrollment period.
Each year, you can change your plan options during the Annual Enrollment Period (AEP) from October 15 to December 7.
What Does Medicare Cost?
How Can I Prepare for Enrollment?
Jumpstart Your Prep
Don’t wait until your 65th birthday to do your research.
Research Plan Options
Check what’s available in your area and what fits your life, medication needs and budget.
Enroll Early
You can enroll as soon as three months before you turn 65.
Medicare FAQs
- 1. You can choose Original Medicare. If you want prescription drug coverage, you must join a Medicare Prescription Drug Plan (Part D).
2. You can choose to join a Medicare Advantage plan (like an HMO or PPO). Most Medicare Advantage plans include prescription drug coverage. - Medicare doesn't cover everything. If you need certain services that aren't covered under Medicare Part A or Part B, you'll have to pay for them yourself. Medicare generally does not cover items such as dental care, eye exams, hearing services, and outpatient prescription drugs.
All of these plans help cover healthcare expenses not covered by Medicare. MA plans include your Original Medicare benefits and other benefits in one plan. If you join an MA plan, you will use one member ID card for your healthcare and prescription drug needs. You do not need an additional Medicare plan. You can choose either a Medicare Advantage or a Medicare Supplement plan but not both. MA plans generally have lower out-of-pocket costs and offer health and wellness benefits.
Benefits, premiums, and copays may change from year to year. Help is available to find the best plan for your needs. Contact us 1-888-288-4398, TTY: 711 Monday thru Friday 8 a.m. to 8 p.m. (Arizona time) or call your insurance agent.
- Prescription drug costs can add up quickly and many people need financial assistance covering some of the costs. If you meet certain income requirements, you could be eligible for Medicare's assistance program, Extra Help.
To see if you qualify for Extra Help, contact Medicare, the Social Security Administration, or your state Medicaid office.
- Medicare: 1-800-633-4227 (TTY: 1-877-486-2048) 24 hours a day, seven days a week
- The Social Security Administration 1-800-772-1213 (TTY: 1-800-325-0778) 7 a.m. to 7 p.m., Monday through Friday
- The state Medicaid office - To be eligible for either a Medicare Advantage or a Medicare Supplement plan, you must reside in the plan’s service area, have Medicare Part A and Part B and continue to pay your Part B premiums (and Part A, if applicable) unless otherwise paid for by a third party. To be eligible for a Medicare Part D plan, you must be enrolled in Part A and/or Part B and you don’t have other drug coverage (creditable coverage).
- This is coverage that pays as much as or more than Medicare's standard prescription drug coverage. If you have prescription drug coverage through your employer, it may be creditable (contact your benefits administrator or human resources contact to find out). That means, if you decide to switch to a stand-alone prescription drug plan later, you would not have to pay the Part D late enrollment penalty (LEP). If your coverage is not creditable, you may have to pay the Part D LEP.
SilverSneakers® gives members on select AZ Blue Medicare plans the opportunity to conquer their health goals. Follow these steps to get started with SilverSneakers®.
- Get ID number. Find your Member ID number at SilverSneakers.com/StartHere, through the SilverSneakers® GO mobile app, or by calling 1-888-423-4632.
- Find a location. Visit SilverSneakers.com for an interactive map showing participating locations.
- Get active from home. Members can log in with their ID number at SilverSneakers.com/StartHere. Here, you can access SilverSneakers® LIVE virtual classes, 200+ On-Demand videos and other exclusive member resources.
- Set a date. Take your ID number to the location of your choice or choose a day to start your virtual workouts.
SilverSneakers is a registered trademark of Tivity Health, Inc. © 2024 Tivity Health, Inc. All rights reserved. Tivity Health, Inc. is an independent and separate company contracted with Blue Cross Blue Shield of Arizona AZ Blue to provide health and wellness services to AZ Blue members. The SilverSneakers program is not an insurance policy and does not provide insurance coverage.
Medicare is the federal health insurance program for:
- People who are 65 or older
- People under 65 with certain disabilities or conditions
- People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)
The Arizona Health Care Cost Containment System (written as AHCCCS and pronounced 'access') is Arizona's Medicaid program, a federal health care program jointly funded by the federal and state governments for individuals and families who qualify based on income level. AHCCCS provides medical insurance coverage and health care programs to thousands of Arizonans each year.
Yes, you can. AHCCCS Members who also have Medicare are called Dual Eligible Members. Visit azahcccs.gov for more information.
- Yes. If a spouse will be or is already covered by Medicare, you can sign up for this plan and open and contribute to an HSA. If you file taxes jointly with your spouse, you can use your HSA to help pay for your spouse’s qualified expenses, such as Medicare Advantage premiums.
- The IEP is a 7-month period that begins three months prior to your 65th birthday, continues through the month of your 65th birthday, and extends three months after your 65th birthday.
- After you turn 65 or start receiving Medicare benefits, you may withdraw money from your HSA for medical and non-medical purposes without penalty. When your Medicare coverage starts, you can use your HSA to pay your Medicare Advantage premiums, deductibles, and copayments.