Insurance Help

• Health insurance that a company selects and pays for partly or fully on behalf of its employees
• Employer contracts with an insurance carrier (or self-funds the plan)
• Employees typically contribute a portion of the premium through payroll deductions
• Often covers spouse and dependents for an increased payment
• When you lose your job, you also lose your health insurance
• However, COBRA requires employers to allow employees to continue to purchase employer sponsored insurance for 18 months after losing their jobs
• With COBRA, the cost to purchase your employer sponsored insurance is higher

Federal health insurance for people 65+ and those with certain disabilities or ESRD

Who Qualifies:

• Age 65 or older
• Younger people with disabilities (receiving Social Security disability benefits for at least 2 years)
• People with End-Stage Renal Disease (need hemodialysis or kidney transplant)
• People with ALS (receiving disability benefits)
• People who developed health conditions after environmental hazard exposure in an emergency declaration area (after 6/17/2009)

How to Apply:

• Visit Medicare.gov
• Call 1-800-MEDICARE
• Apply at Social Security office
• Some people are automatically enrolled and others have to sign up
• If you apply to start getting retirement benefits from Social Security at least 4 months before you turn 65, you will automatically be enrolled in Medicare Part A and B when you turn 65
• If not you will have to contact Social Security when you are ready to sign up for Medicare

Coverage Details:

• Part A: inpatient insurance, such as hospital stays, nursing home stays, home health care after hospitalization, and hospice (certain number of days covered)
• Part B: outpatient insurance, such as coverage for clinician services, preventative care and home health care
• Part C: Medicare Advantage, which is a private insurance plan (alternative to part A and B)
• Part D: prescription drug benefit
• Part A and B are subject to cost sharing
• Part B is not required but most people have it
• Medicare Advantage plans must cover all regular Medicare benefits but may cover more
• Medicare Advantage plans may have limitations on which clinicians you can see
• Part D is voluntary and operates through contracts with private insurers
• Part D premiums are based on income
• Part D is subsidized especially for low income beneficiaries

• Coverage for active duty military members, some retirees and their dependents
• Covers hospital and outpatient care as well as medications through TRICARE system
• Some services are covered outside TRICARE system
• Active duty and their families do not pay but there is a copay for retirees
• Learn More