What is Medicare?

What Is Medicare?

Medicare is health insurance for people 65 or older, people under 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant). There are multiple parts of Medicare, and different costs associated with each part. Below are some informational slide-downs that provide you with some basics. Click through each header to see the information.

  • Medicare Part A (Hospital Insurance)
    Medicare Part A helps cover:
    • Inpatient care in hospitals
    • Skilled nursing facility care
    • Hospice care
    • Home health care
    You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working. People who have to buy Part A will pay up to $407 each month in 2015.

    Medicare Part A has a $1,216.00 deductible (per 60 day benefit period) for 2015.  This deductible amount usually changes each year and is determined by Medicare.  Many Medicare Supplement plans cover this deductible.
  • Medicare Part B (Medical Insurance)
    Medicare Part B helps cover:
      • Services from doctors and other health care providers
      • Outpatient care
      • Home health care
      • Durable medical equipment
      • Some preventive services
      You usually pay a monthly premium of $104.90 in 2015 (you will pay more if your 2013 tax income is more than $85,000 individually or $170,000 jointly).

    Medicare Part B has an annual deductible of $147.00 for 2015.  This deductible amount usually changes each year and is determined by Medicare.  Some Medicare Supplement plans cover this deductible.
  • Medicare Part C (Medicare Advantage)
    • Includes all benefits and services covered under Part A and Part B
    • Usually includes Medicare prescription drug coverage (Part D) as part of the plan
    • Run by Medicare-approved private insurance companies
    • May include extra benefits and services for an extra cost
    You may only join or leave a Medicare Advantage plan at certain times during the year unless you have a special enrollment period (i.e. moving out of coverage area or involuntarily losing current insurance coverage).
  • Medicare Part D (Medicare Prescription Drug Coverage)
    • Helps cover the cost of prescription drugs
    • Run by Medicare-approved private insurance companies
    • May help lower your prescription drug costs and help protect against higher costs in the future
    Note: 1. If you have a higher income, you might pay more for your Part D coverage. 2. You may owe a late enrollment penalty if at any time after your Initial Enrollment Period is over, there’s a period of 63 or more days in a row when you don’t have Part D or other creditable prescription drug coverage.

What Does Medicare Cost?

  • Medicare Part A
    Medicare Part A usually is free if you or your spouse paid medicare taxes while working. People who have to buy part A will pay up to $407 each month in 2015.

    Medicare Part A has a $1,216.00 deductible (per 60 day benefit period) for 2015. This deductible amount usually changes each year and is determined by Medicare. Many Medicare Supplement plans cover this deductible.
  • Medicare Part B
    Sliding scale chart:
    If your yearly income in 2013 was:
    Filed individual
    return:
    Filed joint
    return:
    Filed married &
    separate tax return:

    You pay (in 2015):
    $85,000 or less $170,000 or less $85,000 or less $104.90
    above $85,000 up to $107,000 above $170,000 up to $214,000 N/A $146.90
    above $107,000 up to $160,000 above $214,000 up to $320,000 N/A $209.80
    above $160,000 up to $214,000 above $320,000 up to $428,000 above $85,000 up to $129,000 $272.70
    above $214,000 above $428,000 above $129,000 $335.70


    Medicare Part B has an annual deductible of $147.00 for 2015. This deductible amount usually changes each year and is determined by Medicare. Some Medicare Supplement plans cover this deductible.
  • Medicare Part C
    Medicare Part C cost varies depending upon the Medicare Advantage Plans offered by private insurance companies. You still continue to pay your Medicare Part B monthly premium while enrolled in a Medicare Advantage Plan.
  • Medicare Part D
    Sliding scale chart:
    If your yearly income in 2013 was:
    Filed individual
    return:
    Filed joint
    return:
    Filed married &
    separate tax return:

    You pay (in 2015):
    $85,000 or less $170,000 or less $85,000 or less Your plan premium
    above $85,000 up to $107,000 above $170,000 up to $214,000 N/A $12.30 + your plan premium
    above $107,000 up to $160,000 above $214,000 up to $320,000 N/A $31.80 + your plan premium
    above $160,000 up to $214,000 above $320,000 up to $428,000 above $85,000 up to $129,000 $51.30 + your plan premium
    above $214,000 above $428,000 above $129,000 $70.80 + your plan premium
    In 2015, there are 31 different Medicare Part D plans offered in Texas with monthly premiums ranging from $15.60 to $152.10 depending upon the plan that you select.