What You Need to Know About Medicare

This information explains what Medicare is and which Medicare coverage is best for you. This guide also has information about paying for your care at Memorial Sloan Kettering (MSK).

What is Medicare?

Medicare is the federal health insurance plan for people age 65 and older. Some people younger than 65 may be able to get Medicare coverage if they:

• Have a physical disability.
• Have lifelong special health needs.

Read more about Medicare coverage on the Medicare.gov website.

What does Medicare pay for?

There are 3 parts to Medicare. Each part pays for different health care services you may need.

Medicare Part A

Medicare Part A helps you pay for care you need at the hospital, such as surgery. It also helps pay for:

• Your stay and the care you get at a rehabilitation center or skilled nursing home.
  • These places offer special health care services you may need after a hospital stay.

  Medicare Part B

  Medicare Part B helps you pay for outpatient care that’s not in a hospital. You can use this plan to pay for:

  • Office visits to your healthcare provider.
  • Prevention and wellness care.
  • Imaging tests, such as an x-ray or mammogram.
  • Physical therapy.
  • Medical supplies, including wheelchairs.
  • Some medicines, including chemotherapy.

  Medicare Part D

  Medicare Part D can give you more coverage for your prescription drugs.

  • You can choose to join Medicare Part D, in addition to your Medicare Parts A and B coverage.
  • You can also get Medicare Part D if you join a Medicare Advantage Plan.

  What is a Medicare Advantage Plan?

  Medicare Advantage is a private insurance plan that could cover the cost of getting healthcare services at a facility outside of your network. This will require authorization (approval) to be covered. It’s sometimes called Medicare Part C. These are health plans offered by private companies approved by Medicare.

  Medicare Advantage Plans can help you pay for:

  • Some prescription drugs.
  • Teeth cleanings and dental care.
  • Checkups with the eye doctor.
  • Hearing tests and hearing aids.
  • Changes you need to make to your home for a health reason.

  Learn more about the options for Medicare Advantage Plans on .the Medicare.gov website.

  What is Medicare Supplemental Insurance?

  Medicare Supplemental Insurance is extra insurance you can buy. It is also called Medigap because it pays for the gaps in Medicare coverage you normally must pay for. Medigap helps you pay for your share of the health care costs.

  Medigap:

  • Is not the same as a Medicare Advantage Plan.
  • Only covers 1 person. If you and your partner both want Medigap, you must buy separate policies.
  • Does not include prescription drug coverage. You must get a Medicare Part D plan to help you pay for medications.
  • Comes with a fee each month. This fee is also called a premium and is in addition to what you may need to pay for your Part B plan.

  Learn more about Medigap on the Medicare.gov website.

  Ask these questions about getting your care at MSK

  • Does MSK accept my Medicare plan?
  • I have other health plans, such as Medigap or Medicare Advantage. Does MSK accept those?
  • Do I need Medicare supplemental coverage to have more of my care at MSK covered?
  • When can I join Medicare?
  • How do I know what cancer care services at MSK are covered?

  Actions you can take when you’re ready

  • Apply for Medicare. You can do this in 3 ways:
  1. Visit the Social Security Administration website at www.SSA.gov/medicare.
  2. Go in-person to your local Social Security Administration office.
  3. Call the Social Security Administration at 800-772-1213.

  If you have questions or concerns, contact your healthcare provider. A member of your care team will answer Monday through Friday from 9 a.m. to 5 p.m. Outside those hours, you can leave a message or talk with another MSK provider. There is always a doctor or nurse on call. If you’re not sure how to reach your healthcare provider, call .

  If you have questions or concerns, contact your healthcare provider. A member of your care team will answer Monday through Friday from 9 a.m. to 5 p.m. Outside those hours, you can leave a message or talk with another MSK provider. There is always a doctor or nurse on call. If you’re not sure how to reach your healthcare provider, call .

  For more resources, visit www.mskcc.org/pe to search our virtual library.

  What You Need to Know About Medicare - Last updated on November 9, 2023
  All rights owned and reserved by Memorial Sloan Kettering Cancer Center