Medicare is health insurance for people aged 65 and older, people 64 and younger with disabilities and any person with end-stage renal disease (ESRD), with limited exceptions. As a federal health program, most tax-paying U.S. citizens qualify for Medicare after working for a set period of time. Medicare plans fall into four programs, or “parts,” that cover certain aspects of services.
- Medicare Part A covers care received from hospitals, skilled nursing facilities, nursing homes, hospice and some home health services. Part A and Part B is considered Original Medicare.
- Medicare Part B covers certain doctors’ services, outpatient care, medical supplies and preventative services. If you choose this coverage you agree to pay Medicare a monthly premium.
- Medicare Part C is also known as Medicare Advantage and is offered by a private company that contracts with Medicare to provide you with all of your Part A and Part B benefits. To select Medicare Advantage you will need to meet certain criteria to qualify.
- Medicare Part D is prescription drug coverage and offered to everyone with Medicare. You do not have to qualify to receive Medicare Part D coverage.
Medicare Enrollment Periods
You can enroll for a Prominence Health Plan Medicare Advantage HMO during specific Medicare Enrollment Periods and avoid fees or penalties.
Frequently-asked Questions about Medicare
Get answers to the most frequently-asked questions about Medicare and Prominence Health Plan Medicare Advantage.
Qualifying for Medicare Advantage
People with Medicare are often surprised to learn that it does not cover all hospitalization and doctor costs. This means you may be responsible for paying more than you expected. Prominence Health Plan Medicare Advantage HMOs can fill some of these gaps in coverage and save you money. To qualify, you must meet the following requirements:
- Have existing Medicare Parts A and B coverage and pay your Part B premiums
- Permanently reside in the following areas:
- Nevada: Carson City, Douglas, Lyon, Storey and Washoe counties
- Texas: Brooks, Cooke, Deaf Smith, Fannin, Gray, Grayson, Hidalgo, Moore, Potter, Randall and Starr counties
Although there are exceptions, Medicare Advantage is not available for those with end-stage renal disease.
Some people get Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) automatically and other people have to sign up for it. In most cases, it depends on whether you’re getting Social Security benefits.
If you do not receive Social Security retirement benefits by the time you’re 65, you will need to apply for Medicare during an enrollment period. You can apply in one of three ways:
- Visit your local Social Security office
- Call Social Security: 1-800-772-1213 (TTY: 1-800-325-0778) between the hours of 7 a.m. and 7 p.m., Monday through Friday
- Or go to www.ssa.gov >
Prominence Health Plan is a Medicare Advantage HMO plan with a Medicare contract. Enrollment depends on contract renewal.
Last Update 12/19/17