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Our partner Connie Health will learn your needs and help you make the best Medicare choices. Questions about your plan? Not sure what steps to take? Connie will help.
How it works
Fabric will connect you with our trusted partner, Connie Health.
You can call them now or schedule an appointment.
Connie will learn your unique needs and guide you on next steps.
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Turning 65 soon and not sure what steps to take?
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Your questions, answered
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Not necessarily. Some people who are already receiving Social Security, Railroad Retirement Board benefits, or disability payments are automatically enrolled when they turn 65. You may need to apply.
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You qualify for Medicare if you are age 65 or older, or under 65 with certain qualifying disabilities or medical conditions, and meet citizenship or residency rules.
Citizenship or Residency: You must be a U.S. citizen or a permanent legal resident who has lived in the U.S. continuously for at least five years.
Qualifying at Age 65 or Older:
You or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters).
You receive or are eligible to receive retirement benefits from Social Security or the Railroad Retirement Board.
You are younger than 65 but your spouse qualifies based on their work history.
Qualifying Under Age 65 (Disabilities & Conditions):
Disability: You have received Social Security Disability Insurance (SSDI) benefits for 24 months.
ALS: You have been diagnosed with amyotrophic lateral sclerosis (Lou Gehrig's disease).
ESRD: You have permanent kidney failure requiring regular dialysis or a kidney transplant (End-Stage Renal Disease)
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Medicare has four main parts (A, B, C, and D) that cover different types of health care services.
Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care.
Part B (Medical Insurance): Covers doctor visits, outpatient care, medical equipment, and preventive services.
Part C (Medigap / Medicare Advantage): Bridges the gaps in Medicare coverage.
Part D (Prescription Drug Coverage): Helps cover the cost of prescription medications through private plans.
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Annual Enrollment Period (AEP) runs from October 15 through December 7. Everyone can make changes to their plan during this period. But there are many other special periods throughout the year, and most Medicare / Medicaid duals can make changes more frequently. There are frequent opportunities to improve your coverage.
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Medicare is not free for most people, and costs can include premiums, deductibles, copays, and coinsurance. For a full rundown of Medicare costs, https://www.medicare.gov/basics/costs/medicare-costs.
There are many programs that can reduce the costs of Medicare, though, including:
Medicare Savings Programs. These are programs through Medicaid which can pay some of the associated costs, like premiums, copays, and deductibles. Eligibility depends on income and household size.
Medicare Extra Help. Medicare Extra Help can greatly reduce the costs of Medicare Part D (prescription drugs). Eligibility is based on income and household size.
Start today.
Find out what you are eligible for.
Medicare is a federal health insurance program in the United States primarily for people who are 65 or older, as well as younger individuals with specific disabilities.
For most enrollees, Medicare Part A (hospital insurance) has no monthly premium, though Part B (medical insurance) requires a standard monthly premium. While there are deductibles and co-pays, Medicare pays its share of the approved amount directly to your providers. (1,2)
The informed reader zone
What is Medicare?
What it covers?
Doctor visits
Primary care, specialists, and preventive checkups. Many preventive services are covered at no cost.
Prescriptions
Covered if you add a Part D or Medicare Advantage plan, including a $35 monthly cap on covered insulin (3)
Hospital care
Emergency visits, surgeries, and hospital stays, without the giant bill.
Preventive and senior care
Annual wellness visits, cancer screenings, and skilled nursing facility care.
Coverage details vary by state.
How Medicare works
Eligibility is generally determined by age (65 and older) and work history, though younger people can qualify based on certain disabilities or conditions like End-Stage Renal Disease (ESRD) or ALS(4). Because Medicare is a federal program, the basic eligibility rules and core benefits are the exact same across the country.
You can apply directly through the Social Security Administration (SSA) website or at a local office. Some people are enrolled automatically when they start receiving Social Security benefits, while others need to actively sign up during their Initial Enrollment Period (which surrounds their 65th birthday). If you miss this window, you could face late enrollment penalties (5).