Medicare

Frequently asked questions

Senior member discussing Medicare enrollment and coverage options with a MetroPlusHealth representative.

What is Medicare and how does it work?

Medicare is a government-funded healthcare plan that covers people who meet eligibility requirements. There are four parts to Medicare: Part A (hospital insurance), Part B (Medicare insurance), Part C (Medicare Advantage plans), and Part D (drug coverage).

Most people don’t pay for Part A, while premiums for parts B, C and D can change yearly and are based on your income or what plan you chose to enroll in.

 

What’s the difference between Medicare and Medicaid?

While both Medicare and Medicaid are government-funded programs, eligibility requirements are different.

Medicare is primarily for people 65 or older, or younger people with disabilities or certain illnesses, including ALS and end-stage kidney failure. Medicaid is for low-income individuals, families and children, with the specific income requirements varying by state.

When is it time to look at Medicare?

If you’re 65 or older and need health insurance, or if you have a disability, ALS (Amyotrophic Lateral Sclerosis; also known as Lou Gehrig’s Disease) or end-stage renal failure, you may want to consider Medicare. The initial enrollment period for someone  just turning 65 begins at 64 & 9 months.

 

How do I apply for Medicare?

You can apply for Medicare on your own by going through the Social Security website, or you can work with a MetroPlusHealth customer representative to find the right Medicare plan for you.

Are there people who can assist with navigating Medicare?

MetroPlusHealth’s customer service representatives can walk you through the enrollment process and answer any questions you may have. To speak to a representative, call 866.496.6636.

When can I enroll in Medicare?

If you’re newly eligible for Medicare, you have a seven-month period to enroll, the three months before your 65th birthday month, your birthday month, and the three months after.

You can also enroll in Medicare during the annual enrollment period from Oct. 15 – Dec. 7 each year, or you may be able to enroll during special enrollment periods depending on your circumstances.

To find out if you can enroll during a special enrollment period, or for help enrolling, you can call MetroPlusHealth at 1.800.986.0356.

 

A woman bends down to smell flowers at a storefront

 

Am I eligible for Medicare?

Medicare is generally for people 65 or older, though individuals with disabilities, end-stage renal failure, or ALS (Amyotrophic Lateral Sclerosis; also known as Lou Gehrig’s Disease) may also be eligible.

Is there Medicare coverage for home health aides?

Medicare does provide some coverage for home health services, but what it will cover depends on your plan.

Does Medicare cover dental and vision?

Medicare doesn’t cover routine eye exams for prescription updates, but it does cover yearly glaucoma screenings and certain diagnostic tests and treatment for some people with age-related macular degeneration.

Medicare also doesn’t cover routine dental cleanings, fillings, tooth extractions, or things like dentures and implants. However, there are certain scenarios when Medicare may cover dental services, such as if it’s a dental service directly related to certain covered medical treatments.

Learn about your Medicare options

1-800-475-6387 (TTY: 771) 1-800-475-6387 (TTY: 771)

Let our representatives find a plan that’s best for you

Monday–Friday | 8 am–8 pm (ET), Saturday | 9 am–5 pm (ET)
last updated: August 22, 2025
MetroPlusHealth
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