Gem State Financial Group
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    • Medicare
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  • Small Business
  • Individuals and Families
  • Medicare
  • Contact Us

Medicare

Who is Eligible for Medicare

Who is Eligible for Medicare

Who is Eligible for Medicare

 Individuals age 65+, those under 65 with qualifying disabilities, or anyone with ESRD or ALS may be eligible for Medicare coverage. 

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The Parts of Medicare

Who is Eligible for Medicare

Who is Eligible for Medicare

 There are four parts of Medicare that each cover different types of healthcare services, including hospital care, medical care, and prescription drugs. 

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Where to get Started

Who is Eligible for Medicare

Where to get Started

 Our team is ready to help. Medicare can feel confusing, but you don’t have to navigate it alone—reach out today or book an in-person appointment. 

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Who is Eligible for Medicare

Age 65 or Older

 Most people become eligible for Medicare when they turn 65. Eligibility usually applies if the individual or their spouse has a work history where Medicare taxes were paid. Enrollment is typically automatic for those receiving Social Security benefits at age 65. 

Under 65 with Certain Disabilities

 Individuals under 65 may qualify for Medicare if they have been receiving Social Security Disability Insurance (SSDI) benefits for 24 months.

Any age with ESRD

 End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or transplant) 

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Parts of Medicare

Medicare Part A

Medicare Part A, also known as Hospital Insurance, helps cover the cost of inpatient hospital stays, skilled nursing facility care, hospice services, and certain home health care. Part A is designed to give you peace of mind when you need hospital or facility care, helping protect you from large medical bills. Here’s a closer look at what Part A can cover: 

 

  • Hospital Care
  • Skilled Nursing Facility Care
  • Hospice Care
  • Home Health Services


While Medicare Part A covers a wide range of hospital and inpatient services, beneficiaries may still be responsible for certain costs, including deductibles and coinsurance. For most people, Part A enrollment happens automatically at age 65 if they meet eligibility criteria, such as having paid Medicare taxes through their work history. 

Medicare Part B

 Medicare Part B, also called Medical Insurance, helps cover a variety of outpatient services and doctor visits. It’s designed to make it easier to get medically necessary care and preventive services that keep you healthy—often outside of a hospital setting. Here’s a closer look at what Part B can cover: 

 

  • Doctor’s Services
  • Outpatient Care:
  • Preventive Services:
  • Durable Medical Equipment (DME)
  • Medical Tests and Lab Services
  • Emergency Ambulance Services
  • Mental Health Services
  • Limited Prescription Drugs
  • Outpatient Rehabilitation Services
  • Part B also covers some preventive screenings and counseling services for alcohol misuse and tobacco cessation.


 Medicare Part B helps cover important medical services like doctor visits, outpatient care, and preventive screenings. While it does come with a monthly premium, an annual deductible, and some coinsurance or copayments, the exact costs can vary based on your income and circumstances 

Medicare Part C

Medicare Part C, also known as “Medicare Advantage,” offers an alternative way for Medicare beneficiaries to receive their Original Medicare benefits through private insurance companies approved by Medicare and State Insurance Department. Medicare Advantage plans provide all the benefits of Original Medicare (Part A and Part B) and will likely include additional benefits not covered by Original Medicare.


Medicare Advantage plans aren’t one-size-fits-all—each plan can differ in coverage, costs, provider networks, and extra benefits. If you’re thinking about a Medicare Advantage plan, it’s a good idea to explore the options available in your area and find one that fits your healthcare needs and budget. Be sure to understand how the plan works, including its network of doctors and any requirements for seeing specialists. Many people find Medicare Advantage appealing because it combines hospital and medical coverage while often offering additional benefits beyond Original Medicare. 

Medicare Part D

Medicare Part D, also called Prescription Drug Coverage, helps cover the cost of the medications you need to stay healthy. Part D plans are designed to give you access to a wide variety of prescription drugs, making it easier to manage your health and maintain your well-being. Whether you take routine medications or need coverage for unexpected prescriptions, Part D can help make them more affordable.

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Where to Get Started

 Getting started with Medicare doesn’t have to be confusing—and you don’t have to do it alone. The first step is to get in touch with our team. We’re here to answer your questions, walk you through your options, and help you find the plan that best fits your healthcare needs and budget.

Here’s what to do next:

 

  • Review your eligibility: We’ll help you understand if you qualify based on age, disability, or certain medical conditions. 
  • Learn about your options: Explore Original Medicare (Parts A & B), Medicare Advantage (Part C), and Prescription Drug Coverage (Part D) to see what works best for you. 
  • Compare plans in your area: We can guide you through the available plans, helping you understand coverage, costs, and extra benefits. 
  • Make an informed choice: With our support, you can select the plan that fits your needs and gives you peace of mind about your healthcare. 


Current Carriers We represent:


  • Aetna
  • Blue Cross of Idaho
  • Humana
  • Mountain Health Co-Op
  • Mutual of Omaha
  • PacificSource
  • Regence Blue Shield
  • St. Alphonsus Health Plan
  • United Healthcare


Contact us today to take the first step toward confident Medicare coverage!

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Contact Us

Drop us a line!

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Better yet, see us in person!

We love our customers, so feel free to visit during normal business hours.

Gem State Financial Group

8620 W Emerald St, Boise, ID, USA

(208) 377-1428

Hours

Open today

09:00 am – 05:00 pm

We do not offer every plan available in your area. Currently we represent 5 organizations which offer 20 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.



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* Scott Leavitt offers products and services using the following business names: Gem State Financial Group – insurance and financial services | Ameritas Investment Company, LLC (AIC), Member FINRA/SIPC – securities and investments | Ameritas Advisory Services (AAS) – investment advisory services. AIC and AAS are not affiliated with Gem State Financial Group.


Products and services are limited to residents of states where the representative is registered. This is not an offer of securities in any jurisdiction, nor is it specifically directed to a resident of any jurisdiction. As with any security, request a prospectus from your representative. Read it carefully before you invest or send money. A representative will contact you to provide requested information. Representatives of AIC and AAS do not provide tax or legal advice. Please consult your tax advisor or attorney regarding your situation.

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