Government Health Insurance Programs
Core concepts
Understand Medicare parts: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drugs). Know eligibility (age 65, certain disabilities, ESRD), enrollment periods (initial, general, special), and late-enrollment penalties. Understand Medigap as supplemental coverage that fills Medicare cost-sharing gaps.
Know Medicaid as a joint federal-state program for low-income individuals, with state-set eligibility and benefits. Understand CHIP for children, TRICARE for military families, and VA benefits for veterans. Know COBRA as a continuation right for group coverage (not a government health program, but often tested alongside them), and ACA marketplace subsidies and essential health benefits.
Traps
Questions confuse Part A and Part B coverage, or assume Medigap works with Medicare Advantage (it generally does not). Another trap: treating Medicaid as fully federally administered-states set eligibility. Watch for COBRA duration questions (typically 18 months, with extensions) and for Medicare enrollment penalty calculations.
Worked example
A 67-year-old enrolls in Medicare Part B three years late without qualifying for an exception. A late-enrollment penalty (generally 10% of the premium for each 12-month period of delay) may apply for as long as the person has Part B. Part A may also carry a penalty if not premium-free.
Rule of thumb: Part A = hospital; Part B = medical; Part C = Advantage; Part D = drugs; Medigap supplements Original Medicare only.