Medicare basics

Medicare, explained one part at a time

Medicare makes sense once you can see how the pieces fit. This page sets out each part, the dates that matter and where to get official answers. Your personal guide then applies it to you.

Our focus

We help people new to Medicare, and people already on it, understand what their choices are. Plain words, no sales, and one guide written for each person.

Why it matters

Medicare decisions come with deadlines, and a missed one can mean a gap in cover or a penalty that lasts. Knowing the basics early takes most of the worry out of it.

How we help

Whether you turn 65 next spring or have had Medicare for years, we explain your options, work out your dates and show you how to compare plans for yourself.

The four parts

What Parts A, B, C and D each do

Parts A and B together are called Original Medicare. Part C is a different way to get them. Part D adds drug cover.

A

Part A

Hospital insurance

Helps pay for inpatient hospital stays, care in a skilled nursing facility after a hospital stay, hospice care and some home health care.

  • Most people pay no monthly premium for Part A if they or a spouse paid Medicare taxes while working for long enough.
  • Signing up happens through Social Security.
B

Part B

Medical insurance

Helps pay for doctor visits, outpatient care, many preventive services and medical equipment such as walkers and oxygen.

  • Part B has a monthly premium, and it is set each year.
  • After the yearly deductible you usually pay a share of each bill, often 20 percent.
C

Part C

Medicare Advantage

An alternative way to get your Part A and Part B cover, through a private company that Medicare approves. Most of these plans include drug coverage too.

  • Plans usually have a network of doctors and hospitals, and some need referrals.
  • Many add dental, vision or hearing cover that Original Medicare leaves out.
D

Part D

Prescription drug coverage

Helps pay for the medicines you take at home. It comes from private plans, either on its own beside Original Medicare or inside a Medicare Advantage plan.

  • Every plan has its own list of covered drugs, called a formulary.
  • Joining late without other drug cover can mean a penalty that lasts.
An older man reading a letter at a table
Medigap

Medigap fills gaps in Original Medicare

Medicare Supplement Insurance, or Medigap, is sold by private companies and helps pay the deductibles, coinsurance and copayments that Original Medicare leaves to you.

It only works alongside Original Medicare, not with a Medicare Advantage plan, and it does not include drug cover, so most people pair it with a Part D plan. The six months that start when you are 65 and have Part B are usually the easiest time to buy one; after that, insurers in most states can ask about your health.

Key dates

The windows when you can sign up or make changes

Outside these windows most changes have to wait, which is why the dates are the first thing your guide sets out.

Around your 65th birthday

Initial Enrollment Period

Seven months: the three months before the month you turn 65, that month, and the three after. Sign up early in the window and cover can start on time.

October 15 to December 7

Open Enrollment

Each year anyone with Medicare can join, switch or drop a Medicare Advantage or Part D plan. Changes start on January 1.

January 1 to March 31

Medicare Advantage Open Enrollment

If you are in a Medicare Advantage plan you can switch to another one, or go back to Original Medicare, once during these three months.

When your life changes

Special Enrollment Periods

Moving, losing coverage from a job, or leaving a plan's area can each open a window of their own outside the usual dates.

Still working at 65 with coverage from that job? You may be able to put off Part B without a penalty. Ask Social Security or your plan before you decide.

Want this worked out for your own situation?

Sign up and a person on our team writes your guide within two working days. For official answers at any time, call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048).

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