Part A — Hospital Insurance
Inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people pay no premium for Part A because they paid Medicare taxes while working.
◊ Medicare basics
What is Medicare?
Medicare is the federal health insurance program for people who are 65 or older, and for certain younger people with disabilities or End-Stage Renal Disease.
The four parts of Medicare
Medicare is split into four parts. Parts A and B together are called Original Medicare and are administered by the federal government. Parts C and D are sold by private insurance carriers that are approved by Medicare, which is why availability and pricing change from state to state and often from ZIP code to ZIP code.
Part B — Medical Insurance
Doctor visits, outpatient care, preventive services, lab work, and durable medical equipment. Part B carries a monthly premium, and higher-income beneficiaries pay an income-related adjustment (IRMAA).
Part C — Medicare Advantage
A private alternative that bundles Parts A and B, usually with drug coverage and extras like dental or vision. In exchange you use the plan's provider network and follow its referral and prior-authorization rules.
Part D — Prescription Drug Coverage
Standalone drug plans you add to Original Medicare. Each plan has its own formulary and pharmacy network, so the right plan depends on the exact prescriptions you take.
Understand your enrollment periods
There are two main enrollment times for people entering Medicare, and missing them can mean lifelong late-enrollment penalties.
- Initial Enrollment Period. A seven-month window: the three months before the month you turn 65, your birthday month, and the three months after.
- Medigap Open Enrollment Period. A one-time, six-month window that starts the month you are 65 and enrolled in Part B. During it, no carrier can decline you or charge you more for health history.
- Annual Election Period. October 15 through December 7 each year, when you can change Medicare Advantage and Part D plans for the following year.
- Special Enrollment Periods. Triggered by qualifying events such as moving out of your plan's service area or losing employer coverage.
See what is available in your state
Plan availability and pricing are local. Start with your state, or find an advisor.