Medicare

Medicare is a federal health insurance program primarily for people age 65 and older, as well as certain younger individuals with disabilities. It helps cover many healthcare costs, but understanding your options — and how they fit together — can make a big difference in your coverage and out-of-pocket costs.

Original Medicare

Original Medicare is the foundation of your Medicare coverage. It’s provided directly by the federal government and includes two parts:

Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing care, hospice care, and some home health services. Most people don’t pay a premium for Part A if they’ve worked and paid Medicare taxes long enough.

Part B (Medical Insurance): Covers doctor visits, outpatient care, preventive services, and some medical equipment. Part B does require a monthly premium.

What’s not included: Original Medicare doesn’t cover most prescription drugs, dental, vision, or hearing services — and there’s no limit to your annual out-of-pocket costs.

Medicare Advantage

Medicare Advantage plans are an alternative to Original Medicare, offered by private insurance companies approved by Medicare. These plans combine your Part A and Part B coverage, and often include:

Prescription drug coverage (Part D)

Dental, vision, and hearing benefits

Fitness programs and other extras

Many people choose Medicare Advantage for its simplicity — one plan for all benefits — and its annual out-of-pocket maximum, which Original Medicare doesn’t have. However, these plans often use provider networks (HMO or PPO), so it’s important to check which doctors and hospitals are included.

Medicare Supplement

Medicare Supplement Insurance, also known as Medigap, helps fill the “gaps” in Original Medicare — such as deductibles, copayments, and coinsurance. These plans are offered by private insurers and can help you reduce unexpected medical expenses.

Key things to know:

You must have Original Medicare (Parts A & B) to buy a Medigap plan.

Medigap does not include prescription drug coverage — you’ll need a separate Part D plan for that.

You can see any doctor or hospital that accepts Medicare, with no network restrictions.

Turning 65? Here’s What You Need to Know

Key Dates and Deadlines

Initial Enrollment Period (IEP): Your IEP starts 3 months before your 65th birthday month, includes your birthday month, and ends 3 months after — a total of 7 months. This is your first chance to sign up for Medicare.

Annual Enrollment Period (AEP): Every year from October 15 to December 7, you can change or join Medicare Advantage or Prescription Drug plans. Changes take effect January 1.

Medigap Open Enrollment: The best time to enroll in a Medigap plan is during the 6-month period starting the month you’re both 65 or older and enrolled in Part B. During this time, you can buy any Medigap plan without medical underwriting.

Tips for Choosing the Right Medicare Plan

Compare your total costs, not just premiums: Look at deductibles, copays, and maximum out-of-pocket limits.

Check your prescriptions: Make sure any Part D or Medicare Advantage plan covers your medications.

Consider your doctors and hospitals: If you prefer specific providers, make sure they’re in your plan’s network (if applicable).

Think about travel: If you spend time in multiple states, Original Medicare with a Medigap plan may offer more flexibility.

Review your coverage every year: Plans can change, and so can your health needs — it’s worth a yearly checkup to ensure you’re still getting the best value.

Late Enrollment Penalties

Missing enrollment deadlines can lead to permanent penalties:

Part B Penalty: For every 12-month period you delay enrolling in Part B (without other creditable coverage), your monthly premium increases by 10% — for life.

Part D Penalty: If you go without prescription drug coverage for 63 days or more, you’ll pay an extra 1% of the national base premium for each month you delayed — also for life.