Medicare, explained in plain English
Four parts, several enrollment windows, and a lot of acronyms. Here's the whole picture in a few minutes, and a free expert ready to apply it to your situation.
The short version
Medicare is federal health insurance for people 65+ (and some younger people with disabilities). It comes in four parts: Part A (hospital), Part B (doctors), Part C / Medicare Advantage (a private all-in-one alternative), and Part D (prescription drugs). You can build your coverage one of two ways. Original Medicare (A + B), usually paired with a Supplement and a Part D plan; or a single Medicare Advantage plan that bundles it all together.
What do Parts A, B, C and D cover?
Hospital insurance
Covers inpatient hospital stays, skilled nursing facility care, hospice and some home health care. Most people get Part A premium-free because they paid Medicare taxes while working.
Medical insurance
Covers doctor visits, outpatient care, preventive screenings, lab work and durable medical equipment. Part B has a standard monthly premium and an annual deductible set by Medicare each year.
Medicare Advantage
A private, all-in-one alternative to Original Medicare. These plans bundle Parts A and B (and usually D) and often add extras like dental, vision, hearing and a $0 premium, in exchange for using a plan network.
Prescription drug coverage
Helps pay for prescription medications. Each plan has its own list of covered drugs (a "formulary"), so the right plan depends entirely on the specific medications you take.
Which path is right for me?
There's no universally "best" choice, it depends on your doctors, your budget, your medications and how you like to get care. Here's the trade-off.
Original Medicare + Supplement
- See any doctor or hospital that accepts Medicare, no network
- Very predictable out-of-pocket costs with a Medigap plan
- Add a separate Part D plan for drugs
- Usually a higher monthly premium
Medicare Advantage (Part C)
Often $0 premium- Everything bundled into one plan, often $0 premium
- Extras Original Medicare doesn't cover, dental, vision, hearing
- A yearly cap on what you pay out of pocket
- You use the plan's network of doctors and hospitals
When should I sign up for Medicare?
Miss the right window and you can face a lifelong late-enrollment penalty, so the dates matter. Here are the ones to know.
Initial Enrollment Period
The 7 months around your 65th birthday, starting 3 months before your birthday month and ending 3 months after.
Annual Enrollment Period
October 15 to December 7 every year. This is when anyone can join, switch or drop a Medicare Advantage or Part D plan for the next year.
Special Enrollment Periods
Life changes, moving, losing employer coverage, or qualifying for Extra Help, can open a window to enroll or switch outside the usual dates.
Can I get help paying for Medicare?
Many people qualify for savings programs and don't know it. We check every one you may be eligible for, at no cost.
Extra Help (LIS)
A federal program that can dramatically lower, or eliminate, your Part D drug plan premiums, deductibles and copays.
Medicare Savings Programs
State programs that can help pay your Part B premium and other costs if your income and resources are limited.
$0-premium Advantage plans
In most areas, several Medicare Advantage plans carry a $0 monthly premium while still including drug coverage and extras.
Still have questions? That's what we're here for.
Bring your doctor and medication list, we'll turn all of this into a clear recommendation made for you.