Whether you're turning 65 or helping a parent, Medicare can seem confusing at first. Here are the basics in plain language.
The parts of Medicare
- Part A (hospital insurance) helps cover inpatient hospital stays, skilled nursing facility care, hospice, and some home health care.
- Part B (medical insurance) helps cover doctor visits, outpatient care, preventive services, and medical equipment.
- Part C (Medicare Advantage) is an alternative way to receive your Part A and Part B benefits through a private plan approved by Medicare. Many plans also include prescription drug coverage and extra benefits, which vary by plan.
- Part D (prescription drug coverage) helps cover the cost of prescription medications.
Parts A and B together are often called Original Medicare. Some people with Original Medicare also buy a Medicare Supplement (Medigap) policy to help with costs such as deductibles and coinsurance.
Key enrollment periods
- Initial Enrollment Period: a seven-month window around your 65th birthday — the three months before, your birthday month, and the three months after.
- Annual Enrollment Period: October 15 to December 7 each year, when you can join, switch, or drop Medicare Advantage and Part D plans.
- Medicare Advantage Open Enrollment Period: January 1 to March 31, when people already in a Medicare Advantage plan can make certain changes.
- Special Enrollment Periods: available in certain situations, such as moving or losing other coverage.
Missing your enrollment window can lead to late enrollment penalties in some cases, so it's worth planning ahead.
Questions to ask before you choose
- Are my doctors in the plan's network?
- Are my prescriptions covered, and at what cost?
- What is the most I could pay out of pocket in a year?
- Do I travel often, or spend part of the year in another state?
Get help understanding your options
I can walk you through how these options work and compare available plans with you. For information on all of your options, you can also contact Medicare.gov or 1-800-MEDICARE.
Maryam Kasimova is not affiliated with or endorsed by the U.S. government or the federal Medicare program. See the full Medicare disclaimer.
This article is for general information only and is not insurance, legal, or tax advice. Rules, dates, and plan details can change, and benefits vary by carrier and plan. For guidance on your situation, ask Maryam.