Medicare 101
Start here if you're new to Medicare. No jargon, just clear answers.
What is Medicare?
Federal health insurance program primarily for people 65 and older, and some younger individuals with qualifying disabilities or conditions.
Part A — Hospital Insurance
Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people pay no premium if they or their spouse paid Medicare taxes.
Part B — Medical Insurance
Covers doctor visits, outpatient care, preventive services, and medical supplies. Has a monthly premium (income-based).
Part C — Medicare Advantage
Private insurance alternative that bundles Parts A, B, and often D. May include extra benefits like dental, vision, and hearing. Network-based plans.
Part D — Prescription Drugs
Add-on prescription drug coverage through private insurers. Helps lower medication costs. Can be purchased standalone or included in Advantage plans.
Medigap (Supplement)
Private supplemental insurance that fills the "gaps" in Original Medicare — deductibles, copays, and coinsurance. Works with any doctor that accepts Medicare.
Medigap vs. Medicare Advantage
Medigap
- •Higher monthly premium, lower out-of-pocket
- •Any doctor that accepts Medicare
- •No referrals needed
- •Guaranteed renewable
- •Best for frequent travelers or high medical needs
Medicare Advantage
- •Lower (or $0) premium, cost-sharing per visit
- •Network-based (HMO/PPO)
- •Often includes dental, vision, hearing
- •Annual out-of-pocket maximum
- •Best for healthy retirees wanting all-in-one
When to Enroll
Initial Enrollment Period (IEP)
7-month window around your 65th birthday (3 months before, birthday month, 3 months after).
Annual Election Period (AEP)
Oct 15 – Dec 7 each year. Switch Advantage plans or go back to Original Medicare.
Special Enrollment Period (SEP)
Qualifying life events (move, lose coverage, etc.) trigger additional enrollment windows.