Couple in their sixties reviewing Medicare enrollment options together at home.

Medicare Basics.

Medicare is the federal health insurance program for people age 65 and older, and for certain younger individuals with disabilities. It is administered nationwide by the Centers for Medicare & Medicaid Services (CMS).

Understanding how Medicare works is the first step to choosing the right plan for your health and your budget.

Medicare Explained Quickly

Turning 65 or helping someone who is shouldn't feel like decoding a foreign language. Medicare comes in four parts, and once you see how they fit together, the whole thing gets a lot less intimidating. Here's the short version, no jargon.

Four Parts of Medicare

  • Part A - Hospital Insurance. Covers inpatient hospital stays, skilled nursing, hospice, and some home health care. Most people pay nothing for Part A because they paid into it through payroll taxes while working.

  • Part B - Medical Insurance. Covers doctor visits, outpatient care, preventive services, and durable medical equipment like walkers. Part B has a monthly premium (2026: $202 for most people).

  • Part C - Medicare Advantage. A private-plan alternative that bundles Part A and Part B, usually adds Part D, and often includes extras like dental and vision. (More on our Medicare Advantage page.)

  • Part D - Prescription Drug Coverage. Helps pay for medications, sold as standalone plans by private insurers.

When Should You Enroll?

Most people enroll during their Initial Enrollment Period, a 7-month window that starts 3 months before your 65th birthday month and ends 3 months after. Missing it can mean lifelong late-enrollment penalties, so timing matters. If you're still working and covered by an employer plan, the rules are different, and it's worth a quick conversation before you decide.

What Original Medicare Doesn’t Cover

Original Medicare (Parts A and B) leaves gaps. There's no yearly cap on what you'd pay out of pocket, and you're responsible for 20% of most Part B costs with no ceiling. That's why most people add a Medicare Supplement (Medigap) plan, a Medicare Advantage plan, or a Part D plan to round out their coverage.

Where Part ABC Comes In

We walk you through your options side by side, in language that actually makes sense, and help you enroll with confidence. No pressure, no sales pitch. Just clear answers. Book your free Health Insurance Audit.

Original Medicare: Part A and Part B

Medicare is made up of two core parts, often called Original Medicare:

Part A

(Hospital Insurance)

  • Covers inpatient hospital care, skilled nursing, hospice, and some home health services.

  • Premium is usually $0 if you or your spouse worked and paid Medicare taxes for at least 10 years.

Think of Part A as your “room and board” coverage for hospital stays and facilities.

Part B

(Medical Insurance)

  • Covers doctor visits, outpatient care, preventative services, durable medical equipment, and some home health care.

  • Premium is income-based. However, most people pay the standard premium.

Think of Part B as your “doctor and outpatient” coverage, everything outside the hospital walls.

Important: Original Medicare (Part A & B) does not cover everything. You’re responsible for deductibles, coinsurance, and there is no out-of-pocket maximum.

Medicare Options Beyond Parts A & B

Because Original Medicare leaves gaps, most people choose one of these paths to round out their coverage:

  • Medicare Advantage (Part C): Private plans that bundle Part A & B, usually Part D, and often include extras like dental, vision, hearing, and fitness.

    • Best for people who want an all-in-one plan with lower upfront costs but are comfortable with provider networks.

  • Prescription Drug Plans (Part D): Standalone plans that cover medications. Usually paired with Original Medicare or Medigap.

    • Best for those sticking with Original Medicare + Medigap who need drug coverage.

  • Medicare Supplement (Medigap): Private policies that help pay deductibles, coinsurance, and gaps left by Original Medicare.

    • Best for people who want freedom to see any doctor nationwide and predictable costs.

  • Ancillary Products: Add-ons like dental, vision, or hearing plans.

    • Best for rounding out coverage that Medicare doesn’t touch.

Older couple walking arm in arm, confident about their Medicare coverage
Licensed agent guiding an older woman through Medicare sign-up

What Does Medicare Cost?

Part A: $0 premium for most (if you worked 10+ years).

  • Part B: Standard premium, varies yearly based on income.

  • Part D: Varies by plan.

  • Medigap & Medicare Advantage: Premiums vary depending on carrier, plan, and location.

    • Bottom line: Original Medicare is not free, but with the right combination of options, you can design a plan that fits your health and your budget.

Older man considering Medicare out-of-pocket costs at his computer

When Can I Sign Up?

Enrollment timing is critical. Missing your window can mean penalties.

  • Initial Enrollment Period (IEP): 7-month window around your 65th birthday (3 months before, your birthday month, and 3 months after).

    • Example: If you turn 65 on March 8, you can sign up Dec 1 – June 30.

  • General Enrollment Period (GEP): Jan 1 – Mar 31 if you missed IEP. Coverage starts July 1.

  • Annual Enrollment Period (AEP): Oct 15 – Dec 7. Make changes to Medicare Advantage or Part D plans.

  • Open Enrollment Period (OEP): Jan 1 – Mar 31. Switch Medicare Advantage plans.

  • Special Enrollment Period (SEP): Triggered by life events like retirement, moving, or losing employer coverage. Each SEP has its own rules.

Next Steps.

Understanding Medicare is the first step. The next is figuring out which path works best for you.

Schedule your free Medicare Audit™ today. We’ll compare your options side-by-side, explain them step-by-step, and help you feel confident about your coverage.

Schedule My Free Medicare Audit™

Medicare FAQS

Still have questions?

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    1. Part A (Hospital Insurance): Covers hospital stays, skilled nursing, hospice, and some home health.

    2. Part B (Medicare Insurance): Covers doctor visits, outpatient care, preventive services, and durable medical equipment.

    3. Part C (Medicare Advantage): Private plans that bundle Part A, Part B, often Part D, and may include extras like dental and vision. Medicare Advantage can unfairly get a bad rap, but depending on location and needs, can be exactly what you need.

    4. Part D (Prescription Drug Coverage): Helps pay for medications.

    • Dental, vision, or hearing

    • Long term care

    • Most prescription drugs

    • Routine foot care, cosmetic surgery, or overseas care

      • Many people add a Medigap, Medicare Advantage, or ancillary plans to feel these gaps.

  • Most people should enroll during their Initial Enrollment Period, a 7-month window around their 65th birthday. If you miss it, you may face penalty

  • No. While most people pay $0 for Part A, Part B comes with a monthly premium, and additional coverage (Part D, Advantage, Medigap) also has costs. The right combination of plans helps keep your out of pocket expenses predictable.

  • Yes. Many people delay Medicare Part B if they still have employer coverage. The rules depend on your company size and benefits, so it’s important to review your situation before making a decision.

  • Absolutely. Either Medigap, Advantage, and/or Part D depending on your needs and budget. If you don’t you’re billed at 20% for everything under Original Medicare, with no yearly cap.