Medicare basics

The four 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, medical equipment, and many preventive services.
• Part C (Medicare Advantage) is an alternative way to get your Part A and Part B benefits through a private plan approved by Medicare.
• Part D (prescription drug coverage) helps cover the cost of prescription drugs and is offered through private plans.

Original Medicare, Medicare Advantage, and Medicare Supplement

Original Medicare is Part A and Part B, run by the federal government. You can generally see any doctor or hospital that accepts Medicare, and you usually pay a deductible and a share of the cost.

Medicare Advantage (Part C) plans are offered by private insurers. They include Part A and Part B benefits, and many also include drug coverage and extras such as dental or vision. Networks, costs, and benefits vary by plan and location.

Medicare Supplement (Medigap) policies are sold by private insurers and work alongside Original Medicare to help pay some of the costs it leaves to you. You cannot use a Medigap policy with a Medicare Advantage plan.

The four enrollment windows

• Initial Enrollment Period: 7 months around your 65th birthday: the 3 months before, your birthday month, and the 3 months after.
• Annual Enrollment Period: October 15 to December 7. You can join, switch, or drop a Medicare Advantage or Part D plan.
• Medicare Advantage Open Enrollment Period: January 1 to March 31. If you are in a Medicare Advantage plan, you can make one change.
• Special Enrollment Periods: certain life events, such as moving, losing coverage, or Medicaid changes, can open a window outside these dates.

Who qualifies under 65

Most people qualify at 65, but some people qualify sooner:

• People who have received Social Security disability benefits (SSDI) for 24 months
• People with ALS (Lou Gehrig's disease), generally as soon as their disability benefits begin
• People with end-stage renal disease (permanent kidney failure)

Where to learn more

You can get information on all of your options at Medicare.gov or by calling 1-800-MEDICARE. If you would like help comparing plans available in your area, a licensed insurance agent can walk you through them.

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