Medicare questions, answered.

Medicare is the federal health insurance program for people 65 and older, and for some people under 65 with a disability, ESRD (kidney failure), or ALS. It's run by the Centers for Medicare & Medicaid Services (CMS), and many people enroll through Social Security. The parts, simply put:

• Part A — hospital/inpatient care, skilled nursing, hospice.
• Part B — doctor visits, outpatient care, preventive care.
• Part C (Medicare Advantage) — an all-in-one private plan that includes A and B and usually drug coverage, using a network.
• Part D — prescription drugs (if not already included in a Medicare Advantage plan).

Most people become eligible at 65; some earlier with a qualifying condition. If you're already getting Social Security before 65, you may be enrolled automatically; otherwise you sign up through Social Security. Each fall, Medicare's Open Enrollment (October 15 – December 7) lets you review or switch Advantage and drug plans for the next year.

Part A is Medicare's hospital insurance. It helps pay for inpatient hospital care, skilled nursing facility care after a qualifying hospital stay, hospice, and some home health. It's one half of "Original Medicare" (the other half is Part B). It generally does not cover long-term custodial care, most dental/vision/hearing, or most non-medical home help. Doctor services are usually billed under Part B — even in the hospital.

Part B is Medicare's medical insurance. It helps pay for doctor visits, outpatient care, durable medical equipment, home health, and many preventive services. In short, it covers:

• Medically necessary services to diagnose or treat a condition
• Outpatient care, labs, imaging, and mental health
• Durable medical equipment (wheelchairs, walkers, and the like)
• Many preventive services — often $0 when the provider accepts assignment

Part C is Medicare Advantage — private, Medicare-approved plans that give you your Part A and Part B coverage (and usually Part D drugs) in one bundle. Plans use networks and their own rules, and must follow Medicare's standards.

• All-in-one: includes A and B; most plans also include Part D.
• Networks & rules: HMOs, PPOs, and other types, each with different provider rules and referrals.
• Costs: you generally keep paying the Part B premium, plus any plan premium and copays. Every plan has a yearly out-of-pocket limit, after which covered Part A/B services are $0 for the rest of the year.
• Extras: many plans add benefits Original Medicare doesn't (like limited dental/vision/hearing), but details vary by county.

You can't use a Medigap policy with a Medicare Advantage plan.

Part D is Medicare's prescription drug coverage, offered by private insurers approved by Medicare — either as a stand-alone drug plan with Original Medicare or built into many Medicare Advantage plans. What shapes your cost:

• Formulary: each plan covers its own list of drugs and places them in tiers (lower tiers usually cost less).
• Pharmacy network: you generally pay least at preferred in-network pharmacies; some plans only cover in-network pharmacies.
• Rules: some drugs have prior authorization, step therapy, or quantity limits.

If you go 63 or more days without Part D or other creditable drug coverage after you're first eligible, you can owe a late-enrollment penalty added to your premium — usually for as long as you have Part D.

Medicare is health insurance from the federal government, mainly for people 65 and older (and some younger people with certain conditions). Part A helps pay for hospital stays, skilled nursing, hospice, and some home health; Part B helps pay for doctor visits, tests, supplies, and outpatient care; Part D helps pay for prescription drugs. You can get Medicare directly from the government (Original Medicare) or through a private company (Medicare Advantage).

Yes. Many people keep working and sign up only for Part A (hospital coverage) at 65, since it's usually premium-free if they've worked enough years. They can wait to add Part B (doctor coverage) until they stop working or lose their job's health insurance — and they won't owe a late penalty if they enroll during their special enrollment period.

Medigap is supplemental insurance that helps pay Original Medicare's costs; Medicare Advantage is an alternative way to get your Medicare through a private plan. You can't have both at the same time.

Medigap (Medicare Supplement) works with Original Medicare (A & B), so you keep nationwide access to any provider that accepts Medicare. It helps pay copays, coinsurance, and deductibles; plans are standardized A–N. Drug coverage is separate (add Part D). The best time to buy is your six-month Medigap Open Enrollment that starts when Part B begins at 65+; after that, medical underwriting may apply.

Medicare Advantage (Part C) is run by private insurers and uses networks and rules (referrals/authorizations vary). It often bundles Part D and may include extras like dental or vision, and each plan has an annual out-of-pocket limit.

Which to consider? Choose Medigap if you want the broadest provider choice and predictable cost-sharing; choose Medicare Advantage if you're comfortable with networks and like an all-in-one plan (often with low or $0 premiums and extras).

With Original Medicare, you can see any doctor or hospital in the U.S. that takes Medicare, so it travels with you across the country — and some Medigap plans even cover emergencies in other countries. Medicare Advantage plans (like HMOs and PPOs) may only cover you in their service area except for emergencies and urgent care, so check before you travel.

Sign up for Part B when you first turn 65 unless you still have qualifying health insurance from your job (or your spouse's job). If you keep qualified job coverage, you can wait. Once that job coverage ends, you have eight months to sign up for Part B without a penalty.

It depends on your county and the plan. Most people keep paying the Part B premium (set each year by Medicare), plus whatever the plan charges — many Advantage plans have a $0 premium. You'll also have copays or coinsurance as you use care, up to your plan's yearly out-of-pocket limit.

There isn't one plan that literally covers everything. The "best" fit depends on your doctors, prescriptions, travel, and budget. Medicare gives you two main paths:

• Original Medicare + Medigap + Part D — widest provider choice and predictable cost-sharing, but separate premiums, and extras like dental/vision aren't built in.
• Medicare Advantage (Part C) — one-card coverage for A & B (usually with Part D) plus a yearly out-of-pocket cap and possible extras, but it uses networks and plan rules, and benefits differ by county.

Plans are local to your county, and the official, complete list for your area is on Medicare's Plan Finder. Go to Medicare.gov, choose "Find & compare plans," enter your ZIP code, and select "Medicare Advantage" to see every plan with its costs, doctors, drugs, and star ratings. We're also glad to walk through it with you.

Medigap is supplemental insurance you buy from a private insurer to help pay your share of Original Medicare costs — like deductibles, copays, and coinsurance. You must have Part A and Part B to buy one.

• It works with Original Medicare — it's not a replacement, and you can't use it with a Medicare Advantage plan.
• Plans are standardized (lettered A–N), so benefits are comparable across companies.
• Medigap generally doesn't include drugs; add a separate Part D plan if you need them.
• Each policy covers one person and is generally guaranteed renewable if you pay premiums on time.
• Some plans include limited foreign-travel emergency coverage.

The best time to buy is your six-month Medigap Open Enrollment that starts the month you're 65+ and enrolled in Part B. After that, insurers can usually use medical underwriting (state rules vary).

Hang up. Medicare won't call, text, or email you out of the blue to "update" your card or ask for your Medicare or Social Security number. If someone does, it's a scam. Safe steps:

• Don't share info. Never give your Medicare Number, SSN, or payment details to an unsolicited caller.
• Verify directly. If you genuinely need a new card or an address change, use your account at Medicare.gov or call 1-800-MEDICARE (TTY 1-877-486-2048).
• Report it. Call 1-800-MEDICARE, or the Senior Medicare Patrol at 1-877-808-2468, or the HHS OIG fraud hotline at 1-800-HHS-TIPS.
• Already shared info? Call 1-800-MEDICARE right away, then watch your Medicare Summary Notices for suspicious charges.