Answer
How does Medicare work, and when should I sign up?
The short answer
Medicare is federal health insurance for people 65 and older and some younger people with disabilities. Part A covers hospital care, Part B covers doctors, and Part D covers drugs. You choose Original Medicare or a Medicare Advantage plan. Your first sign-up window lasts 7 months around your 65th birthday.
Key takeaways
- Original Medicare lets you see any provider that takes Medicare. Medicare Advantage usually uses a network and may need approvals.
- Missing your sign-up window can mean a monthly Part B penalty for as long as you have Part B.
- Free, unbiased counseling is available through your State Health Insurance Assistance Program (SHIP).
Words in this lesson
- Medicare
- Federal health insurance for people 65 and older and for some younger people with disabilities or certain conditions.
- Medicare Advantage (Part C)
- A private plan approved by Medicare that bundles Part A, Part B, and usually drug coverage. It often uses a network and may require prior authorization.
- Medigap
- Extra insurance from a private company that helps pay your share of costs in Original Medicare. Plans are standardized and named by letters in most states.
- Coinsurance
- Your share of a covered cost as a percentage, such as 20%, usually after you meet your deductible.
- Prior authorization
- Your plan's approval before certain care. Approval is not a guarantee of payment.
Related
This is general education. For decisions about your own plan, taxes, or legal rights, check your plan documents or a qualified professional.