Medicare is individual health insurance offered to U.S. citizens and other eligible individuals based on age, disability, or qualifying medical conditions. Medicare is made up of different parts, some which are offered by the federal government, and others which are offered by private insurance. The resources on this page are here to help you understand more about Medicare and learn which options may be best for you.
Being familiar with the different parts of Medicare can help you choose the right plan. Medicare is divided into four parts, but there are a few add-ons and special plans you should be familiar with as well.
Coverage from the Federal Government that includes hospital visits, skilled nursing facilities, & home healthcare
Coverage from the Federal Government that includes outpatient care, doctors’ visits, occupational therapy & preventive care
Coverage from a private insurer that usually combines Parts A, B, & D and offers extra benefits, like dental & vision
Prescription drug coverage from a private insurer that helps pay for your prescription medications
Additional coverage from a private insurer that helps pay for costs which Original Medicare doesn’t cover (cannot be combined with Part C)
A unique type of Medicare Advantage Plan that covers more specific health care & financial needs
With My Medicare App, you can enroll in a Medicare Advantage plan (Part C), a Prescription Drug plan (Part D), a plan that combines the two (C + D), or a Medigap plan all on your own. Simply press “Get My Quotes and Enroll Online” to fill out some information and see which plans are available. Please note that you must have Original Medicare (Parts A & B) to join a Medicare Advantage plan or a Medigap plan. And to be eligible for Part D, you must have either Part A or Part B before you can enroll.
Getting enrolled in Original Medicare is easy. Some people are enrolled automatically if they receive Social Security or Railroad Retirement Board benefits. But others must sign up for Original Medicare by themselves. You can enroll at the Social Security website or by calling your local Social Security office. There are specific times when you can enroll, called enrollment periods. Whether you are enrolled automatically or not, you should be aware of these times, especially your Initial Enrollment Period (IEP), where you can make coverage decisions and avoid possible penalty fees on your premiums. You can learn more about enrollment periods below.
Here are some general guidelines regarding when each enrollment period occurs, and what you can do during these time periods. If you have questions about how these apply to you, you can always ask a licensed insurance agent by clicking “Review My Benefits” above.
When you are first eligible to apply for Medicare, or 3 months before and after your 65th birthday month.
When you can change, drop, or enroll in Medicare Advantage plans & Prescription Part D plans
When you can change, switch, or drop your existing Medicare Advantage plan
When you can enroll in Part A or Part B if you missed your Initial Enrollment Period
When you can enroll due to events like moving, getting married, or ending employment (timing depends on eligibility)
Everyone who is 65 and older that applies for Medicare has a different Initial Enrollment Period (IEP) depending on their birthday. To find your IEP, you would take the three months before your 65th birthday, the month of your birthday, and the three months after your birthday. People who apply for Medicare who are not yet 65 have a separate IEP date.
When exploring Medicare Advantage plans and coverage, it’s good to be aware of all the terms associated with payments and how the costs are shared. Move your mouse over each keyword to learn more about what the term means when relating to Medicare and insurance.
The costs that you and the health insurance plan pay are split on a percentage basis. For example, you might pay 20% of a service and the remaining 80% would be paid by the plan.
The fixed amount you pay at the time you receive a covered service. For example, you might pay $20 when you visit the doctor or $12 when you fill a prescription.
A set amount you pay out of pocket for covered services each year before your plan begins to pay.
The maximum amount you pay during a policy period, not including premiums or non-covered services. Once this maximum is reached, your plan pays 100% of the allowed costs until the period ends.
The fixed amount you pay for insurance coverage. You may pay your premium to Medicare, to a private insurance company or both, depending on your coverage. Most premiums are charged monthly.
The costs you pay out-of-pocket. This term generally includes deductibles, coinsurance, and copayments, but doesn't include premiums, non-network provider charges, or the cost of non-covered services.
Original Medicare (Parts A & B) doesn’t cover everything. Many people choose additional coverage so they can save on prescription drugs or be part of a dental or vision plan. Here is a quick guide to help you decide what you need depending on factors such as health, lifestyle, and budget.
If you use prescription drugs, you will either need to get a stand-alone Part D prescription drug plan or a Medicare Advantage plan that includes drug coverage.
Medicare Advantage plans (Part C) are the only ones that offer dental, vision, hearing, transportation, fitness benefits, and much more.
You can add a Medigap plan to Original Medicare to help with out-of-pocket costs or enroll in a Medicare Advantage plan that includes an out-of-pocket maximum.
Medicare Advantage plans called Special Needs Plans (SNPs) are tailored to people with specific needs, like those who are eligible for both Medicare and Medicaid.