Medicare Education
Understanding Medicare, from A to D
Medicare doesn't have to be confusing. Here's a clear, plain-language guide to every part of the program — so you can make informed decisions about your coverage.
Medicare Part A
Hospital Insurance
Medicare Part A covers inpatient hospital care, skilled nursing facility stays, hospice care, and some home health services. Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes for at least 10 years.
What it covers
- Inpatient hospital stays
- Skilled nursing facility care (after a qualifying hospital stay)
- Hospice care
- Some home health services
Long-term custodial care, most dental, vision, or hearing services.
Medicare Part B
Medical Insurance
Medicare Part B covers outpatient medical services including doctor visits, preventive screenings, lab tests, and medically necessary equipment. Part B requires a monthly premium, which is typically deducted from your Social Security benefit.
What it covers
- Doctor visits and specialist consultations
- Outpatient procedures and surgeries
- Preventive screenings and vaccines
- Durable medical equipment (wheelchairs, walkers)
Most prescription drugs, routine dental, vision, and hearing care.
Medicare Part C
Medicare Advantage
Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurance companies approved by Medicare. These plans must cover everything Original Medicare covers, and most include additional benefits like dental, vision, and hearing.
What it covers
- All Part A and Part B benefits
- Often includes prescription drug coverage (Part D)
- May include dental, vision, and hearing
- May include fitness benefits and telehealth
Coverage varies by plan — network restrictions often apply.
Medicare Part D
Prescription Drug Coverage
Medicare Part D helps cover the cost of prescription medications. These plans are offered by private insurers and vary widely in which drugs they cover (the formulary) and what you pay. Enrolling when first eligible helps you avoid late enrollment penalties.
What it covers
- Generic and brand-name prescription drugs
- Drugs on the plan's formulary (drug list)
- Vaccines not covered under Part B
- Some over-the-counter drugs (plan-specific)
Drugs not on the plan's formulary without an exception.
Medigap Supplement Plans
Fill the gaps in Original Medicare
Original Medicare covers many costs, but it doesn't cover everything. Medigap (Medicare Supplement Insurance) policies are sold by private companies to help pay some of the remaining costs — like copayments, coinsurance, and deductibles.
Plan A
Basic benefits only — covers Part A coinsurance and hospital costs.
Plan G
Most popular plan — covers nearly all gaps except the Part B deductible.
Plan N
Lower premiums with some cost-sharing — good for healthy beneficiaries.
Medigap plans are standardized by letter — Plan G from any insurer offers the same benefits. The difference is price and customer service.
Enrollment Periods
When you can enroll — and why timing matters
Initial Enrollment Period (IEP)
A 7-month window around your 65th birthday — 3 months before, the month of, and 3 months after. Enrolling on time avoids late penalties.
Annual Enrollment Period (AEP)
October 15 – December 7 each year. You can switch, join, or drop Medicare Advantage or Part D plans. Changes take effect January 1.
Special Enrollment Period (SEP)
If you have qualifying life events — like losing employer coverage — you may be eligible to enroll outside the standard windows.
Medicare Advantage Open Enrollment
January 1 – March 31. If you're already in a Medicare Advantage plan, you can switch to another MA plan or return to Original Medicare.
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