Medicare, explained in plain English.
Turning 65 or new to Medicare? Start here. This guide covers the four parts of Medicare, the two main ways to build your coverage, the dates that matter, and what things cost in 2027.
The four parts of Medicare
Medicare is federal health insurance for people 65 and older, and for some younger people with certain disabilities or conditions. It is split into four lettered parts, each covering something different.
Part A: Hospital insurance
Inpatient hospital stays, skilled nursing facility care, hospice and some home health care. Most people pay no premium if they or a spouse worked and paid Medicare taxes for about 10 years.
Part B: Medical insurance
Doctor visits, outpatient care, lab work, medical equipment and many preventive services. Part B has a monthly premium, which is higher for people with higher incomes.
Part C: Medicare Advantage
Private plans approved by Medicare that bundle Parts A and B, and usually D, into one plan. Many include extras such as dental, vision and hearing. Read the Tampa Bay guide.
Part D: Prescription drugs
Drug coverage offered by private plans. In 2027, what you pay out of pocket for covered drugs is capped at $2,400 for the year. Read the enrollment guide.
Two paths to your coverage
Everyone starts with Original Medicare (Parts A and B) from the federal government. From there, most people choose one of two paths. Neither is right for everyone. The best fit depends on your health, your doctors, your prescriptions, how much you travel and your budget.
Path 1Original Medicare + Medigap + Part D
Keep Original Medicare, add a Medicare Supplement (Medigap) plan to help with costs Medicare doesn't pay, and add a standalone Part D drug plan.
- See any doctor nationwide who accepts Medicare
- More predictable out-of-pocket costs
- Usually a higher monthly premium
Path 2Medicare Advantage (Part C)
Choose one private plan that replaces how you get your Part A and B benefits, and usually includes drug coverage.
- Often a low or $0 plan premium
- Uses a provider network, with copays as you go
- Yearly limit on in-network out-of-pocket costs; many include dental, vision and hearing
You keep paying your Part B premium on either path. A $0-premium plan still has copays, coinsurance and deductibles.
Key enrollment dates
Enrolling on time is as important as choosing the right plan. Missing your window without other qualifying coverage can mean late-enrollment penalties that last as long as you have Medicare.
A 7-month window: the 3 months before, your birthday month, and the 3 months after.
Switch between Original Medicare and Medicare Advantage, change plans, or join, drop or switch Part D. Changes start January 1.
If you're in a Medicare Advantage plan, you can switch to another one, or return to Original Medicare and add Part D.
Moving or losing employer coverage, for example, can open a window to make changes outside the usual dates.
Your Medigap open enrollment period is the 6 months starting the month you're 65 or older and enrolled in Part B. It's usually the easiest time to buy a Medigap plan. Turning 65 soon? Read our Turning 65 guide.
Key Medicare numbers for 2027
2027
2026, for comparison
The Part D figures are final for 2027. The Centers for Medicare & Medicaid Services usually announces the 2027 Part B premium and the Part A and Part B deductibles in November, and we'll add them here as soon as they're released. People with higher incomes pay more for Parts B and D. Original Medicare has no yearly out-of-pocket limit on its own, which is one reason many people add coverage. Verify current figures at Medicare.gov (opens in a new tab).
Common first questions
Is Medicare free?
Not entirely. Part A is premium-free for most people, but Part B has a monthly premium, and Part D and Medicare Advantage premiums vary by plan. Even a $0-premium plan has copays and deductibles.
Is Medicare the same as Medicaid?
No. Medicare is federal insurance based mainly on age or disability, regardless of income. Medicaid is a state and federal program for people with limited income and resources. Some people qualify for both.
When should I start learning about Medicare?
About six months before you turn 65. That gives you time to understand your options before your Initial Enrollment Period opens.
Do I need Part D if I don't take any medications?
If you don't have other creditable drug coverage, enrolling when you're first eligible helps you avoid a Part D late-enrollment penalty, which is added to your premium for as long as you have drug coverage.
What if I'm still working at 65?
It depends on your employer coverage and the size of your employer. Some people can delay Part B without a penalty. Talk with us or your benefits administrator before you decide.
Still have questions?
Maxwell can walk you through your options one-on-one, in plain English, with no pressure. Prefer to read first? Download the free Medicare guide.
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