Medicare 101

The parts of Medicare, in plain English.

Four parts, two paths, a handful of deadlines. Here's the fifteen-minute version of everything you need to know before you compare plans.

Senior couple smiling while learning about Medicare on a laptop

The building blocks

Parts A, B, C, and D

Part A — Hospital Insurance

Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people pay no premium for Part A if they worked and paid Medicare taxes for at least 10 years.

Part B — Medical Insurance

Covers doctor visits, outpatient care, preventive services, lab work, and durable medical equipment. Part B has a monthly premium set by Medicare each year, plus a deductible and 20% coinsurance with no annual cap on its own.

Part C — Medicare Advantage

Private plans that replace how you receive Parts A and B, usually bundling drug coverage and extras like dental and vision. Plans use networks and set their own copays, with an annual out-of-pocket maximum.

Part D — Drug Coverage

Prescription drug coverage offered by private plans — either built into a Medicare Advantage plan or purchased as a stand-alone plan alongside Original Medicare.

The fork in the road

Two ways to arrange your coverage

	Original Medicare + Medicare Supplement + Part D	Medicare Advantage (Part C)
Doctors	Nearly any provider that accepts Medicare, nationwide	Plan networks (HMO/PPO); costs are lowest in network
Monthly cost	Part B premium + Medicare Supplement premium + Part D premium	Part B premium + plan premium (often low or $0)
Out-of-pocket	Very predictable; Medicare Supplement covers most gaps	Copays as you go, capped by an annual maximum
Extras	Not included; purchased separately	Often includes dental, vision, hearing, fitness
Referrals	Not required	Sometimes required (HMO plans)

Neither path is "better" — they fit different priorities. Flexibility and predictability point toward Medicare Supplement; lower monthly cost and bundled extras point toward Medicare Advantage.

Timing matters

Enrollment windows

Initial Enrollment Period (IEP)

Seven months around your 65th birthday — the three months before your birthday month, your birthday month, and the three months after. Enrolling early in this window prevents coverage gaps and late penalties.

Annual Enrollment Period (AEP): Oct 15 – Dec 7

Switch, join, or drop Medicare Advantage and Part D plans. Changes take effect January 1. This is the season to re-shop, because plans change their costs and benefits every year.

Medicare Advantage Open Enrollment: Jan 1 – Mar 31

If you're already in a Medicare Advantage plan, you get one switch to another Advantage plan or back to Original Medicare.

Special Enrollment Periods (SEP)

Life events — moving, losing employer coverage, retiring after 65 — can open a personal window to enroll or change plans outside the normal seasons.

Working past 65?

If you have creditable employer coverage, you may be able to delay Part B without penalty. The rules depend on employer size and your situation — this is worth a conversation before your 65th birthday.

Questions? Let's talk them through.

A free 30-minute review with a licensed insurance agent.

Call (555) 555-0142

By calling this number, you will be connected with a licensed insurance agent who may discuss Medicare Advantage, Medicare Supplement, and Prescription Drug Plan options.