Medicare in One Paragraph
Medicare is health insurance from the federal government for people 65 and older (and some younger people with disabilities or specific conditions). It’s not one plan. It’s a system with multiple parts, and you have choices about how to use them.
The Four Parts
Part A: Hospital Insurance
Covers inpatient hospital stays, skilled nursing facility care (not long-term custodial care), hospice, and some home health services. Most people don’t pay a monthly premium for Part A because they (or their spouse) paid Medicare taxes for at least 10 years while working.
2026 Part A deductible: $1,676 per benefit period.
Part B: Medical Insurance
Covers doctor visits, outpatient care, preventive services, durable medical equipment, and some home health services. You pay a monthly premium for Part B.
2026 Part B premium: $202.90/month (standard). Higher-income beneficiaries pay more through IRMAA.
2026 Part B deductible: $257/year.
Part C: Medicare Advantage
An alternative way to get your Part A and Part B benefits through a private insurance company. Most Medicare Advantage plans include Part D (drug coverage) and may include extras like dental, vision, and hearing. You still pay your Part B premium, and some plans charge an additional premium.
Part D: Prescription Drug Coverage
Covers prescription medications. Available as a standalone plan (if you have Original Medicare + Medigap) or built into most Medicare Advantage plans.
2026 Part D out-of-pocket cap: $2,100/year.
Two Paths, One Choice
When you enroll in Medicare, you’re really choosing between two approaches:
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Original Medicare (Parts A + B) + Medigap + standalone Part D - You keep your freedom to see any doctor who accepts Medicare. Medigap covers most of what Medicare doesn’t. You buy a separate Part D plan for medications.
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Medicare Advantage (Part C) - One plan from a private insurer replaces Parts A and B (and usually includes Part D). Often lower premiums, but you’re locked into a network and need referrals.
Neither path is universally better. The right answer depends on your health, your doctors, your medications, and your tolerance for cost surprises.
Want to see how these two paths compare side by side? Check our Compare Plans page.
Who Qualifies
- Age 65+ and a U.S. citizen or permanent resident who has lived in the U.S. for at least 5 consecutive years
- Under 65 with certain disabilities (after 24 months of Social Security disability benefits)
- Any age with End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig’s disease)
When to Enroll
Your Initial Enrollment Period (IEP) is a 7-month window around your 65th birthday: 3 months before, your birthday month, and 3 months after.
If you’re still working and have employer coverage at 65, you may be able to delay enrollment without penalty. But this has specific rules. Get it wrong and you could face late enrollment penalties for the rest of your life.
For a full breakdown of every enrollment window and what happens if you miss one, see our Enrollment Periods guide.