What is Medicare? A simple guide for you

Who can get Medicare?

You’re typically eligible for Medicare if:

• You’re 65 or older and a U.S. citizen or permanent legal resident.
• You’re under 65 and have received Social Security Disability Insurance (SSDI) for at least 24 months.
• You have certain conditions like End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig’s disease).

What are the parts of Medicare?

Medicare has four parts, each covering a specific type of care:

• Part A (Original Medicare) covers hospital care and services.
• Part B (Original Medicare) covers medical care and services, including preventive care.
• Part C is also called Medicare Advantage. These plans combine Part A and B (and often Part D prescription drug coverage) into a single convenient plan.
• Part D helps cover prescription medications.

What is Medicare Supplement Insurance (Medigap)?

Medicare Supplement Insurance (also called Medigap) helps pay some of the costs that Original Medicare doesn’t cover—like copayments, coinsurance and deductibles. These policies are sold by private companies and work alongside Original Medicare.

Learn more about Medicare Supplement Insurance

When should I enroll?

Signing up for Medicare: When you turn 65 you must choose either to sign up for Original Medicare (Parts A and B) or a Medicare Advantage Plan through a private insurer.

• You are eligible to sign up during the 3 months before the month in which you turn 65, during your birthday month, and through the 3 months that follow your birthday month. So you have 7 months in which to sign up for Medicare.
• Note: If your birthday falls on the 1st of the month, your initial enrollment period starts 4 months before your 65th birthday and ends 2 months after your 65th birthday. Generally, your Medicare coverage starts on the 1st day of the month before you turn 65.

If you have End Stage Renal Disease or a chronic condition or disability for which you receive Social Security benefits, you would be eligible for Medicare, regardless of age.

Medicare annual open enrollment: Medicare Open Enrollment usually runs from October 15 to December 7, each year. During that time you can decide if you want to make any changes to your current Medicare coverage.

For example, if you signed up for Original Medicare when you turned 65, you may decide you want to try a Medicare Advantage plan instead, or vice versa.

Signing up* for a Medicare Supplement Insurance policy (Medigap): If you are 65 or older and have signed up for Original Medicare then you may be eligible for a Medicare Supplement insurance plan. These plans are not part of the federal government's Medicare program and are sold exclusively through private insurers.

Open Enrollment is a 6-month period when you can buy any Medicare Supplement policy sold in your state, even if you have pre-existing health conditions. This period automatically starts on the first day of the month that you meet both of the following 2 criteria:

• You're 65 (or older) and
• You're enrolled in Medicare Part B (Medical Insurance)

*You can apply for a Medicare Supplement policy any time during the year, however during your Open Enrollment period, you are guaranteed Medicare Supplement coverage. When applying outside of your Open Enrollment period, you may be subject to restrictions based on your previous health history or current medical conditions, and you could also be denied acceptance.

How much does Medicare cost?

Medicare is not free. The different types of Medicare each have certain out-of-pocket costs:

• Part A and Part B, or Original Medicare, come with monthly premiums that vary from year to year, depending on your income level. Part A and Part B each has its own annual deductible, as well as copays and coinsurance for care and services. Learn more about Original Medicare

• Part C, or Medicare Advantage plans, often come with low or no monthly premiums, depending on the plan. You will pay copays and/or co-insurance various services and care, as well as copays for prescriptions if included in the plan. Costs and coverage can vary.

• Part D Prescription drug plans have a monthly premium, as well, and may also have a prescription deductible depending on the types of prescription drugs you need.

• Medicare Supplement, or Medigap, have monthly premiums, which help pay some of the health care costs that Original Medicare doesn’t cover.

Why it matters?

The beauty of Medicare is that you have options. Whether you’re looking for flexibility, extra benefits or help managing costs, there’s a path forward that can support your lifestyle and health goals.

You don’t have to figure this out alone—we're here to guide you through your choices and support your next steps.