More than 65 million Americans are enrolled in Medicare, a government-run healthcare program for people 65 and older, those with specific disabilities, and those with end-stage renal disease (ESRD).
Medicare won’t cover all of your healthcare costs. You’ll be responsible for out-of-pocket expenses and other services such as long-term care.
What you pay in premiums for the different parts of Medicare or supplemental insurance varies.
In some cases, you may pay no monthly premium. In others, you may pay more depending on your income.
You have several ways to set up your Medicare coverage. You can choose Original Medicare, add additional benefits and coverage with Medicare Supplement and Part D or go with an all-in-one Medicare Advantage plan.
Explore all of the Medicare plan options:
Original Medicare Part A (Hospital Insurance)
- Inpatient care in hospitals
- Skilled nursing facility care
- Hospice care
- Home health care
Original Medicare Part B (Medical Insurance)
- Services from doctors and other healthcare providers
- Outpatient care
- Home health care
- Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment)
- Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits)
Part C (Privately owned Medicare also known as Medicare Advantage)
- Alternative to Original Medicare for your health and drug coverage.
- Everything covered by Parts A and B;
- Likely will cover prescription drugs; and
- Possibly additional benefits or services (like hearing, vision, and dental services) depending on the private health plan you choose.
Part D (Drug Coverage)
- Helps cover the cost of prescription drugs (including many recommended shots or vaccines).
- Plans that offer Medicare drug coverage (Part D) are run by private insurance companies that follow the rules set by Medicare.
- Medicare Supplement insurance or Medigap plans (Plans A-N) are sold by private insurance companies to fill “gaps” in Original Medicare (Parts A and B) coverage, including expenses like deductibles, copays, and coinsurance.
How do you sign up?
Most people should apply for Medicare in the seven-month Initial Enrollment Period (IEP) surrounding their birthday.
- The fall Open Enrollment Period runs from October 15 through December 7 annually.
- Suppose you don’t sign up for Medicare when first eligible and don’t qualify for an exception. In that case, you can enroll in Medicare Part A and/or B during the General Enrollment Period (GEP), which runs from January 1 to March 31 each year. You may have to pay a higher Part A and/or Part B monthly premium for late enrollment.
Most Americans need to sign up for Medicare Part A, hospital insurance, and Medicare Part B, medical insurance when they reach 65. You can do so online or through your Social Security office. (Together, Parts A and B are also called Original Medicare.)
You can sign up for Part D, prescription drug coverage, change Medicare Advantage plans and switch between Original Medicare and Medicare Advantage during the appropriate open enrollment periods.
How much does it cost?
- Part A is generally free but has a deductible and copays.
- Part B includes a monthly premium of $164.90 in 2023 (or higher, depending on your income), and also has a deductible and coinsurance.
- Medicare Advantage (Part C) includes a monthly premium (projected average $18 per month in 2023). Deductibles, coinsurance, and copayments vary based on which plan you join.
- Part D (prescription drug coverage) includes a monthly premium of $31.50 (projected in 2023), a deductible ($505 in 2023). You may also have to pay an extra amount each month based on your income.
- Medicare Supplement (Plans A-N) monthly premiums vary by plan type. The average premium for the most popular Plan G was $137 per month.
Knowing the various components and costs related to Medicare can help you make the right decisions for your healthcare needs now and in the future. It’s important to do your research and learn about the different plans available so that you can choose the one that best suits your needs.