A
Hospital insurance
Hospital and inpatient care. Most people who worked long enough pay no Part A premium. In 2026 the hospital deductible is $1,736 each benefit period.
Medicare
The parts, the windows, and the tradeoffs.
This page is the explanation we wish more people had before a sales call. It is education from a licensed agency, not an enrollment, and not the full list of plans in your county.
Four letters. Two of them are not plans you “pick” the same way.
B
Medical insurance
Doctor visits, outpatient care, and other medical services. In 2026 you pay a $283 deductible, then usually 20 percent of the Medicare-approved amount. That 20 percent has no yearly cap.
C
Medicare Advantage
Private plans that bundle Parts A and B, usually with Part D. You generally cannot pair one with a Medigap policy.
D
Prescription drugs
Prescription drugs, standalone or inside many Advantage plans. A gap of 63 days or more without creditable drug coverage can add a late penalty.
Will Medicare enroll you automatically?
It depends on Social Security. Confirm your situation there before you assume a card is on the way.
Already on Social Security
If you get Social Security or Railroad Retirement benefits at least four months before 65, Parts A and B usually start the first day of your birthday month. A card arrives by mail.
Not on Social Security yet
You sign up. Online at SSA.gov, by phone at 1-800-772-1213, or at a local office. We help you choose any extra plan after Parts A and B are in place.
Advantage or Supplement — read both before you fall in love with one premium.
Medicare Advantage
A private plan that includes Parts A and B, and usually Part D. You generally cannot add a Medigap policy to it.
- Premium
- Often low, sometimes $0 from the plan. Most people still pay the Part B premium.
- Doctors
- A network. HMO plans generally mean in-network care. PPOs may allow out-of-network visits at a higher cost.
- Prescriptions
- Usually built in. The formulary belongs to that plan and can change for the next year.
- Extras
- Dental, vision, and hearing show up often, usually with a yearly cap. Cancer, heart attack, stroke, and short-term care are separate policies.
- Watch for
- Referrals and prior authorization. There is an annual out-of-pocket maximum, which Original Medicare alone does not have.
Medicare Supplement
A Medigap policy next to Original Medicare. You add a Part D plan for prescriptions.
- Premium
- A separate premium that varies by letter, age, and carrier — plus Part B, plus Part D.
- Doctors
- Any provider that accepts Medicare, anywhere in the United States. The supplement has no network and does not require referrals. The lowest cost is when the doctor accepts Medicare assignment. Foreign travel is only on some plan letters.
- Prescriptions
- Not included. A standalone Part D plan is the usual pair.
- Extras
- Generally none. The policy is for deductibles and coinsurance, not cleanings or glasses.
- Watch for
- The six-month Medigap window starts the month you are 65 or older and enrolled in Part B. After it, most states allow medical underwriting. Once issued, the policy is guaranteed renewable if you pay the premium. Plan F and Plan C are not sold to people newly eligible on or after January 1, 2020.
Original Medicare by itself is Parts A and B. It is not drug coverage, and it does not cap what you can owe in a bad year. Most people add either an Advantage plan or a Supplement plus a Part D plan.
A Supplement helps pay costs Original Medicare leaves over: the Part A hospital deductible on many plan letters, hospital and skilled nursing daily coinsurance, and the Part B 20 percent after Medicare pays its share. It does not include Part D. Medigap letters are standardized, so a Plan G from one carrier has the same core benefits as a Plan G from another. The price is what changes. People who became eligible for Medicare on or after January 1, 2020 can’t buy Plan C or Plan F. The six-month window starts the month you are 65 or older and enrolled in Part B. During it, you generally cannot be turned down for health reasons. After it, most states allow medical underwriting. Once issued, the policy is guaranteed renewable if you pay the premium. State rules vary.
2026 amounts
The five cost shares of Original Medicare.
Four of the five are Part A. The fifth is Part B, and that 20 percent has no yearly cap. A hospital stay, an ambulance, outpatient surgery, skilled nursing, or treatment for cancer, a heart attack, or a stroke can stack these. A Supplement can help pay some of them. What it pays depends on the plan letter. An Advantage plan uses its own copays and has a yearly limit.
$1,736
1. Part A hospital deductible
Each benefit period, before Medicare pays the hospital stay.
$434 a day
2. Hospital days 61 to 90
Days 1 to 60 are $0 after the deductible.
$868 a day
3. Lifetime reserve days
Up to 60 days. These can be used only once.
$217 a day
4. Skilled nursing, days 21 to 100
Days 1 to 20 are $0 after a qualifying hospital stay.
20 percent
5. Part B coinsurance
After a $283 deductible in 2026. Original Medicare has no yearly cap on that 20 percent.
A new benefit period can start after 60 days out of inpatient care, so the hospital deductible can apply more than once a year. These are 2026 Original Medicare cost shares. They are education, not a plan quote.
When you can actually move.
Seven months around the month you turn 65
Initial Enrollment Period
Three months before your birthday month, the birthday month, and three months after. Enroll in the three months before and coverage can start the first day of the month you turn 65. Enroll during the birthday month or the three months after, and coverage generally starts the first of the next month.
Six months, starting the month you are 65 or older and enrolled in Part B
Medigap open enrollment
During that window you generally cannot be turned down for health reasons. After it, in most states, insurers can use medical underwriting. Once issued, the policy is guaranteed renewable if you pay the premium. State rules vary. A supplement works with Original Medicare, not with Medicare Advantage, and it does not replace Part A, Part B, or Part D.
October 15 – December 7
Annual Enrollment Period
Switch, join, or drop Medicare Advantage and Part D plans. What you choose generally starts January 1. This is the review most people should not skip.
January 1 – March 31
Medicare Advantage Open Enrollment
If you already have an Advantage plan, you can make one change: a different Advantage plan, or back to Original Medicare (and you may pick up a drug plan).
When life changes, not on a fixed calendar
Special Enrollment Periods
Losing employer coverage, moving, or qualifying for Extra Help are examples. The dates are specific. Guessing is how people get penalties.
Still on an employer plan?
Turning 65 does not mean you should leave a group plan. Ask the employer whether that coverage continues and how it works with Medicare. Many people still enroll in premium-free Part A if they qualify. Part B can sometimes wait when the employer coverage is qualifying, and a Special Enrollment Period opens when that coverage ends. Marketplace plans are different: premium tax credits generally end when Medicare Part A starts. Talk with benefits and with Social Security before you decide. This is not legal or tax advice.
Missing the window can follow you.
Waiting without qualifying coverage has a cost. A Part B late penalty is generally 10 percent of the standard premium for each full 12-month period you delay, and it can last as long as you have Part B. A Part D penalty can apply after 63 days or more without creditable drug coverage — coverage at least as good as Medicare Part D. Employer coverage may protect you. Ask before you delay. Rules have exceptions. This is education, not advice.
What to have in front of you.
Check these off before you call. The list stays in this browser so you can come back to it. We never see it.
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