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If you or your spouse are still working, you may be able to wait to sign up for Medicare without paying a late enrollment penalty. If you didn't sign up for Part B because you have group health plan coverage based on current employment, you can sign up any time you're still covered, or during the 8-month period that begins the month after employment or coverage ends, whichever happens first.
If you sign up for Part B late and didn't qualify for a Special Enrollment Period, or go without Part D or other creditable drug coverage, you could owe a penalty. It's added to your monthly premium. It's not a one-time fee, and you usually keep it for as long as you have that coverage.
Open Enrollment happens from October 15 to December 7 and is the time each year when you can make changes to your coverage. The changes you make are effective January 1 of next year. In most cases, if you join a Medicare Advantage Plan, you must keep it for the calendar year. If you're already in one, you can make one change from January 1 to March 31.
Most people can first sign up during their Initial Enrollment Period, a 7-month window. It starts 3 months before the month you turn 65 and ends 3 months after.
It depends. Some people get Part A and Part B automatically, and some have to sign up. If you're already getting benefits from Social Security or the Railroad Retirement Board, you'll automatically get Part A and Part B starting the first day of the month you turn 65. If you're close to 65 but aren't getting those benefits, you'll need to sign up for Medicare.
A deductible is what you pay before Medicare starts to pay. A copayment is a set dollar amount, like a flat fee. Coinsurance is a percentage of the cost, like 20%.
Yes. Medicare Savings Programs are state programs that help pay your Medicare premiums, and sometimes your deductibles, coinsurance, and copayments, if your income and resources are limited. You apply through your state.
Original Medicare (Part A and Part B) on its own has no yearly limit on what you pay out of pocket. Medicare Advantage plans have a yearly limit; once you reach it, you pay nothing for covered services for the rest of the year. And in 2027, your out-of-pocket spending on covered Part D drugs is capped at $2,400.
Most people pay $0 a month for Part A (hospital insurance) because they or a spouse paid Medicare taxes long enough while working. If you're admitted to the hospital in 2026, you pay a $1,736 deductible.
In 2026, most people pay $202.90 a month for Part B (medical insurance: doctor visits and outpatient care). You also pay a $283 yearly deductible, then usually 20% of the cost for each covered service.
Extra Help is a Medicare program that helps people with limited income and resources pay for Part D (prescription drug) coverage. If you have full Medicaid, get SSI, or a Medicare Savings Program pays your Part B premium, you get Extra Help automatically.
Part D is Medicare drug coverage: help paying for the prescription drugs you need, from private insurance companies approved by Medicare. It's optional. In 2027, what you pay out of pocket for your covered drugs is capped at $2,400.
Medicare comes in parts. Part A covers hospital care. Part B covers doctors and outpatient care. Part D covers prescription drugs. Part C (Medicare Advantage) is a private plan that bundles them together.
Medigap (Medicare Supplement Insurance) is extra insurance you can buy from a private health insurance company to help pay your share of out-of-pocket costs in Original Medicare, like copayments, coinsurance, and deductibles. You can only buy Medigap if you have Original Medicare. The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period.
They're for two different paths. Medigap only helps pay your costs under Original Medicare, so it can't be used with a Medicare Advantage plan. In most cases, a company can't sell you Medigap while you're in Medicare Advantage.
Original Medicare includes Part A and Part B, and you can use any doctor or hospital that takes Medicare. A Medicare Advantage Plan is another way to get that coverage, through a Medicare-approved plan offered by a private company. In many cases, you'll need to use health care providers who participate in the plan's network. These plans set a limit on what you'll pay out of pocket each year.
General education, not individualized advice. For your own situation, you can call 1-800-MEDICARE or your State Health Insurance Assistance Program (SHIP).
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