All about Medicare

Part A is hospital insurance. It generally helps cover inpatient hospital stays, skilled nursing facility care after a qualifying hospital stay, hospice care, and certain home health services. Part B is medical insurance. It generally helps cover physician services, outpatient care, preventive services, ambulance services, durable medical equipment, and certain home health services.

In 2026, the Part A inpatient hospital deductible is $1,736 for each benefit period. Hospital coinsurance is $0 per day for days 1–60, $434 per day for days 61–90, and $868 per lifetime reserve day. Skilled nursing facility coinsurance is $0 per day for days 1–20 and $217 per day for days 21–100. Most people pay no Part A premium because they or a spouse paid Medicare taxes long enough; people who buy Part A may pay $311 or $565 per month, depending on work history.

The standard Part B premium is $202.90 per month in 2026, and the annual Part B deductible is $283. After the deductible, you generally pay 20% of the Medicare-approved amount for covered Part B services. Higher-income beneficiaries may pay an income-related adjustment in addition to the standard premium.

Original Medicare does not have an annual out-of-pocket maximum. A Medicare Supplement policy may help with certain remaining costs.

Medicare Advantage plans are offered by private insurance companies approved by Medicare. They provide all Part A and Part B benefits except hospice care, which Original Medicare continues to cover. Most plans include Part D prescription drug coverage, and some include benefits such as routine dental, vision, hearing, fitness, or transportation services.

You must remain enrolled in Parts A and B and continue paying your Part B premium. A plan may also charge its own premium. Provider networks, referrals, prior authorization rules, copayments, drug coverage, service areas, and extra benefits differ by plan and may change each year.

Unlike Original Medicare by itself, Medicare Advantage plans have an annual limit on your out-of-pocket spending for covered Part A and Part B services. Your plan may set a lower limit than the maximum allowed, so review the plan’s Evidence of Coverage before enrolling.

A useful comparison looks at your doctors, hospitals, prescriptions, pharmacies, travel habits, budget, and the plan’s rules—not only its extra benefits.

Medicare Supplement insurance works with Original Medicare and may help pay certain deductibles, coinsurance, and copayments. Plans are identified by letters, and the benefits for the same plan letter are standardized in most states. Premiums, pricing methods, discounts, and customer service can still vary by insurance company.

Your one-time Medigap Open Enrollment Period generally lasts six months and starts the first month you are 65 or older and enrolled in Part B. During this period, you usually have stronger federal protections when buying a policy. Outside that window, medical underwriting may apply unless you have a guaranteed-issue right.

Medigap does not include prescription drug coverage, routine dental or vision care, long-term care, or private-duty nursing. A separate Part D plan is generally needed for prescription coverage. You cannot use a Medigap policy to pay Medicare Advantage plan costs.

Plan availability and consumer protections can differ by state and personal circumstances. We can explain how the rules may apply to you.

Part D plans help cover outpatient prescription drugs. Each plan has its own formulary, preferred pharmacies, cost-sharing tiers, and coverage rules. A plan can change its formulary and pharmacy network, so an annual review should include every prescription you take and the pharmacies you prefer.

In 2026, a Part D plan may charge a deductible of up to $615, though some plans charge less or no deductible. After the deductible, cost sharing depends on the plan and drug tier. Once your out-of-pocket spending on covered Part D drugs reaches $2,100 in 2026, you enter catastrophic coverage and pay nothing for covered Part D drugs for the rest of the calendar year.

The Medicare Prescription Payment Plan may let you spread covered prescription costs across monthly payments during the plan year. It changes when you pay, not the total amount owed, and it does not lower drug prices.

Premiums, formularies, pharmacy networks, and copayments vary by plan. Late-enrollment penalties may apply if you go without creditable drug coverage for too long.

Your Initial Enrollment Period generally lasts seven months: the three months before the month you turn 65, your birthday month, and the three months after. Some people are enrolled automatically, while others need to sign up. Delaying enrollment without qualifying coverage may cause a coverage gap or a late-enrollment penalty.

Medicare Open Enrollment runs October 15 through December 7 each year. During this period, you can change Medicare Advantage or Part D coverage for the following year. Medicare Advantage Open Enrollment runs January 1 through March 31 for people already in a Medicare Advantage plan and generally permits one plan change or a return to Original Medicare.

Special Enrollment Periods may be available after certain life events, such as losing employer coverage, moving out of a plan’s service area, or qualifying for other assistance. The General Enrollment Period for Parts A and B runs January 1 through March 31 for people who missed their initial opportunity and do not qualify for a Special Enrollment Period.

Enrollment rules depend on your current coverage and circumstances. Confirm your dates before making a change so you can avoid an unintended gap.