Who Can Enroll in Medicare?
Am I signed up Automatically?
Who has to sign up?
Where can I find if I'm eligible?
You can only enroll in Medicare during three important timeframes: The Initial Enrollment Period, the Special Enrollment Period, and the General Enrollment Period. To find out more about How and When to Enroll.
Will your Medicare plan allow you to keep your Personal Care Physician? What about Prescription Drugs? Making informed Medicare decisions is a complex task, be sure to consider these important questions and factors before doing so.
What Is Medicare?
Medicare is a federal health insurance program for eligible beneficiaries 65 and older, and beneficiaries with a qualifying medical disability.
There are four parts to Medicare (Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D) that cover Hospital and Inpatient care, Doctor Visits and outpatient care, private insurance companies that have contracts with Medicare to provide Medicare Advantage, and Prescription Drug coverage. Most will only need to pay the Part B Premium of $185.00 per month for 2025.
Hospital Stays/Inpatient Care
Medicare Part A helps cover the costs of hospital stays, skilled nursing facility care, hospice services, and home health care.
In most cases, if Medicare taxes were deducted from your paycheck while you were employed, you may qualify for premium-free Part A.
Coverage under Medicare Part A typically begins automatically once you become eligible at age 65, or if you have received Social Security disability benefits for 24 months.
Doctor Visits and Outpatient Care
Medicare Part B covers a wide range of healthcare services, including doctor visits, outpatient care, durable medical equipment, and various medical and surgical services — both inpatient and outpatient. It also helps pay for physical therapy, speech therapy, diagnostic tests, and medical supplies. Generally, you can apply for Medicare Part B starting three months before your 65th birthday month and up to three months after your birthday month, giving you a seven-month enrollment window.
Medicare Advantage Plans
Medicare Part C, commonly known as Medicare Advantage, includes health plans offered by private insurance companies that are approved by Medicare. These companies must follow Medicare's rules and guidelines. A Medicare Advantage plan bundles your Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance), and often Medicare Part D (Prescription Drug Coverage) into a single comprehensive plan.
While you are still enrolled in Medicare when you join an Advantage plan, it is the private insurance company — not Medicare — that pays your healthcare claims.
Prescription Drug Coverage
Since 2006, Medicare has offered insurance coverage for prescription medications through Medicare Part D Prescription Drug Plans.
These plans are provided by private insurance companies that follow rules set by Medicare. When enrolled in a Part D plan, you may need to pay a portion of your prescription drug costs before the plan starts covering expenses.
Typically, generic medications are more affordable than brand-name drugs.
Each plan has its own formulary — a list of all covered prescription medications.
Medicare Supplement Overview
Medicare Supplement insurance plans, also known as Medigap plans, have been available since shortly after Medicare was introduced in the 1960s.
While Original Medicare covers many healthcare services and supplies, it doesn't cover everything.
Medigap policies, offered by private insurance companies, help pay for some of the remaining costs — such as copayments, coinsurance, and deductibles.
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This is the time frame most people sign up for Medicare. A seven-month period, starting three months before the month in which you turn 65 and ending three months after that month (assumes you do not delay enrolling in Medicare Part B plan).
Beneficiaries may switch, add, or delete a plan. New plans will be effective January 1 of the following year.
Medicare Advantage plan enrollees may enroll in another MA plan or disenroll from their MA plan and return to Original Medicare. Individuals may make only one election during this enrollment period.
Special enrollment periods may apply when certain events happen in your life, such as relocation, loss of group coverage, your current plan ends its Medicare contract, etc... The amount of time you have to make a change depends on the qualifying SEP event.
Click here to get the information you would need about official Medicare information, publications, apps, and more. Medicare is available 24 hours a day, 7 days a week by calling 1-800-MEDICARE (1-800-633-4227, TTY users call 1-877-486-2048).
Trouble paying your Medicare expenses? Are your Prescription Drug costs unaffordable? Click here for resources for helping pay your health care costs, including various programs such as Medicare’s “Extra Help,” Pharmaceutical Assistance Programs, Program of All-inclusive Care for the Elderly (PACE), and Supplemental Security Income (SSI), and more.
Click here to find additional helpful resources, including websites and contact information, for understanding Medicare, your rights, government/military benefits, and other helpful information.
Confused or unsure about Medicare and other health insurance terminology? Click here for a quick and easy definitions guide to specific terms and phrases used in Medicare.
Have questions about Medicare? You are not the only one! Read more here for some answers to 'frequently asked questions' about Medicare.
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