Medicare is a federal health insurance program designed to provide affordable healthcare coverage for older adults and certain individuals with disabilities. It helps cover hospital care, doctor visits, preventive services, prescription drugs, and more—offering peace of mind and protection from high medical costs.

You may qualify for Medicare if you meet one or more of the following conditions:

• You are 65 years or older and are a U.S. citizen or permanent legal resident who has lived in the U.S. for at least five years.

• You are under 65 but have received Social Security Disability benefits for at least 24 months.

• You have been diagnosed with End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a transplant).

• You have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.

The Four Parts of Medicare

Medicare is divided into four main parts, each covering different types of healthcare services:

• Part A: Hospital Insurance

• Part B: Medical Insurance

• Part C: Medicare Advantage (all-in-one plans offered by private insurers)

• Part D: Prescription Drug Coverage

Many people also choose to add a Medigap (Medicare Supplement) plan to help cover costs that Original Medicare doesn’t pay.

Why It Matters

Medicare provides a strong foundation for your healthcare coverage in retirement or during disability. Understanding your options helps you choose the right plan, manage your costs, and get the care you deserve.

Medicare Part A is the part of Original Medicare that helps cover hospital and inpatient care. It’s often called “hospital insurance.”

What Part A Covers

Part A helps pay for:

• Inpatient hospital stays (semi-private room, meals, nursing care, and medications during your stay)

• Skilled nursing facility care (after a qualifying hospital stay)

• Home health care (limited, part-time skilled care ordered by a doctor)

• Hospice care (for people with terminal illnesses who choose comfort care instead of curative treatment)

Medicare Part B is the part of Original Medicare that helps cover medical services and outpatient care. It focuses on the day-to-day health needs that keep you well and help manage ongoing conditions.

What Part B Covers

Part B helps pay for:

• Doctor visits (both primary care and specialists)

• Outpatient care (like same-day surgeries or diagnostic tests)

• Preventive services (such as flu shots, screenings, and annual wellness visits)

• Durable medical equipment (like walkers, wheelchairs, and oxygen)

• Some home health services and mental health care

Medicare Advantage, also known as Part C, is an all-in-one alternative to Original Medicare (Parts A and B). These plans are offered by private insurance companies that are approved by Medicare.

A Medicare Advantage plan covers everything that Original Medicare covers, and most plans offer extra benefits that go beyond basic coverage.

What Medicare Advantage Covers

All Medicare Advantage plans include:

• Hospital coverage (Part A)

• Medical coverage (Part B)

Most plans also include additional benefits such as:

• Prescription drug coverage (Part D)

• Dental, vision, and hearing benefits

• Wellness programs and gym memberships

• Over-the-counter allowances

• Transportation to medical appointments

Why It Matters

•Medicare Advantage plans offer convenience, value, and added benefits that can help you get more from your coverage—all under one plan. They’re a great choice for people who want comprehensive coverage and predictable costs.

Medicare Part D is prescription drug coverage offered by private insurance companies approved by Medicare. It helps pay for the cost of prescription medications—both brand-name and generic drugs.

You can get Part D coverage in one of two ways:

1. As a stand-alone Prescription Drug Plan (PDP) – for people who have Original Medicare (Part A and/or Part B) and want to add drug coverage.

2. As part of a Medicare Advantage Plan (MA-PD) – a Medicare Advantage plan that includes drug coverage along with hospital and medical benefits.

Medigap, also called Medicare Supplement Insurance, is private insurance that helps fill the “gaps” in Original Medicare (Parts A and B) coverage.

It helps pay for out-of-pocket costs that Medicare doesn’t fully cover—like copayments, coinsurance, and deductibles—so you can have more predictable healthcare expenses and peace of mind.

What Medigap Covers

Depending on the plan you choose, Medigap may help pay for:

• Part A and Part B deductibles

• Hospital coinsurance and additional hospital days

• Copayments for doctor visits or outpatient services

• Skilled nursing facility care coinsurance

• Emergency care while traveling outside the U.S.

(Each Medigap plan is standardized by letter, such as Plan G or Plan N, and offers different levels of coverage.)

How It Works

• You must have Original Medicare (Parts A and B) to enroll in a Medigap plan.

• You pay a monthly premium for your Medigap policy (in addition to your Part B premium).

• Medigap only works with Original Medicare, not Medicare Advantage. You can’t have both at the same time.

• You can use your coverage with any doctor or hospital that accepts Medicare—no network restrictions.

Why It Matters

A Medigap plan gives you financial protection and freedom of choice—so you can focus on your health instead of worrying about surprise medical bills. It’s an excellent option for people who want stable, nationwide coverage and fewer out-of-pocket costs.

Knowing when to enroll in Medicare is important so you don’t miss your opportunity to get coverage—or face late enrollment penalties. Your enrollment window depends on your age, employment status, and eligibility.