Medicare guide
Turning 65: Medicare basics and your options
Medicare has four parts, two main paths and a few deadlines that are easy to miss. Here is how it fits together, in plain English.
By Dan Huslin, licensed insurance agent · Updated November 2026
The four parts of Medicare
| Part | What it covers |
|---|---|
| Part A | Hospital stays, skilled nursing care after a hospital stay, hospice and some home health care |
| Part B | Doctor visits, outpatient care, preventive services and medical equipment |
| Part C (Medicare Advantage) | A private plan that replaces Original Medicare (Parts A and B) and usually includes drug coverage |
| Part D | Prescription drug coverage |
Parts A and B together are called Original Medicare. They leave gaps: you generally pay 20% of most Part B costs, there is no yearly limit on what you pay, and routine dental, vision and hearing are mostly not covered.
Two main paths
Path 1: Original Medicare, plus a supplement and a drug plan
You keep Parts A and B, add a Medicare Supplement (also called Medigap) to help pay what Original Medicare doesn't, and add a separate Part D plan for drugs. You can generally see any doctor or hospital that accepts Medicare, anywhere in the country. Monthly premiums are usually higher, and out-of-pocket costs are usually more predictable.
Path 2: Medicare Advantage
A private plan that covers what Parts A and B cover, usually with drug coverage and often extras such as dental or vision. Premiums are often lower, but you generally use the plan's network of doctors and hospitals, and you may need approval before some services. Every plan has a yearly limit on what you pay out of pocket.
Neither path is right for everyone. The better choice depends on your doctors, your prescriptions, how much you travel and how you'd rather pay: a higher premium up front, or more cost when you use care.
When you can sign up
Your Initial Enrollment Period lasts seven months. It begins three months before the month you turn 65, includes your birthday month, and ends three months after. Signing up in the first three months gets your coverage started on time.
If you're still covered by an employer plan from active work, the rules are different. You may be able to delay Part B and sign up later without a penalty. Check with your employer's benefits office first, and ask whether that coverage counts as creditable for drugs.
Late-enrollment penalties
- Part B: your premium goes up 10% for each full 12-month period you could have had Part B but didn't, and the increase lasts as long as you have Part B.
- Part D: if you go 63 days or more without drug coverage that is at least as good as Medicare's, you pay an added amount each month for as long as you have Part D.
Medigap and its sign-up window
You get a six-month Medigap Open Enrollment Period that begins the first month you are 65 or older and enrolled in Part B. During that window, an insurer can't turn you down or charge you more because of your health. After it ends, in most states you may have to answer health questions to buy a Medigap plan, so it pays to decide before the window closes. Some states give extra rights.
Questions to ask before you choose
- Are my doctors and hospitals in the plan's network?
- Are my prescriptions on the plan's drug list, and what will I pay for each?
- What is the total cost: premium, deductible, copays and the yearly out-of-pocket limit?
- Will I travel or spend part of the year somewhere else?
- If I'm planning my retirement income, how will Medicare premiums fit in? Higher income can raise your Part B and Part D premiums. See retirement taxes and RMDs.
Plans and prices vary by state and county. I can walk you through the options in the states where I'm licensed, by phone or video. Call me at 619-251-3868 or get in touch.
This page is general information about Medicare. For official details, see Medicare.gov or call 1-800-MEDICARE.