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Medicare is a federal health insurance program primarily for individuals age 65 and older.
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Medicare covers individuals under age 65 with certain disabilities and conditions, including end-stage renal disease and amyotrophic lateral sclerosis (ALS).
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Medicare Part A covers inpatient hospital stays, skilled nursing stays, hospice stays, and some home health care.
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Medicare Part B covers doctor visits, preventive care, outpatient care, durable medical equipment, and some home health care.
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Medicare Part D covers prescription drugs.
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Parts A and B together constitute original or traditional Medicare.
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In 2025, the Medicare Part A premium is $0 for 99% of beneficiaries.
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In 2025, the Medicare Part A deductible is $1,676.
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In 2026, the Medicare Part A deductible is $1,736.
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In 2025, the Medicare Part B premium is $185.
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In 2025, the Medicare Part B deductible is $257.
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In 2026, the Medicare Part B premium is $202.90.
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In 2026, the Medicare Part B deductible is $283.
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In 2025, the Medicare Part D premium is $36.78.
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In 2025, the Medicare Part D deductible is $590.
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In 2026, the Medicare Part D premium is $38.99.
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In 2026, the Medicare Part D deductible is $615.
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Original Medicare does not provide a cap on out-of-pocket expenses for hospital or outpatient services.
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Medicare Part C is also known as Medicare Advantage.
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Medicare Advantage consists of health plans offered by private companies that contract with Medicare to provide Part A and Part B benefits.
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Most Medicare Advantage plans offer Part D drug coverage.
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Medicare Advantage plans usually require members to receive care only from network doctors and hospitals.
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In 2026, the average Medicare Advantage monthly plan premium is about $14, according to the Centers for Medicare & Medicaid Services.
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Medicare Advantage members must still pay their Part B premium.
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In 2026, the Medicare Advantage maximum out-of-pocket limit for in-network services is up to $9,250.
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In 2026, Medicare Advantage includes a separate $2,100 maximum out-of-pocket limit for prescription drug costs.
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Medicare Advantage plans provide the same coverage as original Medicare.
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Medicare Advantage plans may include extra benefits such as dental, vision, hearing, wellness coverage, and over-the-counter drug coverage.
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Medicare Advantage plans may have restrictions on covering medical care needed outside of the U.S.
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Individuals can sign up for a Medicare Advantage plan by applying online at Medicare.gov.
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Individuals can sign up for a Medicare Advantage plan by calling 1-800-MEDICARE (1-800-633-4227).
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A Medicare supplement plan, also known as Medigap, is designed for people who have original Medicare and need additional coverage for out-of-pocket costs.
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Medigap policies, such as Plan G and Plan N, are offered by private insurers or groups such as AARP.
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Each Medigap plan type must offer the same services regardless of the insurance company selling it.
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Medigap helps cover original Medicare-related costs including deductibles, copayments, and coinsurance.
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Medigap does not cover vision care, dental care, hearing aids, private nursing, long-term care, or custodial care.
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The cost of Medigap plans can vary by state.
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Individuals become eligible for Medicare when they turn 65, regardless of retirement age.
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The Medicare initial enrollment period begins three months before an individual's 65th birthday, includes their birth month, and ends three months after.
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During the initial enrollment period, individuals can enroll in a Medigap plan if they have also enrolled in Medicare Part B.
Meredith Ramsey, independent insurance agent
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"Medicare Advantage plans can have low or no monthly premiums, but they usually require members to get their care only from network doctors and hospitals."
Meredith Ramsey, independent insurance agent
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"Both options (original Medicare and Medicare Advantage) may have deductibles, copays and coinsurance, where you pay a percentage of the bill."
Diane J. Omdahl, founder of 65 Incorporated
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"You can go through your life with just parts A and B, but the out-of-pocket costs will get you."
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