Healthcare Answers
for the rest of us

Medicare is like a giant health insurance club run by the US government. Think of it as a big community piggy bank that helps pay for doctor visits, medicines, and hospital stays so you don't have to pay all the money yourself!

Who can join? You are allowed to join if:

• You are 65 years or older.
• You are a US citizen or a permanent legal resident who has lived here for at least 5 years.
• You are younger than 65 but have a long-term disability or certain serious health conditions (like kidney failure).

Medicare is split into four parts, just like chapters in a school textbook. Each part has a different job:

• Part A (Hospital Insurance): Helps pay for when you have to stay overnight in a hospital. For most people, this is free because they paid taxes while working!
• Part B (Medical Insurance): Helps pay for regular doctor visits, physical therapy, and tests. You have to pay a small monthly price for this.
• Part C (Medicare Advantage): These are private plans (like a bundle) that combine Part A, Part B, and usually Part D, often with extras like dental and vision.
• Part D (Prescription Drugs): Helps pay for your medicine.

You can sign up during your Initial Enrollment Period. This is a 7-month window: 3 months before you turn 65, the month you turn 65, and 3 months after.

How to sign up:

• Go online to the Social Security website at ssa.gov/medicare.
• Call Social Security at 1-800-772-1213.
• Visit a local Social Security office in person.

Tip: If you are already receiving Social Security retirement checks when you turn 65, you don't even have to apply! They will sign you up automatically and mail you your card.

Medicare isn't completely free, but it's a huge help! Here is the breakdown:

• Part A: $0 a month for 99% of people! You already paid for it by working and paying taxes.
• Part B: Most people pay a standard monthly price of about $185 a month (in 2026). If you have a high income, you'll pay more.
• Part C & D: Price depends on the private plan you choose. Some Part C plans are $0 extra!
• Deductibles & Co-pays: When you actually go to the hospital or doctor, you might have to pay a small portion of the bill yourself (like $20 or $1,600) before Medicare pays the rest.

Nope! There are no income limits to qualify for Medicare. Anyone who is 65 or older and is a US citizen or legal resident can join, regardless of whether they make a lot of money or no money at all.

However, if you make a very high income (over $106,000 a year as a single person), the government will charge you an extra fee for your Part B and Part D monthly premiums. This extra fee is called IRMAA. But you still get the exact same great healthcare coverage!

They sound similar but are totally different:

• Medicare is for older people (65+) and people with long-term disabilities, no matter how much money they make. Think: "Care" for our seniors.
• Medicaid is for people of any age who have low income. It is run by both the US government and your state. Think: "Aid" for those in financial need.

If you are 65+ and also have a low income, you can actually have both at the same time! These are called "Dual Eligibles" and get their healthcare almost completely free!

Original Medicare (Part A and B) does not cover regular dental cleanings, eye glasses, or hearing aids.

However, you can get these covered easily by choosing a Part C (Medicare Advantage) plan from a private company, which usually bundles dental, vision, and hearing checkups into your plan for free!

Original Medicare pays for a lot of your health costs, but not all. It leaves about 20% of your doctor bills for you to pay. Medigap is extra insurance you buy from a private company to fill in those "gaps" and pay that remaining 20% so you don't get surprised by big bills.

Important rule: You cannot have both Medigap and Medicare Advantage. You must choose one or the other!

If you don't sign up for Part B or Part D when you're first allowed to (and you don't have other health insurance, like from a job you are currently working), the government will charge you a Late Enrollment Penalty.

This is a late fee that gets added to your monthly bill forever! For example, for Part B, your monthly premium goes up by 10% for every full year you waited. It's super important to sign up on time so you don't pay extra for the rest of your life!

To find the best plan, check three simple things:

• Your Doctors: Call and ask them if they accept the plan you want.
• Your Medicines: Check if the plan covers your exact prescriptions (this list of medicines is called a "formulary").
• Your Wallet: Look at the monthly fees and what you have to pay when you visit the doctor.

The absolute best way to compare plans is to visit medicare.gov/plan-compare. It lets you type in your medications and tells you exactly which plan will save you the most money!