What is Medicare?

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Medicare is the federal health insurance program for people 65 and older. It also covers some younger people with disabilities, End-Stage Renal Disease (permanent kidney failure), or ALS (Lou Gehrig’s disease). Medicare is divided into different Parts. Let us help you understand how they work together.

Medicare Part A

(Hospital)

Part A is hospital insurance that assists you with the cost of inpatient care and skilled nursing facility stays. It also helps with things like hospice and home health care. In general, you should think of the inpatient hospital benefit as Medicare coverage for your semi-private room.

However, Part A does NOT cover all of the treatments that might occur in a hospital or clinical setting, such as outpatient surgeries. Those could fall under Part B.

Hospital building icon representing Medicare Part A coverage for inpatient care and services.

Medicare Part B

(Doctor)

Part B is your outpatient medical coverage. It covers your doctor's visits. This includes visits while in the hospital. It also includes medical coverage for lab work, preventive services, ambulance services, and outpatient surgeries. You need Part B to cover these costs.

In addition, Part B covers cancer therapy and kidney dialysis, which can be extremely expensive charges if not covered.

Stethoscope symbol representing medical care and outpatient services related to Medicare Part B coverage.

Medicare Part C

(Medicare Advantage)

Part C refers to the Medicare Advantage program. Medicare Advantage plans are offered by private insurance companies approved by Medicare. Premiums vary by plan and county, and you continue to pay your Part B premium.

To enroll in a Part C plan, you must first be enrolled in both Parts A and B. Part C is voluntary.

When you join, you’re still in Medicare. Your Part A and Part B benefits are provided through the plan instead of Original Medicare.

Health insurance card icon representing Medicare coverage options.

Medicare Part D

(Drug)

Part D helps pay for prescription drugs you get at a pharmacy or by mail. You get it through a private plan approved by Medicare: either a stand-alone drug plan (to go with Original Medicare) or a Medicare Advantage plan that includes drug coverage. Part D is optional. But if you go 63 days or more without Part D or other creditable drug coverage after you’re first eligible, you may pay a late enrollment penalty for as long as you have Part D. In 2026, your out-of-pocket costs for covered drugs are capped at $2,100 ($2,400 in 2027).

Prescription medication bottle with pills, representing Medicare Part D coverage for retail prescription drugs.

2026 Medicare costs at a glance

  • Part A premium: $0 if you or your spouse have 40 credits (about 10 years of work) paying Medicare taxes. Otherwise up to $565 a month.

  • Part A hospital deductible: $1,736 per benefit period.

  • Part B standard premium: $202.90 a month (higher if your income is above $109,000 single / $218,000 joint).

  • Part B deductible: $283 a year. After that, you usually pay 20%.

  • Part D: Your out-of-pocket costs for covered drugs are capped at $2,100 in 2026 ($2,400 in 2027).

2027 Part A and B amounts are usually announced in the fall. We’ll update this page when they’re released.

Key Medicare dates

  • Initial Enrollment: the 7 months around your 65th birthday month.

  • Annual Enrollment: October 15 – December 7 (changes start January 1).

  • Medicare Advantage Open Enrollment: January 1 – March 31 (if you’re already in a Medicare Advantage plan).

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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Medicare has neither reviewed nor endorsed this information. We are not connected with or endorsed by the United States government or the federal Medicare program.

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