Medicare Basics

Part A – Hospital
A monthly payment, or premium, is not required for people (including spouses) who are 65 or older and paid Medicare taxes while they were working. You don't pay a premium if you are 65 or older and you get retirement benefits from Social Security or the Railroad Retirement Board. You also don't pay a premium if:

• You are younger than 65 and have received Social Security or Railroad Retirement Board disability benefits for 24 months.
• You have end-stage renal disease (kidney failure) and need dialysis or a transplant.
• If you are 65 or older and don't qualify for premium-free Medicare, you can buy Part A with a monthly premium. If you buy Part A, you also need to pay a premium for Part B. Check online at www.medicare.gov for details on premium amounts.

You usually need to pay some amount (deductibles or co-pays) for services before Medicare pays. But if you have a Medigap policy, it may cover your deductibles and co-pays. (See "What is Medigap?" for more information.)

Part B – Medical
Most people pay a standard monthly premium and an annual deductible. Above a certain income, you pay more based on the amount of your income. Most preventive services–such as flu shots, mammograms and colorectal screenings–are free if the provider accepts Medicare.

Part C – Medicare Advantage
These plans have different costs depending on the plan you choose. You may have monthly premiums, as well as deductibles and co-pays.

All-in-one Medicare Advantage plans help simplify the complexity around Medicare, and may offer more comprehensive and cost-effective benefits–including Medicare Parts A, B and D. Some also include dental and vision care.

Part D – Prescription
You pay a premium for the drug plan, which can vary based on what is covered in the plan.

Medicare doesn't cover everything. If you need certain services Medicare doesn't cover, you'll have to pay for them yourself unless:

• You have other insurance that covers these services
• You have a Medicare Advantage plan that covers them

Even if Original Medicare covers a service or item, you generally have to pay your deductible and coinsurance.

Some of the items and services that Original Medicare doesn't cover include:

• Long-term care
• Most dental care
• Eye exams related to prescribing glasses
• Dentures
• Cosmetic surgery
• Acupuncture
• Hearing aids and exams for fitting them
• Routine foot care

Choose an all-in-one Medicare Advantage plan. These plans help simplify the complexity around Medicare, and may offer more comprehensive and cost-effective benefits.

Watch the Medicare & You: Different Parts of Medicare video to learn about the different ways you can get coverage.

Follow these six steps to help you make informed decisions when getting started with Medicare.

Review this comprehensive guide (PDF) to get answers to the most frequently asked questions about Medicare.

Watch the Medicare & You: Ways to Save Money video for information on special needs plans and ways to save money on your Medicare coverage.

Review this comprehensive fact sheet (PDF) to help you make important Medicare coverage decisions.