Medicare Basics

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.)

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.

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.

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