Medicare Basics

Medicare Basics addresses some of the most commonly asked questions about Medicare, highlighting:

The benefits of Medicare Advantage plans
The importance of enrolling when first eligible
How to avoid Medicare’s late enrollment penalties
How to save money, and
Where to go for additional help

Do you have to pay for medicare?

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.

Exclusions

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.

Special Needs Plans

Millions of Americans are eligible for Medicare Savings Programs and Extra Help, but not yet enrolled. These programs help qualifying patients with limited income and resources pay Medicare’s cost-sharing expenses, including premiums, deductibles, and coinsurance.

If you would like more information about Medicare's Extra Help programs or need help determining whether you are eligible, complete our secure form to have a licensed insurance broker contact you. Brokers are available in person, by telephone or virtually.

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Medicare Enrollment Periods

Annual Election Period

Make sure your coverage still meets your healthcare and prescription drug needs.

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Initial Enrollment Period

Learn about the penalties that may apply if you don’t enroll during your Initial Enrollment Period.

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Special Enrollment Period

Life changes such as retirement, change in address, or lost coverage may qualify you for a special enrollment period.

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

Millions of Americans are eligible for Medicare Savings Programs and Extra Help, but not yet enrolled. These programs help qualifying patients with limited income and resources pay Medicare’s cost-sharing expenses, including premiums, deductibles, and coinsurance.

If you would like more information about Medicare’s Extra Help programs or need help determining whether you are eligible, please send us an email with your name, preferred contact information, and ZIP code of residence. We will provide your information to a local agent to contact you.

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This is not an advertisement on behalf of any Medicare Advantage health plan or plans. For information about Medicare, visit medicare.gov or call (800) MEDICARE 24 hours a day, seven days a week.

Medicare Basics

Watch Our Medicare Basics Video

Do you have to pay for medicare?

Part A – Hospital

Part B – Medical

Part C – Medicare Advantage

Part D – Prescription

Exclusions

Special Needs Plans

Medicare Enrollment Periods

Annual Election Period

Initial Enrollment Period

Special Enrollment Period

Resources

Compare Your Plan Options

Helpful Resources

Medicare Home

Medicare Advantage

Medicare Basics

Medicare Events

Wellness Visits

Late Enrollment Penalties

Accessing Care