Hospital insurance
Helps cover inpatient hospital stays, eligible skilled nursing care, hospice and some home health care.
PART OF ORIGINAL MEDICAREYOUR GUIDE TO MEDICARE · 2027
Make sense
of Medicare.
Make your next
move with confidence.
Understand your coverage, know when to enroll, and learn which benefits may be available where you live.
An independent guide. Not affiliated with Medicare or any government agency.
01 / THE BASICS
Four parts.
A clearer starting point.
Medicare is federal health insurance, generally for people 65 and older and some younger people with qualifying disabilities or conditions.
Medical insurance
Helps cover doctor visits, outpatient care, medical equipment and many preventive services.
PART OF ORIGINAL MEDICAREMedicare Advantage
A Medicare-approved private plan combining Part A, Part B and usually Part D. Networks and plan rules apply.
AN ALTERNATIVE TO ORIGINAL MEDICAREDrug coverage
Helps pay for covered prescriptions. Available as a separate plan with Original Medicare or through many Advantage plans.
PRESCRIPTION DRUG INSURANCELearn more: Medicare.gov’s guide to the parts of Medicare.
02 / YOUR COVERAGE CHOICES
Two ways to get
your Medicare coverage.
The right fit depends on your doctors, medications, budget and how you use care. Look at the whole plan before choosing.
| What to compare | Original MedicareParts A + B | Medicare AdvantagePart C |
|---|---|---|
| Doctors & hospitals | Generally, any U.S. provider that accepts Medicare. | Often a provider network; out-of-network rules and costs vary. |
| Prescription drugs | Add a separate Part D plan. | Usually included. Check the specific plan. |
| Yearly medical costs | No annual out-of-pocket limit without supplemental or other coverage. | An annual limit for covered Part A and Part B services. |
| Extra benefits | Most routine dental, vision and hearing services are not covered. | May include dental, vision, hearing and other extras. |
| Getting care | Generally fewer referrals and prior approvals. | Referrals or prior authorization may be needed. |
You generally keep paying your Part B premium with either option. A plan with a $0 premium can still have other costs.
03 / IMPORTANT DATES
Know your enrollment window.
Signing up for Medicare for the first time and changing a health or drug plan use different enrollment periods.
OCT 15 — DEC 72026
Annual Open Enrollment
Change Medicare Advantage or Part D plans, or move between Original Medicare and Medicare Advantage. Changes made during this window generally start January 1, 2027.
AROUND AGE 65A seven-month window
Initial Enrollment
Usually the three months before your 65th birthday month, that month, and the three months after. Some people qualify earlier.
JAN 1 — MAR 312027
Medicare Advantage Open Enrollment
For people already enrolled in Medicare Advantage: make one switch to another Advantage plan, or return to Original Medicare and add Part D.
WHEN LIFE CHANGESTiming depends on your situation
Special Enrollment Periods
A move, loss of certain coverage or other qualifying circumstances may give you another opportunity to enroll or change plans.
Check Medicare’s plan enrollment rules · Check when to sign up for Parts A and B.
Still working with employer coverage? Review your situation before delaying Medicare or changing coverage. Missing a required enrollment window can lead to gaps or penalties.
BEFORE YOU CHOOSE
A better plan starts
with the right questions.
Bring this short checklist to a plan comparison or a conversation about your coverage.
Use official Medicare Plan Compare- 01
Can I keep my doctors?
Confirm your physicians, specialists and preferred hospitals with both the plan and the provider.
- 02
What will my prescriptions cost?
Check every drug, dose and pharmacy. Compare the yearly estimate, not just the monthly premium.
- 03
What would I pay when I need care?
Review deductibles, copays, coinsurance, authorization rules and the medical out-of-pocket maximum.
- 04
What is changing for next year?
Read your plan’s Annual Notice of Change. Benefits, costs and coverage can change each year.
Sources: Choosing a plan · Annual Notice of Change
04 / BEYOND THE BASICS
Extra benefits,
with the details that matter.
Some Medicare Advantage plans offer additional benefits. Availability, amounts and eligibility depend on the plan and your location.
Dental, vision & hearing
Look for covered services, participating providers, copays and benefit limits. An allowance does not mean every treatment is covered.
Over-the-counter allowance
Eligible items, participating stores, refill schedules and unused-balance rules depend on the plan. Check exactly what the allowance can buy.
Grocery & food benefits
Offered by some plans for qualifying members, often with health-related eligibility requirements. A food allowance may share a limit with other benefits.
Part B giveback
Some plans pay part of your monthly Part B premium. Confirm the reduction amount and how it will be reflected in your premium payment.
Read more: Plan costs and premiums · CMS supplemental benefit rules. Specific allowances are governed by each plan’s coverage documents.
What may be available near you?
Explore local plan benefits and the requirements that go with them.
05 / HELP WITH COSTS
Check for help
you may qualify for.
Income and resource rules vary. A program may still be worth checking even if you are unsure whether you qualify.
Medicare Savings Programs
These programs may help pay Medicare premiums and, for some qualifying people, deductibles and other costs. Your state determines eligibility, and its rules may be more generous than federal limits.
Explore Medicare Savings Programs →Extra Help
Helps people with limited income and resources pay Part D premiums and other drug costs. Some qualify automatically; others can apply through Social Security. Separate programs apply in U.S. territories.
Learn about Extra Help →Special Needs Plans
Medicare Advantage plans designed for specific groups, such as people with Medicare and Medicaid, qualifying chronic conditions, or certain institutional care needs. Membership requirements apply.
Understand Special Needs Plans →06 / COMMON QUESTIONS
A few things
worth knowing.
Do I need to sign up for Medicare myself?
Some people receiving Social Security benefits are enrolled automatically. Others need to apply. Review your enrollment notice or check with Social Security, especially if you are still working or delaying Part B.
See Social Security’s enrollment guidanceIs a $0-premium plan completely free?
No. You generally still pay the Part B premium. Deductibles, copayments and coinsurance may also apply. Compare total expected costs alongside the plan premium.
Review Medicare coverage costsDoes everyone with Medicare get a grocery card?
No. Grocery benefits are plan-specific and may have additional eligibility requirements. Entering a ZIP code can identify local possibilities; it does not establish your personal eligibility. Confirm approved items, available funds and conditions with the plan.
Read CMS’s supplemental benefit guidanceCan I switch to Medigap during fall Open Enrollment?
The fall Medicare enrollment period does not automatically guarantee the right to buy Medigap. Your Medigap enrollment window, federal protections and state rules determine your options. Check these before leaving an Advantage plan.
Review Medigap enrollment protectionsDo I have to change my plan every year?
You do not need to choose a different plan just because it is Open Enrollment. Review your plan’s Annual Notice of Change to decide whether next year’s coverage and costs still meet your needs.
Learn what to check in your annual noticeWhere can I check official plan information?
Use Medicare.gov Plan Compare for available health and drug plans. Read a plan’s Summary of Benefits and Evidence of Coverage, and verify provider and drug coverage directly before enrolling.
Go to Medicare Plan CompareYOUR NEXT STEP
A little clarity goes a long way.
Start with your doctors, prescriptions and care needs.
Then explore the benefits available in your area.