Beginner's Guide to Medicare

New to Medicare? This guide explains everything you need to know before turning 65, including how Medicare works, who qualifies, and what steps you should take.

What Is Medicare?

Medicare is the federal health insurance program for Americans age 65 and older, as well as some younger people with disabilities or End-Stage Renal Disease. It's not free—you pay premiums, deductibles, and copays—but it's more affordable than private insurance for most retirees.

Medicare is divided into four parts: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage plans), and Part D (prescription drug coverage). Understanding how these parts work together is essential to making smart enrollment decisions.

Who Qualifies for Medicare?

You qualify for Medicare if you're 65 or older and a U.S. citizen or permanent resident who has lived in the United States for at least five consecutive years. You may also qualify before age 65 if you have certain disabilities or conditions like ALS or ESRD.

Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes while working. Part B and Part D require monthly premiums, and your income can affect how much you pay.

When Should You Enroll?

Your Initial Enrollment Period (IEP) begins three months before your 65th birthday and ends three months after. Missing this window can result in late penalties that last for life. If you're still working and have employer coverage, you may be able to delay enrollment without penalty—but check with your HR department first.

After your IEP, you can make changes during the Annual Enrollment Period (AEP) from October 15 to December 7 each year, or during a Special Enrollment Period if you qualify due to life events like moving or losing other coverage.

Medicare Parts Explained

Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people get it premium-free.

Part B covers doctor visits, outpatient care, preventive services, and medical equipment. Standard premium in 2026 is $202.90/month.

Part C (Medicare Advantage) is an alternative to Original Medicare that bundles Parts A, B, and usually D into one plan through private insurers. These plans often include extra benefits like dental and vision.

Part D adds prescription drug coverage. If you don't enroll when first eligible and don't have creditable coverage, you'll face a late enrollment penalty.