What is Medicare?
Federal health insurance, in four parts, with two main ways to get it.
Medicare is the federal health insurance program for people 65 and older, and for some younger people with a disability, ALS, or permanent kidney failure. The Centers for Medicare & Medicaid Services (CMS) runs it, and Social Security handles most enrollment.
It isn't one policy. It's four parts, and the choices you make about how to combine them decide what you pay, which doctors you can see and how much protection you have from large bills.
The four parts in one minute
Each part covers a different kind of care. Parts A and B are run by the federal government; Parts C and D are sold by private companies that Medicare approves and regulates.
- Part A (hospital insurance): inpatient hospital stays, limited skilled nursing facility care, hospice and some home health care.
- Part B (medical insurance): doctors' services, outpatient care, preventive services, lab tests and medical equipment.
- Part C (Medicare Advantage): a private plan that provides your Part A and Part B coverage instead of Original Medicare, usually with drug coverage built in.
- Part D (drug coverage): prescription drug plans, sold on their own or inside a Medicare Advantage plan.
Two main paths: Original Medicare or Medicare Advantage
With Original Medicare (Parts A and B), you can see any doctor or hospital in the US that accepts Medicare. You usually add a Part D drug plan, and many people also buy a Medicare Supplement (Medigap) policy to cover some of the costs Parts A and B leave behind, such as the 20% coinsurance.
With Medicare Advantage, one private plan replaces Parts A and B, usually includes Part D, and often uses a network of doctors and hospitals. Plans have a yearly limit on what you pay for covered care, which Original Medicare doesn't.
Neither path is right for everyone. The tradeoffs are laid out side by side in our comparison of Original Medicare and Medicare Advantage.
Who pays for what
Most people don't pay a premium for Part A because they or a spouse paid Medicare taxes for at least 40 quarters (about 10 years) of work. Almost everyone pays a Part B premium: the standard amount is $202.90 a month in 2026, and people with higher incomes pay more.
Drug plans, Medigap policies and Medicare Advantage plans each have their own premiums, set by the company and varying by where you live. On top of premiums, you pay deductibles, coinsurance and copayments when you use care.
What Medicare doesn't cover
Original Medicare doesn't cover most dental care, eye exams for glasses, hearing aids, or long-term custodial care such as help with bathing and dressing in a nursing home. It also generally doesn't cover care outside the US. Some Medicare Advantage plans offer limited dental, vision and hearing benefits, but none of them cover long-term custodial care in the way people often assume.
Your first decisions
If you're approaching 65, the order matters more than the details:
- Find out whether you'll be enrolled automatically (you will be if you already get Social Security benefits).
- Decide whether you need Part B now or can delay it because of coverage from a current job.
- Choose Original Medicare (usually with a drug plan and possibly Medigap) or a Medicare Advantage plan.
- Mark your Medigap Open Enrollment Period if you're considering Medigap, because it's the best time to buy.
Common questions
No. Most people get Part A without a premium, but Part B has a monthly premium ($202.90 standard in 2026) and there are deductibles and coinsurance. Drug plans, Medigap and Medicare Advantage plans have their own costs.
No. Medicare is federal insurance based mainly on age or disability. Medicaid is a joint federal-state program based on income and resources. Some people qualify for both.
If you get Social Security benefits before 65, you're enrolled in Parts A and B automatically. Otherwise you sign up through Social Security. Delaying Part B without other qualifying coverage can lead to a lifelong penalty.
No. Medigap works only with Original Medicare, and it's illegal for an insurer to sell you a Medigap policy if you're in a Medicare Advantage plan, unless you're switching back to Original Medicare.
Want help with your own choices?
Every state runs a State Health Insurance Assistance Program (SHIP) with trained counselors who give free, unbiased Medicare help and do not sell plans. Find yours on our Medicare by state pages, or call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week).
Planning the rest of your coverage in retirement? We can help with life insurance later in life and final expense coverage.
Sources
- Medicare costs, Medicare.gov. Checked September 29, 2026.
- 2026 Medicare Parts A & B Premiums and Deductibles, Centers for Medicare & Medicaid Services. Checked September 29, 2026.
- What's not covered by Part A & Part B, Medicare.gov. Checked September 29, 2026.
- When can I buy Medigap?, Medicare.gov. Checked September 29, 2026.
General information about the federal Medicare program, not advice about your situation. Figures are for 2026 unless stated and change every year; last reviewed September 29, 2026. Quote My Policy is a private company. Not connected with or endorsed by the United States government or the federal Medicare program.
Quote My Policy does not sell Medicare plans on this site. For plan-specific help, contact Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week) or your State Health Insurance Assistance Program.