Guides
Medicare, in plain words
68 short guides to the questions people ask most, checked against official sources. General information, not advice about a specific plan. How we check facts.
Signing up
Turning 65: when to sign up for Medicare
Your 7-month sign-up window, when you can wait because you're still working, and the deadline that matters for Medigap.
Medicare enrollment periods, explained
Every window to sign up for or change Medicare, what you can do in each one, and when coverage starts.
Losing job-based coverage after 65: your Special Enrollment Period
How long you have to sign up for Part B, Medicare Advantage and Part D when you retire or your employer coverage ends, and why COBRA doesn't count.
Moving with Medicare: what happens to your coverage
What to do with Original Medicare, Medicare Advantage, Part D and Medigap when you move, and how long you have to change plans.
HSAs and Medicare: when to stop contributing
You can't put money into a Health Savings Account once Medicare starts, and Part A can start up to 6 months early. When to stop, and how to use your HSA after 65.
Medicare and your spouse: when one of you is younger
Medicare covers only the person who qualifies. Getting Part A through your spouse's work, the age-62 rule, and health coverage options for a younger spouse.
Medicare Open Enrollment checklist (October 15 to December 7)
What to review each fall before December 7: your plan's change notice, drugs, doctors, pharmacies and costs, plus what you can and can't change, and when new coverage starts.
Medicare Advantage Open Enrollment (January 1 to March 31)
If you're in a Medicare Advantage plan, you get one change from January 1 to March 31: a different plan or back to Original Medicare. What you can and can't do.
Choosing your coverage
Medicare Advantage or Medigap: the basic difference
Two different ways to fill the gaps in Original Medicare, and what you trade off with each.
Medigap Plan G vs. Plan N
The two most popular Medicare Supplement plans for new enrollees: what each covers, where they differ, and who each tends to suit.
Medicare Advantage plan types: HMO, PPO, PFFS and Special Needs Plans
What each kind of Medicare Advantage plan means for your doctors, referrals and costs.
Switching Medigap plans later: birthday rules and other state rights
When you can change Medigap plans without health questions, the federal rights everyone has, and the states with yearly birthday windows or year-round switching.
Medigap if you're under 65: which states require it
If you have Medicare because of a disability or kidney failure, whether insurers must sell you a Medigap policy depends on your state.
Medicare star ratings: what they mean and the 5-star window
How Medicare rates Advantage and drug plans from 1 to 5 stars, when you can switch to a 5-star plan mid-year, and what low ratings warn you about.
Special Needs Plans: D-SNP, C-SNP and I-SNP explained
Medicare Advantage plans built for people with Medicaid, certain chronic conditions or nursing-home-level needs: who qualifies, when you can join, and what to check first.
Medicare Advantage: out-of-pocket limits and prior authorization
How a Medicare Advantage plan's yearly spending limit works, when you need the plan's approval before care, how fast plans must decide, and what to do if they say no.
Medicare Cost Plans and PACE: two lesser-known options
Medicare Cost Plans let you use Original Medicare outside the plan's network and leave any time. PACE gives all-in-one care to people 55+ who need nursing-home-level care at home.
What it costs
What Medicare costs in 2026
The 2026 Part B premium and deductible, the Part A hospital deductible, and the cap on Part D drug costs.
Medicare Part D: prescription coverage basics
How to get drug coverage, the 2026 out-of-pocket cap, and how to avoid the late penalty.
Extra Help and Medicare Savings Programs: 2026 limits
Two programs that lower Medicare costs for people with limited income: who qualifies in 2026, what they pay for, and how to apply.
IRMAA: higher Medicare premiums for higher incomes (2026 brackets)
Who pays more for Part B and Part D in 2026, the income brackets, and how to ask for a lower amount after retiring.
QMB billing protections: when providers can't bill you
If you're in the Qualified Medicare Beneficiary (QMB) program, doctors and other providers can't charge you Medicare deductibles, coinsurance or copays. How to prove it and what to do if you get a bill.
When a doctor doesn't take Medicare: assignment, opt-out and second opinions
The three kinds of doctors under Medicare, what you can be charged by each, what happens with a doctor who opted out, and Medicare coverage for second opinions.
Prescription costs: the yearly cap, $35 insulin and spreading payments
The Part D out-of-pocket cap ($2,100 in 2026, $2,400 in 2027), the $35 monthly insulin limit, $0 vaccines, and the Medicare Prescription Payment Plan.
The Medicare GLP-1 Bridge: weight-loss drugs for $50 a month
Medicare's temporary program covering certain GLP-1 weight-loss drugs (Wegovy, Zepbound KwikPen, Foundayo) for a $50 monthly copay: who qualifies and how to get it.
Free or paid Part A: the 10-year work rule and buying Part A
Most people get Part A without a premium after 10 years of Medicare-taxed work. If you don't, what Part A costs in 2026 ($311 or $565 a month), the penalty for waiting, and help paying.
How to pay Medicare premiums
Social Security deductions, Medicare Easy Pay, paying online, by bank or by mail, how often you're billed, and paying Part D and Medicare Advantage premiums.
Outpatient surgery: surgery center vs. hospital costs
What you pay for outpatient surgery with Original Medicare at an ambulatory surgical center vs. a hospital outpatient department, and how to look up the price first.
Everyday care
Dental, vision and hearing: what Medicare covers
What Original Medicare pays for (and doesn't) for teeth, eyes and ears, and where to look for routine coverage.
Free preventive care with Medicare
The screenings, shots and checkups Medicare covers, usually at no cost to you, and how to avoid surprise bills at a wellness visit.
Medicare when you travel: other states, abroad and cruises
How Original Medicare, Medicare Advantage and Medigap work when you travel in the U.S. or abroad, the 3 cases where Medicare pays outside the U.S., and cruise ship rules.
Medical equipment: what Medicare covers and how to get it
Wheelchairs, walkers, CPAP, oxygen, blood sugar supplies and hospital beds: what counts as durable medical equipment, what you pay, renting vs. buying, and choosing a supplier.
What Original Medicare doesn't cover
A plain checklist of what Medicare Part A and Part B don't pay for, from long-term care and dental to hearing aids and routine physicals, and how people fill the gaps.
Ambulance and emergency room coverage
When Medicare pays for an ambulance or air ambulance, what an ER visit costs, the 3-day admission rule, and why inpatient vs. observation status matters.
Medicare vision coverage: cataracts, glaucoma, diabetic eye exams and AMD
Original Medicare doesn't cover routine eye exams or glasses, but it does cover cataract surgery, glasses after it, glaucoma screenings, diabetic eye exams and macular degeneration care.
Does Medicare cover acupuncture and chiropractic care?
Medicare covers acupuncture only for chronic low back pain (up to 20 sessions a year) and chiropractic only for spinal adjustments to correct a subluxation. The details and costs.
Hearing and balance: what Medicare covers (and why not hearing aids)
Medicare covers diagnostic hearing and balance exams, a yearly audiologist visit without a referral for gradual hearing loss, and cochlear implants, but not hearing aids.
Foot care, braces and artificial limbs: what Medicare covers
Medicare covers foot care for diabetes-related nerve damage and conditions like hammer toe and heel spurs, plus braces, artificial limbs and other prosthetics with a doctor's order.
Lab tests, X-rays, MRIs and CT scans: what you pay with Medicare
Most lab tests cost nothing with Medicare. Imaging costs 20%, more at a hospital outpatient department. Accreditation rules for CT, MRI and PET, and blood transfusions.
Lower-cost care: community health centers, rural clinics and urgent care
Federally Qualified Health Centers have no Part B deductible and may offer income-based fees. Rural Health Clinics, urgent care, and how to keep costs down.
If your doctor is in an Accountable Care Organization (ACO)
An ACO is a group of doctors and hospitals that coordinate care for people with Original Medicare. It isn't a plan and doesn't limit your choice of doctors. What it means for you.
Hospital, nursing and home care
Skilled nursing facility care after a hospital stay
When Medicare pays for a short stay in a skilled nursing facility, the 3-day rule, the 2026 costs, and what Medicare never covers.
Hospice and home health care: what Medicare covers
Who qualifies for Medicare's home health and hospice benefits, what's included, what isn't, and what you pay.
Medicare and long-term care: what's not covered and other options
Why Medicare doesn't pay for long-term custodial care, and the ways people do pay for it: Medicaid, PACE, long-term care insurance and savings.
Inpatient or observation? Why your hospital status matters
Staying overnight doesn't make you an inpatient. How hospital status is decided, what it changes about your costs and nursing home coverage, the MOON notice, and how to appeal.
Health conditions and treatment
What Medicare covers for mental health care
Therapy, psychiatric care, telehealth and hospital stays: which mental health services Medicare covers, which professionals you can see, and what you pay in 2026.
Physical, occupational and speech therapy: what Medicare covers
Medicare covers outpatient therapy with no yearly cap, including therapy to maintain your abilities. What you pay, the 2026 $2,480 review amount, and therapy at home.
Medicare and clinical trials
Medicare covers the routine costs of qualifying clinical trials, like office visits and tests, and care for complications. What's covered, what isn't, and how it works with Medicare Advantage.
Medicare and dementia care: what's covered, and help for caregivers
Cognitive checks, a dedicated dementia care planning visit, caregiver training, and Medicare's GUIDE program with respite care, plus what Medicare doesn't pay for.
What Medicare covers for cancer treatment
Chemotherapy, radiation, surgery, drugs, related dental care and hospice: how Part A, Part B and Part D cover cancer care, what you pay, and what to check in your plan.
What Medicare covers for diabetes
Screenings, glucose monitors and supplies, therapeutic shoes, self-management training, nutrition therapy, the Diabetes Prevention Program and insulin: coverage and costs.
Organ transplants and anti-rejection drugs under Medicare
Which transplants Medicare covers, when it pays for anti-rejection (immunosuppressive) drugs, kidney donor costs, and the drug-only benefit after ESRD Medicare ends ($121.60 a month in 2026).
Heart and lung rehab: what Medicare covers
Medicare covers cardiac rehabilitation after a heart attack, bypass, stent or heart failure, and pulmonary rehab for COPD and long COVID. Who qualifies and what you pay.
Chronic care management and other monthly care services
If you have two or more long-term conditions, chronic pain or a mental health condition, Medicare pays providers to coordinate your care each month. What you get and what it costs.
Medicare coverage for opioid use disorder treatment
Medicare covers opioid use disorder treatment through Opioid Treatment Programs with no copays in Original Medicare, plus office-based treatment, counseling and overdose-reversal medicines.
Special situations
Medicare with VA or TRICARE coverage
How Medicare works alongside VA health care and TRICARE For Life, and whether you need Part B and Part D.
Medicare for kidney failure (ESRD)
Who can get Medicare at any age because of End-Stage Renal Disease, when coverage starts for dialysis or a transplant, and your plan choices.
Medicare under 65 with a disability
When Social Security disability benefits lead to Medicare, the ALS and kidney failure exceptions, keeping or turning down Part B, and your choices before and after 65.
Retiree health coverage and Medicare
If you have health coverage from a former employer or union: who pays first, why you usually need Part A and Part B, the Part B trap, and drug coverage questions to ask.
Having both Medicare and Medicaid
If you have Medicare and full Medicaid, most of your costs are covered. What Medicaid adds, how your drugs are covered, your plan choices, and how to find out if you qualify.
Medicare if you live outside the U.S.
Medicare generally doesn't pay for care abroad. What happens to Part A, Part B and drug coverage if you move overseas, and the 2-month window to join a plan when you move back.
Getting help and protecting yourself
Medicare scams: how to spot them and what to do
The calls, texts and offers scammers use on people with Medicare, how to protect your Medicare number, and where to report fraud.
How to appeal a Medicare denial
The steps to appeal when Original Medicare or a Medicare Advantage plan won't pay, the deadlines, and when you can get a fast decision.
Working with a Medicare agent: what to expect
How agents are paid, what they must tell you, and how to spot someone who isn't playing fair.
Your Medicare card: replacing it and keeping your number safe
What your Medicare card shows, when to use it, how to print or order a replacement, and how to protect your Medicare Number from scams.
How to apply for Extra Help and Medicare Savings Programs
Step by step: who gets help automatically, how to apply for Extra Help through Social Security and for a Medicare Savings Program through your state, and what to expect.
Advance care planning and Medicare
Medicare covers conversations with your provider about the care you'd want if you couldn't speak for yourself, including help filling out an advance directive. What it costs and how to start.
How to read your Medicare Summary Notice
The Medicare Summary Notice isn't a bill. What it shows, how to check it for errors and fraud, how to get it online, and how to use it to appeal or prove you're in QMB.