Medicare 101

Medicare made easier, one lesson at a time

Short lessons in plain English. No jargon without a definition, no sales pitch, and a clear next step at the end of every topic.

Learning tracks

Start with the fundamentals

Work through them in order, or jump to the topic you came for.

Medicare foundations

What Medicare is, who qualifies, and how the pieces fit together.

What is Medicare?

Medicare is the federal health insurance program primarily for people 65 and older, and for some younger people with certain disabilities or conditions.

Part A is hospital insurance. Part B is medical insurance. Together they are called Original Medicare.
Part D is separate prescription drug coverage.
Medicare pays a large share of approved costs, but not all of them.
Medicare Advantage is a different way to receive Medicare benefits through a private plan. It is an alternative path, not a supplement.

What next: Read how Part A and Part B work together.

Who qualifies?

Most people qualify at 65. Some qualify earlier based on disability or specific conditions.

Eligibility at 65 generally depends on citizenship or lawful residency plus work history, your own or a spouse's.
Some people are enrolled automatically. Others must sign up through Social Security.
Qualifying does not mean you are automatically enrolled in everything.

What next: Check the enrollment timeline for your situation.

Your Medicare card and terminology

Your card shows your Medicare Number and the dates your Part A and Part B coverage started.

The Part B start date is what begins your six-month Medigap Open Enrollment window.
Never share your Medicare Number with an unsolicited caller.
Keep the card with you at appointments alongside any supplement card.

What next: Review the Medicare glossary of common terms.

Medicare costs

Premiums, deductibles, coinsurance, copayments, and what they mean in practice.

Deductible, coinsurance, copayment

These three words drive almost every Medicare cost conversation.

A deductible is the amount you pay before coverage begins paying its share.
Coinsurance is a percentage of the approved amount you pay after the deductible.
A copayment is a flat dollar amount for a service.
Original Medicare has no annual out-of-pocket maximum on its own.

What next: See what a Medicare Supplement is designed to help with.

Medicare-approved amount and assignment

Medicare sets an approved amount for covered services. Providers who accept assignment agree to it as full payment.

Participating providers accept assignment and cannot bill above the approved amount.
Non-participating providers may bill a limited excess charge where state law allows.
Plan F and Plan G are the standardized letters that address Part B excess charges.

What next: Compare how each plan letter treats excess charges.

Common Medicare mistakes

Most costly Medicare mistakes come from timing, not from choosing the wrong letter.

Assuming Medicare covers everything at 100%.
Missing an enrollment window and facing a late enrollment penalty.
Letting the Medigap Open Enrollment window pass without understanding it.
Comparing premiums without comparing what the plan letter actually covers.

What next: Book a free educational review before a deadline arrives.

Myth vs fact

Clearing up the five most common misunderstandings

Glossary

Medicare terms, defined

Search a word you ran into on a letter, a bill, or a phone call.

Original Medicare: Part A and Part B together, administered by the federal government.
Part A: Hospital insurance. Inpatient care, skilled nursing facility care, hospice, and some home health.
Part B: Medical insurance. Doctor visits, outpatient care, preventive services, and durable medical equipment.
Part D: Separate prescription drug coverage offered by private plans.
Medigap: Medicare Supplement insurance sold by private insurers that helps pay certain costs Original Medicare leaves to you.
Deductible: The amount you pay before coverage begins paying its share.
Coinsurance: A percentage of the Medicare-approved amount that you pay.
Copayment: A flat dollar amount you pay for a service.
Excess charge: An amount above the Medicare-approved amount that a non-participating provider may bill, where permitted.
Assignment: A provider's agreement to accept the Medicare-approved amount as full payment.
Guaranteed issue right: A situation in which an insurer must sell you a Medigap policy without medical underwriting.
Medical underwriting: An insurer's review of your health history when deciding whether to issue a policy and at what price.
Medigap Open Enrollment: The six-month window that begins when you are 65 or older and your Part B coverage starts.
IRMAA: An income-related adjustment that can increase Part B and Part D premiums for higher-income beneficiaries.
Medicare-approved amount: The amount Medicare determines is payable for a covered service.

Next: Original Medicare Book a Medicare review