There’s a lot to take in when it comes to Medicare. Here’s how your choices can keep you healthy.

Happy early birthday! You’re going to be turning 65 soon. And that means it’s time to start thinking about Medicare.

First, it’s a good idea to understand the basics. Medicare is a healthcare program run by the government. It provides benefits for adults 65 years and older. It also covers some people with disabilities and end stage kidney disease.

Signing up for Medicare can sometimes be a little confusing. There are a lot of facts and figures to understand. But with a little help, you’ll get it.

Here’s a crash course on what Medicare is and how it works.

A guide to the parts of Medicare

The first thing to know about Medicare is that it usually comes in four parts. Each one covers different types of healthcare services:

• Part A covers hospital services and care.
• Part B covers outpatient doctor visits and care. (Visits where you don’t spend the night in the hospital.)
• Part C is also called Medicare Advantage. You can choose this instead of parts A and B. It often additionally covers prescription drugs, dental, vision and hearing.
• Part D covers prescription drugs and some vaccines.

You might see Medicare parts A and B called Original Medicare, which you get through the government. Medicare Part C is offered by private insurance companies and must be approved by Medicare.

How to put Medicare’s parts together

Medicare follows a basic rule — the more parts you have, the more healthcare you get:

• If you choose Original Medicare, you’ll get Medicare parts A and B only. You can also add Part D, which gives you a prescription drug plan.
• If you choose to go with Medicare Advantage, you get parts A and B, plus prescription drug insurance. If you pick a plan that doesn’t include drug coverage, you can add a Part D.

What is Medigap?

Some parts of Medicare can be combined with a Medicare supplement health plan. You might also see it called Medigap. These plans cover some out-of-pocket costs that parts A and B don’t cover. Those include things like:

• Coinsurance: This is the percentage you pay for the cost of health services.
• Copay: This is a fixed amount you pay for health services.
• Deductible: This is what you pay for healthcare services before your insurance kicks in.

In most states, Medigap plans are labeled with letters A through N. Every insurance company’s Medigap plans offer the same benefits to you.¹

If you aren’t happy with the parts of Medicare you choose, you can change them. Medicare has a slot each year when you can make changes. It runs from October 15 to December 7. Sometimes, you can make changes before this. That period of time is called the special enrollment period.

What does Medicare cost?

What you pay for Medicare is all about which parts you choose and how you use them. Your costs may include your monthly insurance bill, deductibles, copays and coinsurance.

This is what you’ll pay for Medicare in 2025:

• Part A: If you or your spouse worked and paid Medicare taxes for at least 10 years, you will not pay a monthly bill. If you don’t have that work history, you could pay up to $518 a month.
• Part B: Most people will pay $185 a month, but if your income was high in 2023, you could pay up to $628.90 per month.
• Part C: Many Medicare Advantage plans have $0 or low cost monthly insurance bills. But those monthly bills may be different based on where you live and your doctor.
• Part D and Medigap: Monthly bills and other costs differ based on your plan and your doctor.

You’ll also need to pay out-of-pocket costs when you get certain care. For example, with Medicare Part B, you must meet a $257 deductible in 2025 before Medicare starts paying. After that, Medicare typically pays 80% of your costs. You have to pay the remaining 20%.

If you have Medicare Advantage (Part C), how much you pay will be different depending on your plan. So, you’ll want to look closely at your plan before enrolling.

Can you use your health savings account (HSA) to pay for Medicare costs?

If you have a high-deductible health plan (HDHP), you may have an HSA. An HDHP has a lower monthly insurance bill, but you’ll pay higher out-of-pocket costs for healthcare.

Money saved in an HSA can help you pay for some Medicare costs. Usually, an HSA lets you save money, tax-free. But once you join Medicare, you can’t put any more tax-free money into your HSA. You can still use what you’ve saved to pay Medicare bills and other costs you have to pay.

Is Medicare Advantage better for you?

If you’re still not sure what type of Medicare plan to choose, think about what you’re getting for your money. If you go with Original Medicare, you get Medicare parts A and B. You’ll have to pay more for your Part D prescription drug plan and Medigap.

But if you go with Medicare Advantage (Part C), you may pay little to no monthly premium. That’s because some plans may pay part or all of your Part B bill. You’ll also get Medicare Parts A and B, plus a prescription drug plan, in many cases. And you can get added benefits like:

• Adult day care – a safe place to go during the day for care, activities, and help if you need it
• Dental and vision benefits – Help paying for dentist visits, eye exams, glasses or contacts
• Gym memberships – Free or discounted use of a gym or fitness classes
• Hearing care and hearing aids – Help with hearing tests and getting hearing aids
• Meal delivery – Healthy meals brought to your home after a hospital stay
• Rides to the doctor – Help getting to and from your medical appointments
• Over the counter items – Money each month to buy things like vitamins, pain relievers and cold medicine

Remember that costs and coverage may vary among Medicare Advantage plans. These plans also tend to have a set network of doctors. You’ll be able to check whether your doctor is in the network before you sign up. Always be sure to read the plan’s information carefully.

When can you sign up for Medicare?

The best time to sign up for Medicare is during your initial enrollment period (IEP). This period lasts for 7 months. It includes the month you turn 65, plus the 3 months before and the 3 months after.

If you sign up before your birth month, your benefits will start the month you turn 65. If you don’t, it starts up to 3 months later. That could mean you might not have health insurance for a short period.

Can you delay enrolling in Medicare?

The answer is yes, but there’s a big “but.” You may be able to put off signing up for Medicare if:

• You have insurance through a job and plan to work past age 65.
• You have insurance through your spouse’s job.

So, what happens if you retire or lose your spouse’s insurance? You will get an 8-month SEP. You can use this time to sign up for Medicare Part A and Part B. You can also get Medicare Part D or go with Medicare Advantage. But you only have the first 2 months to do so without paying a penalty.

Can you sign up for Medicare at any other time?

You can also sign up for Medicare Part B during the general enrollment period (GEP). That runs from January 1 to March 31 each year. That’s only if you missed your IEP and don’t qualify for an SEP. Your insurance would start on July 1, so you might not have insurance for several months.

If you sign up for Medicare Part B during the GEP, you can then sign up for Medicare Advantage or Part D from April 1 to June 30. Once you have Medicare Part B, you can also sign up for a Medigap plan.

Can you change your Medicare plan?

You can make changes to your Medicare plan without paying a penalty once a year. That happens during Medicare’s annual enrollment period (AEP). It runs from October 15 to December 7 every year. During the AEP, you can join, switch or drop your Medicare Advantage (Part C) or Part D plan. You can also return to Original Medicare (parts A and B).

If you’re already on a Medicare Advantage plan, you may have another chance to make changes. That happens during the Medicare Advantage open enrollment period. It runs from January 1 to March 31 each year. During this time, you can switch your Medicare Advantage plan or switch back to Original Medicare. (You can’t switch from Original Medicare to a Medicare Advantage plan.)

What if you delay signing up for Medicare?

If you turn 65 and don’t sign up for Medicare on time, it could cost you more money. You might have to pay more per month for Medicare Part A, Part B and Part D.

The rules are different, including what the penalty is, how long it lasts and how often you pay it:

• For Medicare Part A (if you owe a monthly payment): You’ll pay an extra 10% for twice the number of years you delay enrollment. Example: If you delay for 2 years, you’ll pay an extra 10% for 4 years.²
• For Medicare Part B: You’ll pay an extra 10% for each 12-month period you delay enrollment. You’ll have to pay that extra fee forever.³ Example: If you delay for 24 months, you’ll pay an extra 20%.
• For Medicare Part D: You’ll pay an extra 1% of your monthly bill for each month you delay signing up. You’ll have to pay that extra fee for as long as you have Part D. Example: If you delay for 12 months, you’ll pay an extra 12%.⁴

Summary

Medicare offers incredible health benefits, but it has specific rules. It has four parts, each with unique things it covers.

Take time to understand the dates, costs and coverage well before you turn 65. If you don’t sign up on time, you could have to pay fines, so be sure to set reminders.

For full information on Medicare and enrollment periods, go to medicare.gov or call 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week.

Sources:

1. Medicare.gov. Compare Medigap plan benefits. Accessed July 9, 2025.
2. Medicare.gov. Avoid late enrollment penalties. Accessed July 9, 2025.
3. Medicare.gov. What does Medicare cost? Accessed July 9, 2025.
4. Medicare.gov. How much does Medicare drug coverage cost? Accessed July 9, 2025.