Medicare 101 At A Glance
Hospital insurance
Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. Most people pay no premium for Part A.
Medical insurance
Covers doctor visits, outpatient care, X-rays, lab tests, durable medical equipment, and preventive services. Requires a monthly premium.
Medicare Advantage
Private plans that bundle Parts A and B — and usually D — into one plan. Often includes extra benefits like dental, vision, hearing, and fitness.
Prescription drug coverage
Covers brand-name and generic prescription drugs. Sold as a standalone plan or included in many Medicare Advantage plans.
Eligibility & Enrollment Periods
Medicare eligibility
Age 65+, U.S. citizens or lawful residents, or under 65 with qualifying disabilities or certain conditions.
Initial Enrollment Period (IEP)
A 7-month window — 3 months before your 65th birthday, your birthday month, and 3 months after.
Annual Enrollment Period (AEP)
Oct 15 – Dec 7 annually. Make changes to your Medicare Advantage or Part D plan for the following year.
Special Enrollment Period (SEP)
Triggered by qualifying life events: moving, losing employer coverage, qualifying for Medi-Cal, or plan termination.
Becoming a Medicare Member: Step 1
Enroll in Original Medicare through Social Security
You enroll in Medicare Part A & B through Social Security. This step-by-step guide from the Social Security Administration shows you how to set up your online account at ssa.gov.
Late Enrollment = Penalty Fees
Missing your Medicare enrollment window can add a penalty to your Part B premium for as long as you have Medicare.
How to calculate the Part B late enrollment penalty
- Added to your monthly premium, not a one-time fee
- Usually charged for as long as you have Medicare
- Goes up 10% for every full year you went without creditable coverage
2026 example: 10% × $202.90 = $20.29 × 5 years = $101.45 more every month. Use the fillable calculator to figure out your own.
Know Your Medicare Options
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