Medicare
Federal health insurance for adults 65+ and some younger disabled individuals.
About This Program
Medicare is federal health insurance for people 65 and older and for people under 65 with certain disabilities (after 24 months of SSDI) or end-stage renal disease. It is not income-based — you qualify through age or disability status, not financial need. Medicare has four parts. Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people pay no premium for Part A if they or their spouse worked at least 40 quarters. Part B covers outpatient care — doctor visits, lab tests, preventive services, durable medical equipment, and outpatient procedures. The standard Part B premium in 2024 is $174.70 per month, though higher earners pay more. Part D covers prescription drugs and is offered through private insurance plans that contract with Medicare. Part C (Medicare Advantage) is an alternative way to receive Medicare benefits through a private insurer instead of original Medicare. Enrollment timing matters. Your Initial Enrollment Period starts 3 months before your 65th birthday and ends 3 months after. Missing it without having other qualifying coverage (like employer coverage) results in a late enrollment penalty on Part B premiums that lasts for life — 10% per year you delayed. If you are still working and covered by employer insurance at 65, you have a Special Enrollment Period after that coverage ends. Low-income Medicare beneficiaries should also look into Extra Help for Part D drug costs, Medicare Savings Programs that pay Part B premiums, and their state's Medicaid program, which can cover Medicare costs and provide additional benefits.
Eligibility Requirements
| Age | 65+, or under 65 with qualifying disability |
| Employment | 40 work credits (10 years) for premium-free Part A |
Frequently Asked Questions
What does Medicare cover?
Part A covers inpatient hospital stays, skilled nursing facility care after hospitalization, hospice, and some home health care. Part B covers outpatient services — doctor visits, preventive care, lab tests, durable medical equipment, and some drugs. Part D covers prescription drugs (separate enrollment). Parts A and B together are "Original Medicare."
What does Medicare NOT cover?
Original Medicare does not cover: routine dental care, routine vision, hearing aids, long-term custodial care (nursing home stays not preceded by hospitalization), most care outside the US, and most prescription drugs (Part D needed). Many Medicare Advantage (Part C) plans add some dental and vision coverage.
What is the Medicare Part B premium?
The standard Part B premium is $174.70/month in 2024 for most beneficiaries. Higher-income individuals pay more through IRMAA surcharges (up to $594/month). Part A is usually premium-free if you paid Medicare taxes for at least 10 years. Low-income Medicare recipients may qualify for Medicaid or Medicare Savings Programs to have the premium paid for them.
What is Medigap?
Medigap (Medicare Supplement Insurance) is private insurance that pays for Medicare's cost-sharing — deductibles, copays, and coinsurance. During your 6-month Medigap Open Enrollment Period (starting the month you turn 65 and enroll in Part B), you cannot be denied coverage or charged more due to health conditions. After this window, insurers can charge more or deny you.
Is Medicare free?
Part A is usually premium-free. Part B has a monthly premium (~$175/month in 2024). Part D (drug coverage) has a separate premium. Medicare Advantage plans often have $0 premiums but narrow networks. Medicare Savings Programs can pay some or all premiums for low-income beneficiaries — ask your state Medicaid office about MSP eligibility.
Related Programs
Extra Help (Medicare Part D Low Income Subsidy)
Help paying Medicare prescription drug costs for low-income beneficiaries.
Medicaid
Free or low-cost health coverage for low-income individuals and families.
Social Security Retirement
Monthly retirement income based on your work history.
State Pharmaceutical Assistance Programs (SPAP)
State programs that help pay prescription drug costs for low-income residents.
Eligibility requirements may have changed. Verify at the official source before applying.
Benefit Amount
Most pay $0 for Part A; Part B about $174/mo (2024)
Application Guide
How to Apply for Medicare →Category
SeniorsLast reviewed: May 2025