1.      Part A: This is hospital/critical care insurance, so it covers inpatient visits to a hospital or skilled nursing facility. It also covers hospice and some part-time home health care. Please note that there are eligibility requirements for skilled nursing and home health care, and they don’t work as long-term solutions for people with chronic conditions. To cover those situations, you’ll need long-term care insurance.

Everyone who is eligible for Medicare is automatically enrolled in Part A. Generally, Part A has no monthly premium if you’ve worked long enough in the US.

2.      Part B: This is medical insurance, which covers doctor visits and outpatient services. It also covers items and services like ambulances, labs, diabetic supplies, ER visits, flu shots, screening mammograms, physical therapy, and tests, among other things.

You have to choose to enroll in Part B; it’s not automatic. Monthly premiums vary based on income, so with increased income you’ll pay a higher premium.

3.      Part C: This is also called Medicare Advantage, and these plans are offered by private insurance companies. Medicare Advantage is another option for getting Part A and B coverage, and the plans are required to cover everything Parts A and B cover. You’ve probably seen the ads on TV; they usually feature a lot of American flags and an older actor who must have run out of money. These plans often include prescription drug coverage, and some of them offer extras like hearing, vision, dental, and wellness programs.

Part C is optional, and it’s a great idea to work with a Medicare insurance broker to evaluate your options and choose the optimal plan for you, especially if you take prescription medications. Some Part C policies have no premium; others do have a monthly cost but include more perks.

4.      Part D: This covers prescription drugs. The Medicare drug programs are run by private companies, which have to offer coverage that meets or exceeds the standards set for Medicare.

Part D is also optional, so you have to sign up or make sure you have drug coverage in your Advantage plan. There is a monthly premium for Part D.

5.      Medigap/Medicare Supplement Plans: I feel I should say a few words about Medigap; even though it’s not technically one of the four basic parts of Medicare, it’s an add-on to Parts A and B. It is NOT the same as an Advantage plan/Part C, although it’s also provided by private insurance companies. Medigap is a secondary insurance policy which covers most or all of the costs Parts A and B don’t cover, like deductibles, copays, and coinsurance. With Medigap plans, you’re only supplementing Parts A and B, but with Advantage plans you’re replacing Parts A and B and adding some additional benefits.

1.        Initial Enrollment Period: This seven-month period starts three months before you turn 65, includes the whole month of your birthday, and continues for three months after your birthday. During this period, you enroll in both Parts A and B (Original Medicare), and optionally in Parts C and D and Medigap. If you want Medigap, enroll during this period or else the insurers can deny coverage, charge you more, and/or slap you with waiting periods.

You can legitimately delay your enrollment in Parts B and D if you or your spouse still has coverage that is as good or better than Medicare; for example, if you’re still working and have insurance through your employer. That would also mean you can delay enrollment in Part C, since it’s not a required option, anyway. But you should go ahead and enroll in Part A, since it’s typically free and enrollment won’t affect your existing coverage.

2.        Special Enrollment Period: If you delay your Initial enrollment as described above, you’ll get 63 days from the loss of your other coverage to sign up for the parts you delayed.

3.        General Enrollment Period: If you didn’t enroll in Original Medicare during the Initial Enrollment Period and you don’t have other coverage, your next chance to sign up would be each year between January 1 and March 31.

4.        Annual Enrollment Period: If you didn’t enroll in Part C/Medicare Advantage during your Initial Enrollment period, you can still add it from October 15 – December 7 every year. During this time, you can also add or make changes to your Part C and Part D, and Medigap plans.

But please note that you don’t have to keep signing up every year for each part of Medicare. You don’t have to re-enroll once you’ve done it the first time. But if you want to make changes to your plans, the Annual Enrollment Period is the time to do that.

5.        Penalties: This is the important part! Please understand that there are PERMANENT penalties for not enrolling in Parts A, B, and D during your Initial Enrollment Period, unless you do have other, qualifying coverage in place. Once your other coverage ends, you need to sign up for the rest of your Medicare package by the deadline, as outlined above. The longer you wait to sign up, the higher the penalty.

6.        How to Enroll: Have I put the fear of god into you? Good. When it’s time, go to the Medicare site to create an account for more information, and to keep track of your coverage once you enroll. For more information on signing up, Medicare also provides a page for getting started.   

7.        Costs: The cost of everything in the Medicare universe can vary over time and based on your income. Rather than go into a lot of detail, I’ll send you straight to the source so you can check based on your own situation.