Medicare

Original Medicare includes Part A and Part B and is administered by the federal government. You can generally see any provider nationwide who accepts Medicare. You may also choose a Medicare Supplement (Medigap) policy to help with certain out-of-pocket costs and a separate Part D plan for prescription drug coverage.

Medicare Advantage (Part C) plans are offered by private insurance companies approved by Medicare. They provide your Part A and Part B benefits and often include prescription drug coverage and additional benefits. Plan networks, costs, and benefits vary.

Neither option is automatically better—the right fit depends on your doctors, prescriptions, budget, travel habits, and healthcare needs.

Medicare Supplement insurance, also called Medigap, works alongside Original Medicare to help pay certain costs that Part A and Part B don't cover, such as deductibles, copayments, and coinsurance, depending on the plan.

Medigap does not replace Original Medicare, and policies sold today do not include prescription drug coverage. If you need prescription coverage, you can enroll separately in a Medicare Part D plan.

Medicare Part D is prescription drug coverage offered by private insurance companies that contract with Medicare.

With Original Medicare, you can purchase a standalone Part D plan. Many Medicare Advantage plans include Part D coverage within the plan.

Each plan has its own formulary, or list of covered medications, as well as its own costs and pharmacy network. That's why comparing your actual prescriptions can be just as important as comparing premiums.

For most people becoming eligible at 65, the Initial Enrollment Period lasts seven months: the three months before the month you turn 65, your birthday month, and the three months afterward.

There are also other enrollment periods for certain circumstances, including Special Enrollment Periods for qualifying situations. Medicare Advantage and Part D have additional periods when eligible beneficiaries can make certain changes.

Your timing matters because enrolling late in certain parts of Medicare can result in coverage gaps or late-enrollment penalties.

Not necessarily. Whether you should enroll at 65 can depend on the type of health coverage you have through your employer or your spouse's employer, including the size of the employer and whether that coverage is considered creditable.

This is one situation where it’s especially important to understand the rules before declining or delaying Medicare, because the wrong decision can potentially result in penalties or gaps in coverage later.

Original Medicare by itself generally does not provide comprehensive outpatient prescription drug coverage. You can add a standalone Part D prescription drug plan, or choose a Medicare Advantage plan that includes prescription drug coverage.

Because plans can cover medications differently, it’s important to check your specific prescriptions rather than assuming they're covered.

It depends on the coverage you choose.

With Original Medicare, you can generally use any doctor or hospital in the United States that accepts Medicare. Medicare Advantage plans may use provider networks, and the rules for seeing providers outside the network vary by plan.

Checking your preferred doctors and specialists should be one of the first steps when comparing your options.

Often, yes—but when and how you can change coverage depends on the type of coverage and your circumstances.

Medicare provides specific enrollment periods when beneficiaries can make certain changes to Medicare Advantage and Part D coverage. Medigap works differently: depending on when you apply and your state, you may have to answer health questions or go through medical underwriting.

That's one reason it's worth considering both your current needs and how your coverage may work for you longer term.