Who is eligible for Medicare?
Most people first become eligible at 65. Medicare can also begin earlier after certain periods of disability or for people with specific medical conditions. Eligibility does not always mean you should enroll in every part immediately—active employer coverage can change the timing.
The parts of Medicare
Part A · Hospital insurance
Part A helps cover inpatient hospital care, skilled nursing facility care after a qualifying stay, hospice, and certain home health services. Most beneficiaries do not pay a monthly Part A premium because they or a spouse earned enough work credits.
Part B · Medical insurance
Part B helps cover physician services, outpatient care, preventive services, durable medical equipment, and other medically necessary services. It normally has a monthly premium, an annual deductible, and coinsurance.
Part C · Medicare Advantage
Part C is another way to receive Part A and Part B benefits through a private Medicare-approved insurer. Many plans include Part D and additional benefits. Networks, prior authorization, copays, and service areas can apply.
Part D · Prescription drug coverage
Part D is outpatient prescription drug coverage offered by private Medicare-approved plans. Formularies, preferred pharmacies, premiums, and cost sharing vary by plan and can change each calendar year.
What Original Medicare does not fully cover
- Original Medicare has no annual out-of-pocket maximum.
- Routine dental, routine vision, and hearing aids are generally not covered.
- Most long-term custodial care is not covered.
- Prescription drugs taken at home generally require Part D coverage.
- Foreign travel coverage is limited.
Enrollment periods to know
| Period | Timing | What it is for |
|---|---|---|
| Initial Enrollment | 7 months around age 65 | Your first opportunity to enroll in Medicare |
| Annual Election | Oct. 15–Dec. 7 | Changes to Medicare Advantage and Part D for the next year |
| Medicare Advantage Open Enrollment | Jan. 1–Mar. 31 | One change for people already enrolled in Medicare Advantage |
| General Enrollment | Jan. 1–Mar. 31 | Part A/Part B enrollment when another period is unavailable |
| Special Enrollment | Depends on event | Enrollment after qualifying coverage or life events |