Call SelectQuote
Work with one of our licensed insurance agents to get answers to your Medicare questions, unbiased comparisons of coverage and resources to simplify the entire process. Call 1-833-574-3011 (TTY: 1-877-486-2048) to get started.
Speak to a Licensed Sales Agent! Hours: Mon-Thur 7am-8pm; Fri 7am-7pm; Sat 9am-5pm; Sun 10am-3pm CT
Find the coverage that’s right for you.
SelectQuote’s licensed insurance agents can help you review your Medicare Advantage plan options in just minutes. It’s free and there’s no obligation to enroll.
No obligation to enroll
Understanding Medicare Plans and What They Cover
Taking the first steps toward learning about Medicare plans can be overwhelming—there are many terms to understand and options to consider, so it’s completely understandable if the handbooks and pamphlets have left you dazed and confused. The good news is that we’re here to help you cut through the clutter of Medicare plans.
In just minutes, we can compare Medicare Advantage plan options that may be available to you.
No obligation to enroll
What is Original Medicare?
Original Medicare—a federal health insurance program—helps pay for a variety of health care expenses and services such as hospitalizations, physician visits, prescription drugs, preventive services, skilled nursing facility care, home health care, and hospice care. It was created in 1965 for people ages 65 and over, regardless of income, medical history, or health status. In 1972, the program expanded to cover those under age 65 with certain health conditions. Original Medicare is administered by the Centers for Medicare and Medicaid Services (CMS), a division of the U.S. Department of Health and Human Services (HHS). Like Social Security, Original Medicare is an entitlement program, with most U.S. citizens aged 65 and older eligible to receive Medicare Part A (hospital insurance). Individuals and their spouses qualify if they are eligible for Social Security payments and will not have to pay a premium for Part A if they paid payroll taxes for a certain amount of time, typically at least 10 years. If you didn’t work long enough to be entitled to Original Medicare benefits, you still may be eligible to enroll, but you may be subject to additional costs. People under the age of 65 who receive Social Security Disability Insurance (SSDI) payments generally become eligible for Original Medicare after a two-year waiting period, while those diagnosed with end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS) become eligible for Original Medicare with no waiting period.
The Parts of Medicare Insurance
The Medicare program has four different parts. Original Medicare consists of Medicare Part A and Part B, while Medicare Part C plans are offered through private companies approved by the program. Medicare Part D offers coverage for prescription drugs.
Original Medicare: Part A and Part B
Original Medicare is made up of Part A (hospital insurance) and Part B (medical insurance). Many physicians accept Original Medicare, but not all, so you need to confirm this when you make an appointment with your doctor. People who choose Original Medicare may also want to add Part D (prescription drug coverage) to round out their Medicare coverage needs. It is important to understand that Part B of Original Medicare only pays for about 80% of all healthcare costs, so it’s important to consider options to cover the gap.
Medicare Advantage: Part C
Medicare Part C plans are approved by the Medicare program and sold through private insurers. These plans are known as Medicare Advantage plans and must legally offer the same benefits as Original Medicare, but may include additional potential routine benefits. The costs and coverage from Medicare Advantage plans will vary depending on the private insurer you purchase from.
Medicare Prescription Drug Plan: Part D
Medicare Part D is a stand-alone drug plan offered through private insurers that will cover most of your outpatient prescription medications. Keep in mind that if you choose a Medicare Advantage plan instead of Original Medicare, the benefits of Part D may be incorporated into your Medicare Advantage plan.
What are Medicare Supplement Insurance plans?
Because Original Medicare doesn’t cover every expense, many people add a
(also called a Medigap plan) for extra coverage.In most states, there are currently eight Medicare Supplement Insurance plans available through private insurers. Each plan—which is standardized across all the states offering it—has a letter designation: A through N. Keep in mind that not all supplement plans are offered by every private insurer, and private insurers set their own premium rates, so it’s important to shop around.
Enrolling in Original Medicare
You can enroll in Original Medicare during the Initial Enrollment Period (IEP), which begins three months before and ends three months after your 65th birthday. Individuals on Social Security Disability Insurance (SSDI) become eligible for Original Medicare in the 25th month of SSDI benefits and are automatically enrolled in the program by Social Security. Some people may be eligible for Special Enrollment Periods based on their employment history or other health insurance coverage they have. Learn More About Enrolling in Medicare
Things to Keep in Mind
If You're Still Employed
Once you turn 65, Medicare is considered your primary insurer, making other insurance companies your secondary. This is true even if you haven’t applied for Original Medicare yet. It’s also true even if you have retiree health insurance, individual health insurance, or COBRA. It’s important to understand how Original Medicare coverage works if you’re still employed because it means you might not be able to count on your other forms of insurance to pay for your hospital or doctor’s office bills once you turn 65.
If You Miss Your Enrollment Period
If you miss the Initial Enrollment Period (IEP), you can still sign up for Medicare plans during the General Enrollment Period, which runs from January 1 to March 31. People who sign up during the General Enrollment Period will be eligible for coverage the following July. Late enrollment penalties typically apply to people who miss their Initial Enrollment Period. Depending on the Medicare plan you apply for, these penalties can vary from 10% for every 12 months you delay enrollment to 1% per month.
If You’re Taking Social Security
If you’re on Social Security (which you can begin at age 62), then you should be automatically enrolled in Medicare Part A and/or Part B when you turn 65. However, you should check to confirm that this is true—either by contacting Social Security or the Medicare program—or you may incur a late enrollment penalty.
If You and Your Spouse are Both Eligible
Original Medicare is an individual benefit, so each member of your family needs to apply for Original Medicare separately. There are no family Medicare plans.
If You’re a High Earner
If you choose Original Medicare and your income is above a certain threshold, you’ll pay more for Parts B and D. Premiums for both parts can come with a surcharge when your adjusted gross income (plus tax-exempt interest) is more than:
- $106,000 if you are single
- $212,000 if married and filing jointly
If You Might Need Long-Term Care Soon
Those new to Original Medicare (and even some who’ve been enrolled for a while) are sometimes surprised to learn that Original Medicare generally does not cover long-term care. However, there are certain circumstances where services related to long-term care may be covered. One example is services needed after a hospitalization from an acute-care event. In this case, Original Medicare will pay for medically necessary skilled nursing facility (SNF) or home health care. However, “custodial care” services that help you with the activities of daily living, like dressing and bathing, are not covered.
If You’re Concerned About Claim Rejections
There may be an occasion when you don’t agree with an Original Medicare health plan decision about your coverage or payment. In this case, you’re entitled to file an appeal. There are five levels to the appeals process, some of which are settled at lower levels and others taking more time. Be sure to present as much relevant information as you can when you first make your appeal—your physician can help. It’s also important to collect any relevant hospital records or information from other providers and/or suppliers. In situations where a decision needs immediate attention, you can request a fast-track decision, which must be made within 72 hours. However, this requires the agreement of your doctor and/or your Medicare plan.
How can I better understand my Medicare plan options?
We specialize in helping consumers understand the ins and outs of Medicare plans. We can help you understand the possible benefits that may be available to you. In just minutes, we can compare Medicare Advantage plan options that may be available in your area. It’s free and there’s no obligation to enroll.
No obligation to enroll
We do the shopping. You do the saving.
No obligation to enroll
SelectQuote Senior Insurance Services is a division of SelectQuote Insurance Services. © 2025 SelectQuote Senior Insurance Services. All rights reserved.
Please see the Disclosures Page for more information.
MULTI-PLAN_SQSRW2026_M
Looking for an affordable Medicare plan? Let us help.
We’ll call you.
If you’re pressed for time, complete this form and a member of our team will call you at your selected time.