Medicare explained for families: Parts A, B, C, D and Medigap, step by step

Sign up during the 7-month Initial Enrollment Period: the 3 months before your 65th birthday month, that month and the 3 months after. Signing up before the birthday month lets Part A and Part B start on time. Use the date finder above to see the months.

Many people who already get Social Security retirement or disability benefits at least 4 months before turning 65 are enrolled automatically, and Railroad Retirement benefits have their own automatic-enrollment rules. The welcome packet and card arrive about 3 months ahead. If you’re not sure, confirm with Social Security or the Railroad Retirement Board; others need to apply.

It depends on the employer. If you (or your spouse) have coverage from current work and the employer has 20 or more employees, the job plan usually pays first and you may be able to delay Part B. If the employer has fewer than 20 employees, Medicare usually pays first, so you may need Part A and Part B. Ask the benefits office.

No. COBRA and retiree coverage are not coverage from current work. Signing up late because of them can lead to a Part B late penalty. You have 8 months after the job or job coverage ends, whichever comes first, to sign up without a penalty.

Your monthly Part B premium goes up 10% for each full 12-month period you could have had Part B but didn’t sign up, unless you qualified for a Special Enrollment Period. You usually pay it for as long as you have Part B.

You don’t have to join, but if you go 63 days or more in a row without Medicare drug coverage or other creditable drug coverage after your first window, you may pay a Part D late penalty for as long as you have drug coverage. Many people choose a low-cost plan to avoid it.

The October 15 to December 7 Open Enrollment period itself doesn’t let you sign up for Part A or Part B; it is for people who already have Medicare to change drug or Medicare Advantage plans. But you can still sign up during those dates if your own Initial or Special Enrollment Period falls then, and premium-free Part A has separate timing rules. Otherwise, check whether the General Enrollment Period (January 1 to March 31) applies.

Most people pay no Part A premium if they or a spouse worked and paid Medicare taxes for about 10 years. Part B is $202.90 a month in 2026 (more with higher income), with a $283 yearly deductible and usually 20% coinsurance after that. Part D, Medigap and Medicare Advantage plans add their own premiums.

Medigap is an add-on to Original Medicare that pays some or all of your share of costs. Medicare Advantage replaces how you get your Part A and Part B coverage with one private plan, usually with a network and its own copays. You use one or the other, not both.

Medigap can’t pay any Medicare Advantage deductibles, copays, coinsurance or premiums. If you already had a Medigap policy, you have a legal right to keep it after joining Advantage, but you would pay its premium for coverage you can’t use. If you drop it, you may not be able to get the same policy back later.

During your one-time 6-month Medigap Open Enrollment Period, which starts the first month you have Part B and are 65 or older. In that window an insurer can’t refuse you or charge more because of your health.

After your Medigap Open Enrollment Period, and outside other guaranteed situations, insurers in most states can ask health questions and may refuse to sell you a policy or charge more.

Both cover the Part A deductible and Part B coinsurance. Plan G also pays Part B excess charges. Plan N usually costs less each month, but you pay up to $20 for some office visits, up to $50 for some emergency room visits and any excess charges.

With Original Medicare you can see any doctor in the U.S. who accepts Medicare. Medicare Advantage plans usually have networks, so check that your doctors and hospital are in the plan before you join.

Original Medicare doesn’t cover most routine dental care, eyeglasses or hearing aids. Many Medicare Advantage plans offer some of these extras; check what each plan includes.

Medicare covers short-term skilled nursing care after a qualifying hospital stay, not long-term custodial care such as help with bathing and dressing in a nursing home. Medigap doesn’t cover long-term care either.

Original Medicare generally doesn’t pay for care outside the U.S. Several Medigap plans (C, D, F, G, M and N) pay 80% of emergency care abroad up to plan limits. Medicare Advantage plans set their own rules.

Yes: after 24 months of disability benefits, right away with ALS, or with permanent kidney failure that needs dialysis or a transplant, when work-history or benefit rules are met.

They can usually sign up from January 1 to March 31, with coverage starting the next month. A late enrollment penalty may be added to the Part B premium for as long as they have Part B, unless they had qualifying coverage from current work.

Sit with them to sign up online with Social Security or call together. List their medicines, doctors and pharmacy before comparing plans each fall. Medicare can only discuss their account with you if they give permission. Keep their cards and plan letters where the family can find them.

Your State Health Insurance Assistance Program (SHIP) offers free counseling. Find your local SHIP at shiphelp.org or call 1-800-MEDICARE (1-800-633-4227).