Coverage Basics
How hospital cover and medical cover fit together, and what each side pays for.
Read on
Coverage rules, dates and costs pile up fast. Read them here one piece at a time, in the order they matter, with nobody selling you anything.
Everything here is written by me, in plain words, for the stretch when Medicare feels like too much to take in at once. Nothing is a sales pitch, and nothing moves faster than you want it to.
I keep every page to one idea, so you can stop halfway, think it over, and pick up the next piece whenever you are ready for it.
How hospital cover and medical cover fit together, and what each side pays for.
Read onWhich months matter when you first sign up, and what a missed window leads to.
Read onHow prescription cover gets added, and why the drug list on each plan matters.
Read onInpatient hospital stays, skilled nursing after a stay, and hospice care.
Doctor visits, outpatient care, lab tests, and medical gear used at home.
Private plans that deliver Part A and Part B, often with extras added on.
Prescription cover bought on its own, each plan holding a set drug list.
Take them in order. Each one trims the list a little, so the last call is a much smaller one than it looks from where you are standing now.
Write down the doctors you see, the medicines you take and the treatment you already know is coming this year.
Start with what Part A and Part B pay for, then look at how Part C and Part D change or add to that base.
Drop any coverage that leaves out your doctor or your pharmacy, then compare the few that are left side by side.
Not in every case. If a job still covers you, Part B can often wait without a late fee later on. How that works depends on the size of the employer, so check yours before your birthday month goes by.
Part C changes the way Part A and Part B reach you, usually through a network of doctors. A supplement sits beside Original Medicare and picks up part of the share you would owe. You take one road or the other.
Yes, inside set windows. Most switches happen during the autumn stretch each year. Certain events open a window of their own, such as moving to a new address or losing health cover through a job.
Original Medicare leaves out routine dental, vision and hearing care. Some Part C plans fold in a limited version of those benefits, so read what the plan documents actually promise rather than the advert.
Part B carries a monthly premium that is reset each year, and higher past income can raise it. Deductibles and copays sit on top of that, and they differ by the coverage route you end up taking.
Save your place, mark what still needs a second look, and come back to the rest of Medicare whenever the time suits you.