Medicare: The Least You Need to Know

Congratulations, you’ve made it to 65! Or sorry, you have been getting Social Security Disability for two years. Either way, you are now eligible for Medicare (usually.) But what exactly are you eligible for?

Medicare is a Federal program that provides health care to the aged and disabled and those with End Stage Renal Disease (ESRD). It has four parts. Part A is hospital insurance, and it’s usually free. Part B is for medical expenses other than hospitals or prescription drugs, and it costs $135.50 per month in 2019 for most people.

If you want more benefits for (maybe), no more money, you can enroll in Part C – the Medicare Advantage Plans. These replace parts A and B and usually offer additional benefits like prescription drugs, eyeglasses, hearing aids, and, starting in 2019, in-home assistance, meals, and modifications of the home for disabilities. Part D is for prescription drugs, for which parts A and B provide very limited coverage.

How Should I Choose?

Medicare Parts A and B have co-payments, deductibles, and no out-of-pocket limits. Each co-payment and deductible are relatively small, but they can add up to hundreds of thousands in the case of serious illness. Medicare Advantage plans, in contrast, have an out-of-pocket limit, which varies from plan to plan but is usually around $6,500 per year.

A Medicare Supplement Plan (“Medigap”) will cover many of the co-payments and deductibles but does not have extra benefits the way a Medicare Advantage plan does. Nor do they have out-of-pocket limits.

Which plan to pick is a very individual decision. If you are relatively healthy, Original Medicare (Parts A and B) may be all you need. If you regularly take prescription drugs, you should add Part D unless you take only a few very cheap drugs. If you have predictable higher health expenses (you have a chronic condition, for example), you would be well advised to consider a Medicare Advantage Plan. Some have specific plans that are focused on various chronic conditions.

Buying Medicare

If you are not eligible for “free” Medicare based on a limited work history but have paid Medicare taxes for at least 30 quarters, you will be able to buy Parts A and B for a premium that will range from $375.50 to $572.50 in 2019. This is a bargain compared to commercial insurance. If you have parts A and B under this provision, you are eligible to buy Part C, possibly with no additional premium. You are also eligible to buy Part D, for a premium that varies from plan to plan but is typically around $35 per month.

Premiums for Medicare Advantage Plans range from zero to the high $300s per month, depending on where you live and what the plan covers. Premiums for Medicare supplemental plans (“Medigap”) vary a great deal.

You can obtain more information at or by contacting a health insurance broker who represents multiple plans. is not associated with the federal government. All plan information provided on this site is collected from public sources (e.g.,, carrier's website, plan brochures, etc.). Rates shown are for comparison purpose only. Contact your Medicare agent or for a binding quote.