{"id":48081,"date":"2022-01-13T16:16:41","date_gmt":"2022-01-13T21:16:41","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=48081"},"modified":"2026-01-13T11:42:02","modified_gmt":"2026-01-13T16:42:02","slug":"what-is-medicare","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/what-is-medicare\/","title":{"rendered":"What is Medicare?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Learning about Medicare options can feel overwhelming. Many aren&#8217;t sure where to begin. With several parts, plan options, and coverage stages, it can be difficult to know which method of receiving your benefits is the best for you. However, once you understand the basics of Medicare, choosing your coverage options will be much easier. This is a general overview to help you understand what Medicare is and what it will cover.<\/span><\/p>\n<h2 id=\"what-is-medicare\"><span style=\"font-weight: 400;\">What is Medicare?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Medicare is a government-run health insurance program. It helps pay for some of the costs of medical care, including doctor visits, inpatient hospital stays, outpatient services, and prescription drugs.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The initial eligibility age for Medicare is 65. Some people can get Medicare earlier if they are disabled or have specific conditions, like End-Stage Renal Disease (ESRD) that requires dialysis or Lou Gehrig&#8217;s disease (amyotrophic lateral sclerosis).<\/span><\/p>\n<h3 id=\"what-medicare-is-not\"><span style=\"font-weight: 400;\">What Medicare is <\/span><i><span style=\"font-weight: 400;\">not<\/span><\/i><\/h3>\n<p><span style=\"font-weight: 400;\">Medicare is an important safety net for seniors and people with disabilities. It helps pay for some healthcare costs, which can be expensive. However, it&#8217;s important to remember that Medicare does not cover all medical expenses. There may be out-of-pocket costs associated with doctor visits, hospital stays, procedures, or prescription drugs that you will still be responsible for.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medicare is also not a welfare program. To qualify for free Medicare Part A, you must have worked and paid Medicare taxes for at least 10 years to be eligible for benefits. However, you can still be eligible for Medicare Part A with less than 10 years of work history if you meet all other criteria, but you might have to pay a Part A premium. There are some exceptions, but this is the general rule.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Although similar in name, Medicare is not the same as Medicaid.<\/span><\/p>\n<h3 id=\"medicare-vs-medicaid\"><span style=\"font-weight: 400;\">Medicare vs. Medicaid<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Many confuse Medicare with Medicaid. Medicaid is a health insurance program primarily for low-income people who have limited resources, though, like Medicare, it also sometimes provides coverage for certain people with disabilities. It is the main source of healthcare coverage for many women, children, and families who are not eligible for Medicare.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">On the other hand, Medicare is for people 65 and older and people with certain disabilities. It is a health insurance program administered by the federal government that helps make medical care more affordable.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medicare and Medicaid are both government-run health insurance programs, but there are important differences in eligibility, costs, and coverage. For example, some Medicaid services that aren\u2019t covered by Medicare include routine dental care and optometry services.<\/span><\/p>\n<p><b>RELATED:<\/b> <a href=\"https:\/\/www.singlecare.com\/blog\/difference-between-medicare-and-medicaid\/\"><b>Compare Medicare vs. Medicaid<\/b><\/a><\/p>\n<h2 id=\"4-parts-of-medicare\"><span style=\"font-weight: 400;\">4 parts of Medicare<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Medicare has <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-parts\/\"><span style=\"font-weight: 400;\">four different parts,<\/span><\/a><span style=\"font-weight: 400;\"> with each covering a different set of medical costs.\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medicare-part-a\/\"><b>Part A:<\/b><\/a><span style=\"font-weight: 400;\"> Inpatient hospital stays, skilled nursing care, some home health care, and hospice care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medicare-part-b\/\"><b>Part B:<\/b><\/a><span style=\"font-weight: 400;\"> Doctor visits, lab tests, medical equipment, outpatient medical services, and some preventive care.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medicare-advantage\/\"><b>Part C:<\/b><\/a><span style=\"font-weight: 400;\"> Medicare Advantage plans are offered by private insurance companies approved by Medicare, covering all of the services listed in Parts A and B and typically Part D. It is a privately administered alternative to being enrolled in Original Medicare (Parts A and B).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medicare-part-d\/\"><b>Part D:<\/b><\/a><span style=\"font-weight: 400;\"> Prescription drug coverage<\/span><\/li>\n<\/ul>\n<h3 id=\"medicare-part-a\"><span style=\"font-weight: 400;\">Medicare Part A<\/span><\/h3>\n<p><b>Coverage: <\/b><span style=\"font-weight: 400;\">Part A covers hospital stays, skilled nursing facility care, home health, and hospice care.\u00a0<\/span><\/p>\n<p><b>Eligibility: <\/b><span style=\"font-weight: 400;\">You must be a U.S. resident who is eligible for Medicare. For premium-free Part A services, you must have worked and been paying your Medicare taxes for at least 10 years. Sometimes, eligibility may be based on your spouse\u2019s work history.\u00a0<\/span><\/p>\n<p><b>Costs: <\/b><span style=\"font-weight: 400;\">Part A is free for those who have worked and paid Medicare taxes for at least 10 years. If you\u2019ve worked less than 10 years, then you may have to pay a Part A premium, which could range from $311\u2013$565 in 2026. The Part A hospital deductible is $1,736 in 2026 for each benefit period. Part A coinsurance for days 61-90 of hospitalization is $434 per day. Coinsurance for 60 lifetime reserve days of hospitalization is $868 per day. However, these coinsurance costs may be covered if you have a Medigap policy.<\/span><\/p>\n<h3 id=\"medicare-part-b\"><span style=\"font-weight: 400;\">Medicare Part B<\/span><\/h3>\n<p><b>Coverage: <\/b><span style=\"font-weight: 400;\">Part B of Medicare helps seniors pay for some of the costs of doctor visits, outpatient care, durable medical equipment, and <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-part-b-drugs\/\"><span style=\"font-weight: 400;\">some prescriptions<\/span><\/a><span style=\"font-weight: 400;\"> administered by a healthcare provider. It also covers preventive services like cancer screenings.<\/span><\/p>\n<p><b>Eligibility: <\/b><span style=\"font-weight: 400;\">You must be a U.S. resident who is eligible for Medicare.\u00a0<\/span><\/p>\n<p><b>Costs: <\/b><span style=\"font-weight: 400;\">The monthly Part B premium for 2026 is $202.90. However, this may increase based on your income. The 2026 Part B deductible is $283, and coinsurance for covered services varies, though most services are covered at 80% with a 20% coinsurance.<\/span><\/p>\n<p><b>RELATED:<\/b> <a href=\"https:\/\/www.singlecare.com\/blog\/cost-of-medicare-part-b\/\"><b>How much does Medicare Part B cost?<\/b><\/a><\/p>\n<h3 id=\"medicare-advantage-part-c\"><span style=\"font-weight: 400;\">Medicare Advantage (Part C)<\/span><\/h3>\n<p><b>Coverage: <\/b><span style=\"font-weight: 400;\">Medicare Advantage is a private health plan that covers many of the services in Parts A and B. It is a privately-administered version of Medicare offered by insurance companies approved by Medicare. If you are enrolled in a Medicare Advantage plan, you are no longer enrolled in Original (fee-for-service) Medicare.<\/span><\/p>\n<p><b>Eligibility: <\/b><span style=\"font-weight: 400;\">To be eligible for Medicare Advantage, you must have Part A and Part B.\u00a0<\/span><\/p>\n<p><b>Costs: <\/b><span style=\"font-weight: 400;\">The average premium for Medicare Advantage in 2026 is $14 per month. You may have to pay a monthly premium, but not always. Some Medicare Part C plans don\u2019t have a monthly premium but may include a deductible and require a copay at the time of each appointment.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/compare-medicare-advantage-plans\/\"><b>Compare Medicare Advantage plans<\/b><\/a><\/p>\n<h3 id=\"medicare-part-d\"><span style=\"font-weight: 400;\">Medicare Part D<\/span><\/h3>\n<p><b>Coverage:<\/b> <a href=\"https:\/\/www.singlecare.com\/blog\/medicare-part-d-plans\/\"><span style=\"font-weight: 400;\">Part D<\/span><\/a><span style=\"font-weight: 400;\"> is not part of Original Medicare. It\u2019s optional coverage Medicare consumers can enroll in to pay for prescription drug costs.<\/span><\/p>\n<p><b>Eligibility: <\/b><span style=\"font-weight: 400;\">To be eligible for Medicare prescription drug coverage, you must be enrolled in Part A and\/or Part B.\u00a0<\/span><\/p>\n<p><b>Costs: <\/b><span style=\"font-weight: 400;\">The national base monthly premium for Part D is $38.99 per month in 2026 but varies by income. Not all Part D plans have a deductible, but some do. The maximum Part D deductible for 2026 is $615. Copays or coinsurance for covered drugs will vary by plan.\u00a0<\/span><\/p>\n<p><b>RELATED:<\/b> <a href=\"https:\/\/www.singlecare.com\/blog\/medicare-part-d-costs\/\"><b>Medicare Part D costs<\/b><\/a><\/p>\n<h2 id=\"what-isn-t-covered-by-medicare\"><span style=\"font-weight: 400;\">What isn\u2019t covered by Medicare?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Medicare covers many but not all medical services. Here&#8217;s a list of common services that Medicare likely won&#8217;t cover:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Long-term care like nursing homes or custodial care<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Eye exams and glasses*<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cosmetic surgery that is not medically necessary<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Routine dental care and dentures*<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Alternative therapies like acupuncture<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight loss programs<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hearing aids*<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">*<\/span> <a href=\"https:\/\/www.aha.org\/news\/news\/2021-10-29-house-consider-modified-reconciliation-bill-health-care-provisions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Medicare coverage of these items may change soon<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<h2 id=\"how-to-enroll-in-medicare-or-make-changes-to-your-plan\"><span style=\"font-weight: 400;\">How to enroll in Medicare or make changes to your plan<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There are a few different ways to enroll in Medicare coverage. Some will receive benefits automatically when they apply for or are receiving Social Security, while others will need to apply for coverage. You can also choose to enroll in Original Medicare (Parts A and B) or a Medicare Advantage plan (Parts A, B, and typically D administered through a private plan).<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/original-medicare-vs-medicare-advantage\/\"><b>Original Medicare vs. Medicare Advantage<\/b><\/a><\/p>\n<p><span style=\"font-weight: 400;\">The best time to sign up for Medicare is during the Initial Enrollment Period. This seven-month period starts three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">During this time, you can enroll in Medicare without penalty. After the Initial Enrollment Period ends, you may pay a permanent premium penalty for Part B and Part D coverage if you decide to sign up. You can delay Part B or Part D enrollment without penalty if you have creditable coverage. Late penalties may also be eliminated if you qualify for the Medicare Savings Program or Medicare Extra Help.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To make changes to Part A and B after initial enrollment, there is an<\/span> <a href=\"https:\/\/www.singlecare.com\/blog\/medicare-open-enrollment\/\"><span style=\"font-weight: 400;\">Open Enrollment Period<\/span><\/a><span style=\"font-weight: 400;\"> every year from January 1 to March 31. The Open Enrollment Period is from Oct. 15 to Dec. 7 to make changes to Part D.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can also enroll or make changes during Special Enrollment Periods when significant events impact your life. This includes events like losing your job or health coverage.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Many people who are covered by Medicare also have private health insurance. This is called &#8220;<\/span><a href=\"https:\/\/www.medicare.gov\/supplements-other-insurance\/how-medicare-works-with-other-insurance\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">coordination of benefits<\/span><\/a><span style=\"font-weight: 400;\">.&#8221; When you have two or more insurance plans, each plan pays a portion of the costs for covered services.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The plan that pays the most for a service is called the &#8220;primary payer.&#8221; The plan that pays second or pays some of the leftover costs is called the \u201csecondary payer.\u201d While the secondary payer helps cover what the primary payer doesn\u2019t, they may still not cover the entire amount. If a service isn\u2019t covered, neither plan pays. Sometimes Medicare is the primary payer, sometimes it\u2019s secondary, depending on a multitude of factors.<\/span><\/p>\n<h2 id=\"how-to-save-money-on-medicare-related-costs\"><span style=\"font-weight: 400;\">How to save money on Medicare-related costs<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There are other programs available that may help you save money on Medicare-related costs. Some of these programs include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/\"><b>SingleCare:<\/b><\/a><span style=\"font-weight: 400;\"> This free service offers discounts on medications. Compare pharmacy prices, get a free discount card, and save up to 80% on your medications at more than 35,000 nationwide pharmacies.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medigap\/\"><b>Medigaps:<\/b><\/a><span style=\"font-weight: 400;\"> Medigap policies are a type of private medical insurance that pays some Medicare costs associated with Part A and Part B services. These are also referred to as Medicare supplement insurance.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-savings-program\/\"><b>Medicare Savings Programs:<\/b><\/a><span style=\"font-weight: 400;\"> State programs that help pay for Medicare Part A or Part B premiums, deductibles, and coinsurance.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-extra-help\/\"><b>Extra Help:<\/b><\/a><span style=\"font-weight: 400;\"> Federal funds are available to low-income Medicare Part D recipients.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">For more information on these programs or to see if you&#8217;re eligible, please visit <\/span><a href=\"https:\/\/www.medicare.gov\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">medicare.gov<\/span><\/a><span style=\"font-weight: 400;\"> or contact your local Medicare office.<\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/es\/recursos\/que-es-medicare\"><span style=\"font-weight: 400;\">Lea este art\u00edculo en espa\u00f1ol aqu\u00ed.<\/span><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Learning about Medicare options can feel overwhelming. Many aren&#8217;t sure where to begin. With several parts, plan options, and coverage stages, it can be difficult to know which method of receiving your benefits is the best for you. However, once you understand the basics of Medicare, choosing your coverage options will be much easier. This [&hellip;]<\/p>\n","protected":false},"author":87,"featured_media":48083,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2],"tags":[16,15],"coauthors":[20704],"class_list":["post-48081","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-company","tag-medicaid","tag-medicare","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>What is Medicare? | SingleCare<\/title>\n<meta name=\"description\" content=\"Medicare is federal health insurance for seniors or younger people with certain disabilities. 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