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Medicare Basics

New to Medicare? Start Here.

Medicare doesn't have to be confusing. Here's a straightforward overview of how it works, what the parts are, what they cover, and what you need to do when you turn 65.

Payton Knudson
Written by Payton Knudson, licensed Idaho Medicare agent Last reviewed

The Two Ways to Get Covered

Everything below comes back to this one choice. The difference is structural: one route is three separate policies you put together, the other is a single plan that holds everything.

You enroll in Part A and Part B
Path 1

Three pieces you put together

Original Medicare
Parts A and B. Hospital and doctor visits.
Medicare Supplement
Pays the deductibles and coinsurance Original Medicare leaves you.
Part D drug plan
Your prescriptions. Bought separately.
  • Any doctor in the country who takes Medicare
  • No networks and no referrals
  • Costs stay predictable when you use care
  • Higher premium every month
  • Dental, vision and hearing are not included
Path 2

One plan that holds it all

Medicare AdvantagePart C
One plan from a private insurer that replaces how you get Parts A and B.
  • Hospital and doctor visits
  • Prescriptions, in most plans
  • Often dental, vision and hearing
  • Often a $0 plan premium
  • Extra benefits most Supplements don't cover
  • A yearly cap on what you can pay out of pocket
  • You stay inside the plan's network
  • Benefits and networks change every year
Both paths start the same way, at Social Security. The difference is whether you assemble your coverage from separate policies or take one plan that bundles it. Neither is better on paper; it depends on your doctors, your prescriptions and how much you travel.

The Four Parts of Medicare

Part A, Hospital Insurance

Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most people don't pay a premium for Part A if they (or their spouse) worked and paid Medicare taxes for at least 10 years.

2026 Part A costs: $1,736 deductible per benefit period. Coinsurance applies for longer hospital stays.

Part B, Medical Insurance

Pays for doctor visits, checkups, and care you get without staying overnight. Part B has a monthly premium. The standard amount in 2026 is approximately $202.90/month, though it can be higher based on income (IRMAA).

2026 Part B costs: ~$202.90/month premium, $283 annual deductible, then 20% coinsurance for most services.

Part C, Medicare Advantage

Another way to get Medicare, run by private insurers. It covers what Parts A and B cover. It usually adds Part D drug coverage, and often includes dental, vision, and hearing. You must be enrolled in Parts A and B to join a Medicare Advantage plan.

Part D, Prescription Drugs

Standalone prescription drug coverage for people on Original Medicare. Offered by private insurance companies approved by Medicare. Plans vary by which drugs they cover and what you pay. The out-of-pocket cap for 2026 is $2,100.

When Do You Need to Enroll?

Your Initial Enrollment Period (IEP) is a 7-month window: the 3 months before your birthday month, your birthday month, and the 3 months after. Missing this window can mean late enrollment penalties and gaps in coverage.

Still working at 65 with health coverage from your job? You may be able to put off Medicare without a penalty, but the rules are specific. Get advice before assuming you can wait.

What You Should Do Before You Turn 65

  1. Sign up for Medicare Parts A and B here, through Social Security, or call 1-800-772-1213
  2. Gather your list of current medications and the doctors you want to keep
  3. Speak with a licensed Medicare agent (like us) to compare plan options in your county
  4. Enroll in your chosen coverage before your IEP window closes

See all six steps, in order

⚠️ Idaho residents: Check your state programs Idaho has several programs (QMB, SLMB, QI) that can help lower-income residents pay for Medicare costs. Idaho SHIP (Senior Health Insurance Benefits Advisors) also offers free, unbiased counseling. Call Idaho SHIP at 1-800-247-4422.

Turning 65 Soon?

Start the conversation 3–6 months before your birthday month. Plans need time to process enrollment.

Schedule a Free Call (208) 897-2228

By calling you will be connected to a licensed insurance agent. Calls are recorded.

Learn More

Ready to Find the Right Medicare Plan?

Medicare enrollment windows have strict deadlines. Speak with a licensed Idaho agent today, it's completely free.

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(208) 897-2228 By calling the number above, you will be connected to a licensed insurance agent. Calls are recorded.
Annual Enrollment Period: Oct 15 – Dec 7  ·  Available year-round
Where these numbers come from

Every figure on this page comes from an official source, not from us. Check any of them yourself:

If anything here ever disagrees with Medicare.gov, Medicare.gov is right and we want to know about it. Call us at (208) 897-2228.

Call (208) 897-2228