Quick answer
Most older Americans get health insurance through Medicare starting at 65. Original Medicare (Parts A and B) covers hospital and doctor care, and you can add a Part D drug plan and a Medigap policy, or choose an all-in-one Medicare Advantage plan instead. People with limited income can get help from Medicaid, Medicare Savings Programs and Extra Help. Medicare doesn’t cover long-term custodial care, so plan for that separately.
Key takeaways
- Sign up during the 7-month window around your 65th birthday to avoid lifelong late penalties.
- In 2026, Part B costs $202.90 a month with a $283 deductible; most people pay no Part A premium.
- Part D caps out-of-pocket drug costs at $2,100 in 2026 ($2,400 in 2027), and insulin costs no more than $35 a month.
- Your best time to buy Medigap is the 6 months after you turn 65 and enroll in Part B, when insurers can’t turn you down. See Medicare Advantage vs. Medigap.
- If you’re still working at a company with 20 or more employees, you may be able to delay Part B without a penalty.
On this page
The parts of Medicare
| Part | What it covers | 2026 costs |
|---|---|---|
| Part A | Hospital stays, skilled nursing after a hospital stay, hospice, some home health care | Usually no premium. $1,736 deductible per benefit period |
| Part B | Doctor visits, outpatient care, tests, equipment, preventive care, mental health care | $202.90 a month. $283 deductible, then usually 20% |
| Part C (Medicare Advantage) | Private plans that replace Parts A and B, usually with drug coverage and extras | Varies by plan. Networks apply |
| Part D | Prescription drugs | Varies by plan. Out-of-pocket costs capped at $2,100 |
See who is eligible for Medicare for eligibility and enrollment. Medicare Part B covers outpatient mental health care, including therapy; see does health insurance cover therapy. Original Medicare sends a Medicare Summary Notice, its version of an explanation of benefits.
Original Medicare or Medicare Advantage?
- Original Medicare plus Medigap and Part D lets you see any doctor who accepts Medicare nationwide. Medigap covers most of your deductibles and coinsurance, so costs are predictable, but you pay three premiums.
- Medicare Advantage often has low or no extra premium and adds benefits like dental and vision, but you use the plan’s network and may need prior approval for care.
You can switch during Medicare’s open enrollment, October 15 to December 7 each year. Buying a Medigap policy later than your first 6 months can be hard, since insurers in most states can then check your health. For what to review this fall, see Medicare open enrollment: what to check.
Help with costs
- Medicare Savings Programs help pay Part B premiums and sometimes deductibles and coinsurance for people with limited income and savings.
- Extra Help lowers Part D premiums and drug costs.
- Medicaid covers people with low incomes and assets, including many nursing home residents. People with both are called dual eligibles.
See health insurance discounts for more ways to save. Some people also buy plans offered through AARP; see can I get health insurance through AARP.
If you’re still working at 65
If you have coverage through your own or your spouse’s current job at a company with 20 or more employees, that plan pays first and you can usually delay Part B without a penalty. You then get 8 months after the job or coverage ends to sign up. At a smaller company, Medicare pays first, so you generally need Parts A and B. Before dropping your employer’s plan, compare costs and check how a spouse on your plan would be covered.
Before 65: retiring early
If you retire before 65, you’ll need coverage until Medicare starts: retiree coverage, COBRA, a spouse’s plan, or a marketplace plan with a tax credit based on your income. See can I get health insurance if I retire early.
Long-term care
Medicare covers up to 100 days in a skilled nursing facility after a hospital stay of at least three days, with a $217-a-day copay for days 21 to 100 in 2026. It doesn’t pay for ongoing help with daily activities in a nursing home or at home. See will health insurance pay for a nursing home and long-term care insurance.
Related guides: the Medicare Part B premium and IRMAA, Medigap Plan G vs. Plan N and health insurance for a 64-year-old.
Under 65 and need coverage until Medicare? Compare plans by ZIP code.
Frequently asked questions
What’s the late penalty for Medicare?
If you delay Part B without other qualifying coverage, your premium goes up 10% for each full 12 months you waited, for as long as you have Part B. Part D has its own late penalty.
Is Medicare Advantage better than Original Medicare?
It depends on your doctors, budget and how much you travel. Advantage plans can cost less up front but limit you to a network. Original Medicare with Medigap costs more in premiums but lets you see any doctor who takes Medicare.
Does Medicare cover dental, vision and hearing?
Original Medicare generally doesn’t cover routine dental care, eyeglasses or hearing aids. Many Medicare Advantage plans include some coverage.
Sources
This article is general information, not insurance advice. For free, unbiased Medicare help, contact your State Health Insurance Assistance Program. Last reviewed September 2026.