Original Medicare (Parts A & B)

Original Medicare is the federal health insurance program that serves as the foundation for your coverage. Part A covers inpatient hospital stays, skilled nursing facility care, and hospice, while Part B covers outpatient medical services like doctor visits, lab tests, and preventive screenings. For 2026, most retirees pay a standard Part B premium of $202.90 per month, though this can be higher based on your income.

 

Quick Fact for 65+: If you are already receiving Social Security benefits when you turn 65, you are typically enrolled in Parts A and B automatically; if not, your Initial Enrollment Period begins three months before your 65th birthday month.

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Medicare Advantage (Part C)

Medicare Advantage is an "all-in-one" alternative to Original Medicare provided by private insurance companies. These plans bundle Parts A, B, and usually Part D (prescription drugs) into a single package, often including extra benefits like dental, vision, and fitness memberships. While these plans use provider networks (HMOs or PPOs), they feature a Maximum Out-of-Pocket (MOOP) limit that protects you from unlimited medical costs.

 

Quick Fact for 65+: In 2026, nearly 98% of Medicare beneficiaries have access to at least one Medicare Advantage plan with a $0 monthly premium (though you must still pay your Part B premium).

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Medicare Supplements (Medigap)

Medicare Supplement insurance, or Medigap, works alongside Original Medicare to "fill the gaps" in coverage, such as the 20% coinsurance or various deductibles. These plans offer the most freedom because they have no provider networks; you can visit any doctor or hospital in the country that accepts Medicare. Because your costs are largely covered by the supplement, this option provides the highest level of financial predictability.

 

Quick Fact for 65+: Your best time to buy a Medigap policy is during your one-time, 6-month Medigap Open Enrollment Period, which starts the month you are 65 and enrolled in Part B. During this window, companies cannot deny you coverage or charge more for pre-existing conditions.

 

Prescription Drug Plans (Part D)

Medicare Part D provides insurance coverage for your outpatient prescription medications through private insurers. You can get this through a standalone plan (to pair with Original Medicare or a Supplement) or as part of a Medicare Advantage plan. 2026 is a major year for Part D, as new laws have significantly lowered the maximum amount you have to pay at the pharmacy.

 

Quick Fact for 65+: Starting in 2026, there is a hard $2,100 annual out-of-pocket cap on all covered drugs. Once you hit this limit, you pay $0 for your covered prescriptions for the remainder of the calendar year.