01
Medicare foundations
What Parts A, B, C, and D cover and how they fit together.
Explore this topicMedicare Learning Center
Understand Medicare.
Make decisions with confidence.
A plain-language education center for the questions people actually ask—organized so you can learn in small, useful steps.
Learning path
Build your understanding one topic at a time.
Follow the lessons in order or go directly to the subject that matters today.
02
Enrollment periods
The main times you may enroll, review coverage, or make a change.
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Choose a coverage path
Original Medicare with Medigap and Part D versus Medicare Advantage.
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Understand the costs
Premiums, deductibles, copays, coinsurance, and annual limits.
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Prescription coverage
Why formularies, tiers, pharmacies, and annual changes matter.
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Special situations
Chronic-condition, dual-eligible, veteran, and employer-coverage questions.
Explore this topicEnrollment periods
The calendar matters.
These are common enrollment periods. Special enrollment rights may apply, so confirm the rules for your situation before acting.
Initial Enrollment Period
A seven-month period generally beginning three months before your 65th-birthday month and ending three months afterward.
General Enrollment Period
For certain people who did not enroll in Part A or Part B when first eligible. Coverage generally starts the following month.
Annual Enrollment Period
Review or change Medicare Advantage and Part D coverage for the following year.
Special Enrollment Periods
Events such as losing employer coverage, moving, or eligibility changes may create another opportunity to enroll or change coverage.
Two coverage paths
Same Medicare foundation. Different ways to organize coverage.
Original Medicare
Part A and Part B through the federal Medicare program.
- May add a Medicare Supplement policy
- May add a separate Part D plan
- Generally broad access to Medicare-participating providers
- No annual out-of-pocket maximum under Original Medicare alone
Medicare Advantage
Part A and Part B benefits administered by a private Medicare-approved plan.
- Often includes Part D coverage
- Uses plan networks and coverage rules
- Includes an annual medical out-of-pocket maximum
- May include additional dental, vision, hearing, or wellness benefits
Cost vocabulary
A low premium does not always mean low total cost.
Estimate what you may pay across the entire year, including premiums, deductibles, visits, hospital care, prescriptions, and less predictable medical needs.
For Medicare Advantage, review the medical maximum out-of-pocket amount. For Original Medicare, understand what is—and is not—limited without supplemental coverage.
Prescription checklist
Drug coverage deserves its own comparison.
Before choosing coverage, verify:
- Every prescription is on the formulary
- The tier and cost-sharing for each medication
- Your pharmacy’s preferred or standard status
- Prior authorization, step therapy, or quantity limits
- Whether mail order or a 90-day supply changes the cost
Medicare glossary
Important words, explained normally.
Annual Enrollment Period
October 15 through December 7, when people with Medicare can review and change Medicare Advantage or Part D coverage for the following year.
Coinsurance
A percentage of the allowed cost that you pay for a covered service.
Copayment
A fixed dollar amount you pay for a covered service or prescription.
Formulary
A drug plan’s list of covered prescription medications, usually organized into cost-sharing tiers.
Maximum out-of-pocket
The most you pay in a year for covered Part A and Part B services through a Medicare Advantage plan. Prescription costs are handled separately.
Network
The physicians, hospitals, pharmacies, and other providers that contract with a plan.
Premium
The amount paid regularly to maintain coverage. A $0 Medicare Advantage premium does not eliminate the Part B premium or other costs.
Prior authorization
A plan requirement to approve certain services or medications before they are covered.
Personal guidance
Education first. Recommendations only after we understand you.
When you are ready, we can apply what you learned to your doctors, prescriptions, budget, and priorities.