Medicare basics for first-timers
What Medicare is
Medicare is federal health insurance primarily for people age 65 and older. If you’ve been on a work plan for years, the biggest shift is that Medicare is built in parts — and you choose how those parts come together.
Hospital coverage (inpatient care, skilled nursing, hospice).
Medical coverage (doctor visits, outpatient, preventive).
Prescription drug coverage (standalone or bundled).
Medicare Advantage (a private plan alternative that replaces A/B and usually includes Part D).
The two common ways people set up Medicare
- • You keep Medicare A & B as your foundation
- • Add a Part D drug plan if you want prescription coverage
- • Add a Medigap plan if you want help with out-of-pocket costs
- • A private plan replaces A & B
- • Usually includes Part D drug coverage
- • Uses networks and plan-specific copays
Most confusion comes from mixing these paths together. A simple rule: you either stay on Original Medicare and add pieces — or you choose a Medicare Advantage plan that bundles most of it.
Timing matters
The #1 first-time mistake is missing your enrollment window or enrolling too early while you still have active employer coverage.
- • Are you still covered by an employer plan? If yes, when does it end?
- • Are you turning 65 within the next 3 months?
- • Are you already taking Social Security (often triggers automatic Medicare enrollment)?