Medicare: a concise guide

“Original” Medicare is composed of Parts A and B and is part of Social Security. You may defer receiving Social Security until you’re 67, say, or even older, but you have to sign up for Medicare Part A around the month of your 65th birthday (from the 3 months before to the 3 months after – better to do it earlier).

Sign up at www.ssa.gov/medicare/sign-up. The application is simple, but first it has you create an account at login.gov, which requires identification verification via cellphone photos of your driver license or passport or at a Post Office. You can sign up to receive your Social Security benefits at the same time (the monthly amount would be less instead of waiting until you’re older).

If you sign up to receive Social Security before you’re 65 (www.ssa.gov/apply), you will be automatically enrolled in Parts A and B when you turn 65.

Part A covers hospitalization, skilled nursing care, and hospice for 60 days after a deductible ($1,676 in 2025). After 60 days you pay $419 per day, after 90 days $838, and after 150 days everything. The 60-day deductible resets after you’ve been out of the hospital etc. for 60 days.

Part A has no premium if you’ve paid into Social Security for at least 10 years.

Part B helps cover outpatient care, doctor’s charges in a hospital, home health care, durable medical equipment, and some preventive services. It pays 80% of most charges (and 100% of some lab services and home health care) after an annual deductible ($257 in 2025).

There is a premium for Part B. In 2025, it's $185 per month if your income is $106,000 (or $212,000 for joint tax returns) or less. The premium increases with higher income, as well as if you don’t sign up for it when you’re 65. If you are receiving Social Security, the Part B premium is taken out of your monthly check.

More information about costs is available at <a href="https://www.medicare.gov/basics/costs/medicare-costs">https://www.medicare.gov/basics/costs/medicare-costs</a>.

Then there are the add-ons, which add substantially to your monthly premium. They are all are provided by private insurers, and the range of choices can be complicated to wade through. An insurance broker may be helpful.

Part D was added to cover drugs. Medigap (Medicare Supplement Insurance) was added to cover what Part B doesn’t, and Part C (Medicare Advantage) was added to bundle Parts A, B, and D, fill in gaps, and cover other services (eg, dental, eye, hearing care).

The premium for Part D increases if you don’t sign up for it when you sign up for Parts A and B. (And that would also apply if you sign up later for an Advantage plan that includes it.) After you’ve signed up for Medicare Parts A and B, you can enroll in or change an Advantage plan at any time every year from October 15 to December 7.