Medicare 2026 Clear planswith free expert guidance
↓ Scroll to discover
What is Medicare
Medicare is the federal health program in the United States for people 65 and older, and for younger people with certain disabilities or chronic conditions. It works through four distinct parts that cover hospital care, medical visits, prescriptions and additional benefits. We help you understand which combination fits your health, your doctors and your budget, with no pressure and no cost to you.
The four parts of Medicare
Part A: Hospital
Covers hospital stays, skilled nursing facility care, hospice and some home health services. Most people pay no premium if they worked 10 years or more (40 Medicare-qualifying quarters).
Part B: Medical
Covers doctor visits, outpatient services, durable medical equipment and preventive services. The standard 2026 premium is approximately $185 per month, with an income-related adjustment (IRMAA) above certain thresholds.
Part C: Medicare Advantage
Private insurance plans that replace Part A and B. Many include prescriptions, dental, vision, hearing and gym at no additional cost. The premium can be $0 per month on top of Part B.
Part D: Prescriptions
Prescription drug coverage. Starting in 2026 there is a $2,100 annual out-of-pocket cap, a significant relief for those who take expensive or ongoing medications.
Enrollment periods
Knowing when you can enroll is key to avoiding penalties and getting the best coverage. These are the main periods:
- Initial Enrollment Period (IEP): the 7 months around your 65th birthday (3 before, the birthday month, and 3 after).
- Annual Enrollment Period (AEP): October 15 to December 7 each year. Change plans, add Part D, or switch to Advantage.
- General Enrollment Period (GEP): January 1 to March 31, if you missed your IEP and have no coverage.
- Medicare Advantage Open Enrollment (MA-OEP): January 1 to March 31, to switch between Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEP): triggered by moving, losing employer coverage, Extra Help eligibility, or plan changes affecting your coverage.
Who qualifies for Medicare
People 65 or older
Eligible by age, U.S. residents, citizens or legal residents with at least 5 continuous years.
Disability beneficiaries
People under 65 who have received SSDI for at least 24 consecutive months automatically qualify for Medicare.
Qualifying chronic conditions
People with End-Stage Renal Disease (ESRD) or ALS qualify without waiting the 24 months of SSDI.
Dual eligible (Medicare + Medicaid)
If you have limited income and qualify for both programs, you may access special D-SNP plans with expanded coverage and zero premium.
What your plan covers
- Doctor visits, hospitalization and preventive services with no copay in many cases
- Prescription drugs with a $2,100 annual cap in 2026
- Additional Advantage benefits: dental, vision, hearing, gym (SilverSneakers)
- Non-emergency medical transportation in plans that include it
- Telehealth and specialist consultations
- Chronic disease management programs (diabetes, hypertension, COPD)
- Supplemental benefit cards for over-the-counter, food or services
- Worldwide emergency coverage with some Medigap plans
Frequently asked questions
Do I need Medicare if I still have employer insurance?
If you work at a company with 20 or more employees, generally your employer insurance is primary and Medicare is secondary. Many people choose to enroll in Part A (free) and delay Part B with no penalty. We help you evaluate your specific situation.
What is the difference between Medicare Advantage and Medigap?
Medicare Advantage (Part C) replaces Part A and B with a private plan that includes extras and usually has a provider network. Medigap is a supplement that pays what Original Medicare does not cover (deductibles, copays) and lets you use any doctor who accepts Medicare. You cannot have both at the same time.
What happens if I do not enroll on time?
If you delay Part B without credible coverage, you pay 10% extra premium for each full year you delayed. For Part D, it is 1% of the national base price for each month without coverage. These penalties are for life.
Does Medicare cover dental, vision or hearing?
Original Medicare (A and B) does not cover routine dental, vision or hearing. Many Medicare Advantage plans include them at no additional cost. If you want to keep Original Medicare, you can buy separate dental or vision plans.
Can I change plans every year?
Yes. During AEP (Oct 15 to Dec 7) you can switch between Advantage plans, add or change Part D, or return to Original Medicare. During MA-OEP (Jan 1 – Mar 31) you can switch between Advantage plans or return to Original.
How much can I save by comparing plans?
Comparing plans annually can save between $300 and $2,000 a year in premiums and medications. Plans change their formularies and costs every year, so the ideal plan this year may not be next year. That is why we review with you every AEP, at no cost.
Ready to review your Medicare plan?
A licensed advisor calls you, compares plans based on your doctors and medications, and helps you enroll. No cost, no pressure.