What is Medicare?

Medicare is a federal health insurance program. It helps cover your medical expenses if you’re age 65 or older. People under the age of 65 with disabilities or certain health conditions may also qualify for Medicare.

Medicare covers doctor visits, hospital stays, prescriptions, and other medical costs for older adults. It’s made up of four parts.

What are the different parts of Medicare?

Each part of Medicare provides different health care benefits:

• Medicare Part A (Hospital Insurance): Helps pay for inpatient hospital care, skilled nursing home care, home health, and hospice care
• Medicare Part B (Medical Insurance): Helps pay for doctor visits and outpatient services
• Medicare Part C (Medicare Advantage): A private plan that combines Parts A and B; it may include extra benefits
• Medicare Part D (Prescription Drug Coverage): Helps pay for prescription medications

How much does Medicare cost?

Medicare helps pay for medical services, but it’s not free. You will still pay certain out-of-pocket costs. Below is what you can expect to pay for Medicare in 2025:

• Part A costs: Medicare Part A is free if you are age 65 or older and you or your spouse paid Medicare taxes for at least 10 years while working. It is also free if you are younger than 65, have a disability, and have received Social Security Disability Insurance (SSDI) payments for at least two years (24 months).

Note: If you don’t get premium-free Part A, you may pay up to $518 monthly in premiums. For a hospital stay in 2025, you’ll also pay a $1,676 deductible per benefit period.

• Part B costs: You must pay a monthly premium for Part B coverage. Most people will pay the standard Part B premium amount, which is $185 per month in 2025. The Part B deductible is $257 per year. Part B coinsurance is 20% of the cost for each Medicare-approved service or item. Coinsurance is what you pay after reaching your deductible.
• Part C costs: In 2025, the average Medicare Advantage/Part C premiums are expected to range between $0 and $240+. The estimated average plan cost is $17 per month. Most Medicare Advantage plans also have cost sharing, such as a fixed co-payment for doctor visits.
• Part D costs: Annual premiums for Part D average around $46.50 per month in 2025 for standard coverage. The deductible can be no more than $590 per year. In 2025, annual out-of-pocket Part D costs are capped at $2,000.

If you have low income, you may be able to get help paying for your medications from the Low-Income Subsidy (LIS, or Extra Help) benefit. This benefit is valued at $6,200 per year. 

Am I eligible for Medicare?

You can get help from Medicare if you are a U.S. citizen or permanent resident and have lived in the U.S. for at least five years straight. You must also meet one of the following guidelines:

• You are age 65 or older.
• You are age 18 to 64 and:
  • You’ve been receiving Social Security Disability Insurance (SSDI) for at least two years.
  • You were diagnosed with amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease).
  • You were diagnosed with End Stage Renal Disease (ESRD).

When can I enroll in Medicare?

If you get Social Security benefits, enrollment in Medicare Part A and Part B is automatic. If not, you can enroll in Medicare at different times depending on your situation. Here are the main times to sign up:

• You have seven months to enroll when you turn 65. This period starts three months before your 65th birthday, includes your birthday month, and ends three months after.
• If you didn’t sign up when you were first eligible, you can enroll during annual General Enrollment period (Jan. 1 – March 31). You may have to pay a late penalty.
• During annual Open Enrollment (Oct. 15 – Dec. 7), you can switch or join a Medicare Advantage and/or Part D plan.

How do I enroll in Medicare?

There are several ways to apply for Medicare. Read below to find the option that works best for you.

Applying for Medicare online through the Social Security website is the fastest and easiest way to apply.

Apply on Social Security Website

To begin:

1. Visit the Social Security online benefits application.
2. Click "Applying for Myself" or "Applying for Someone Else."
3. If you don’t have a my Social Security account, you’ll need to create one.
4. Follow the steps to complete the online application.
5. Once you’ve answered all of the questions, you can submit your application.

Note:  You can check the status of your Medicare application or appeal the decision by visiting the Social Security website here.

To apply by phone, call the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778 if you’re deaf or hard of hearing).

Tell the representative whether you want to sign up for both Medicare Part A and Part B, Part A only, or Part B only. Agents are available Monday through Friday, 8 a.m. to 7 p.m. (U.S. time zones). Assistance is available in English, Spanish, and other languages.

To apply for Medicare in person, you must first find a nearby SSA office and schedule an in-person appointment. Find the SSA office closest to you.

Who should I contact if I need help with Medicare?

If you have questions about Medicare coverage or need help applying:

• Call the Social Security Administration at 1-800-772-1213 or find your nearest SSA office to schedule an in-person appointment.
• Visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227). Medicare representatives are available 24/7, except for on some federal holidays.
• Contact your local State Health Insurance Assistance Program (SHIP). SHIPs provide free, impartial assistance to Medicare-eligible adults and their families. Find your SHIP by visiting their website or calling 1-877-839-2675.

Frequently asked questions about Medicare

What does Medicare not cover?

Medicare does not pay for:

• Most routine dental care (check-ups, cleanings, fillings)
• Eye exams for glasses
• Hearing aids
• Acupuncture
• Long-term care (like nursing homes)
• Routine foot care

Some people buy additional coverage through Medicare Advantage or a Medigap policy to help cover these costs.

How can I get help paying my Medicare costs?

If you qualify for Medicare and have low income, you may be able to get help from one of the Medicare Savings Programs (MSPs). These are Medicaid-run programs that help cover Medicare out-of-pocket costs. MSP eligibility is income-based, and guidelines may vary from state to state. Check with your state’s Medicaid agency for details.

Who should I contact for more information?

If you need more information about Medicare or how to apply, there are ways to get help. You can:

• Call 1-800-MEDICARE (1-800-633-4227)). If you are a TTY user, call 1-877-486-2048.
• Visit the Frequently Asked Questions page on the Social Security website or find your nearest SSA office to schedule an in-person appointment.