The Most Common Medicare Questions, Answered Plainly

After years of helping people navigate Medicare, certain questions come up over and over. Some are simple. Some feel simple but have an answer that surprises people. All of them deserve a straight answer.

Here are the questions we hear most, along with honest replies.

When Do I Sign Up for Medicare?

Most people sign up during the Initial Enrollment Period, which is a 7-month window. See our complete Medicare eligibility guide for details: the 3 months before your 65th birthday month, your birthday month itself, and the 3 months after.

If you sign up in the first 3 months of that window, coverage starts the month you turn 65. If you wait until your birthday month or later, coverage is delayed by one to three months.

If you are still working at 65 and have coverage through your employer (or your spouse’s employer), you may be able to delay Medicare without penalty. The key word is “active” employment. COBRA and retiree coverage do not count.

What Is the Difference Between Medicare Parts A, B, C, and D?

• Part A covers hospital stays, Skilled nursing facility care, and Hospice.
• Part B covers doctor visits, outpatient care, preventive services, and medical equipment.
• Part C is Medicare Advantage, a private-plan alternative that bundles A and B (and usually D) through an insurer.
• Part D covers prescription drugs.

Most people have Original Medicare (A and B) plus a separate drug plan (D) and, optionally, a Medigap policy to cover what A and B do not.

What Is Medigap and Do I Need It?

Medigap is supplemental insurance that covers the gaps in Original Medicare. Medicare covers most of your costs but not all of them. Part A has a hospital Deductible of $1,736 per Benefit period in 2026. Part B pays 80 percent of costs, leaving you responsible for 20 percent with no cap.

Without Medigap, a serious illness could cost you tens of thousands of dollars out of pocket.

Medigap fills those gaps. The most popular plan, Plan G, pays nearly everything Medicare does not, leaving most people with just the annual Part B Deductible ($283 in 2026) as their only out-of-pocket cost for covered services.

Whether you need it depends on your health situation, your risk tolerance, and your budget. Most people who want predictable costs and freedom to see any Medicare doctor benefit from having a Medigap plan.

What Is the Difference Between Medigap and Medicare Advantage?

This is probably the most important question on this page.

Original Medicare plus Medigap: You pay a monthly Premium for your Medigap plan. In exchange, your costs for covered care are highly predictable. You can see any doctor in the country who accepts Medicare, no network, no referrals, no prior authorizations.

Medicare Advantage: A private plan that replaces Original Medicare. Often has a lower or zero monthly premium. Usually includes drug coverage. But it comes with networks (you must use approved doctors), copays for most services, and Prior authorization requirements that can delay or deny care.

Neither is right for everyone. The honest answer depends on your health, your doctors, your prescriptions, and how you use healthcare. We cover this topic in depth in our guide on Medicare Advantage vs. Medicare Supplement plans.

Can I Get Denied for a Medigap Plan?

After your Medigap Open Enrollment Period, yes. In most states, if you apply for a Medigap plan after your initial 6-month open enrollment window closes, insurers can review your health history and decline to cover you.

This is why timing matters. If you are turning 65 and becoming eligible for Medigap for the first time, apply during your open enrollment window. You cannot be turned down or charged more for pre-existing conditions during that window.

Some states have additional protections, like annual birthday rules that give you a window to switch plans without Underwriting. See our guide on the Medigap birthday rule to understand what your state offers.

Does Medicare Cover Dental, Vision, and Hearing?

Original Medicare does not cover routine dental care, routine vision exams, or hearing aids. These are significant gaps.

Medicare Advantage Plans sometimes include these benefits, which is one reason they Appeal to some beneficiaries. But the coverage varies widely by plan and can change year to year.

If dental, vision, and hearing coverage matters to you, ask specifically about benefit limits and what is actually included, not just whether it is “offered.” A plan may offer $500 in dental benefits annually, which may not cover much.

What Is the Part B Late Enrollment Penalty?

If you do not enroll in Part B when you are first eligible, and you do not have a qualifying reason to delay, you pay a penalty. The penalty is 10 percent added to your monthly Part B premium for each full 12-month period you went without coverage. And it lasts for as long as you have Part B.

That means waiting 2 years to enroll adds 20 percent to your premium. Permanently.

Our Part B Penalty Calculator shows you exactly what you could owe based on how long you have waited.

Do I Need a Separate Drug Plan?

If you have Original Medicare and a Medigap plan, yes, you need a separate Part D drug plan. Medigap does not cover prescriptions.

If you have Medicare Advantage, drug coverage is usually included, but check to make sure before you enroll. Not all Medicare Advantage plans include Part D.

If you skip Part D and later want to enroll, you may face a late enrollment penalty similar to the Part B penalty.

Can I Keep My Doctor?

With Original Medicare plus Medigap: almost certainly yes. Any doctor who accepts Medicare will see you. About 93 percent of physicians in the U.S. accept Medicare.

With Medicare Advantage: it depends. You must use doctors in the plan’s network. If your doctor is not in the network, you will pay more or potentially nothing will be covered. Check before you enroll.

How Much Does Medicare Cost?

In 2026, the standard Part B premium is $202.90 per month. Most people get Part A for free. Part D premiums vary by plan, averaging around $30 to $50 per month for a basic plan.

Medigap premiums vary by plan, carrier, location, and age. Plan G premiums typically range from $100 to $200 per month depending on where you live.

Medicare Advantage plans often advertise $0 premiums but have copays, deductibles, and out-of-pocket maximums that can reach $5,000 to $8,000 or more per year.

Total cost depends on what you enroll in and how often you use healthcare. Our team can help you model out what different options would actually cost you based on your situation.

Still Have Questions?

Medicare has a lot of moving parts, and no two situations are exactly alike. If you have a question that is not covered here, we are happy to answer it.

Schedule a free Medicare consultation and ask us directly. No pressure. No sales pitch. Just a real conversation with someone who knows Medicare inside out.