Medicare, explained in plain English.

Part A and Part B together are called Original Medicare. And Original Medicare doesn't cover everything — which raises the question every Medicare decision eventually runs into:

The gap question: Medigap or Medicare Advantage?

They're two different answers to the same question: how do you handle what Original Medicare doesn't cover?

Neither one is "better." It depends on how you get care. Anyone who tells you otherwise before asking about your doctors, your prescriptions, and your budget is selling, not teaching.

What are Medicare Parts A, B, C, and D?

Part A is hospital insurance — it covers inpatient hospital stays, limited skilled nursing care, hospice, and some home health care. Part B is medical insurance — it covers doctors, outpatient care, and preventive services, and a monthly premium applies. Part C, called Medicare Advantage, is an alternative way to receive your Medicare benefits through private plans that bundle Part A, Part B, and usually Part D. Part D is prescription drug coverage from private plans; the list of covered drugs and the costs vary by plan. Together, Part A and Part B are called Original Medicare.

When do I sign up for Medicare if I'm turning 65?

Most people first sign up during their Initial Enrollment Period — a 7-month window that starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after it. If you're already receiving Social Security benefits when you turn 65, you're generally enrolled in Part A and Part B automatically. If you're not receiving benefits yet, enrollment doesn't happen on its own — you sign up through Social Security.

What happens if I miss my enrollment window?

If you miss your Initial Enrollment Period and don't qualify for a Special Enrollment Period, you can sign up during the General Enrollment Period, January 1 through March 31 each year, and your coverage starts the month after you enroll. Waiting can also mean late enrollment penalties. For Part B, the penalty is 10% for each full 12-month period you could have had Part B but didn't, and you generally pay it for as long as you have Part B. Part D has its own penalty — about 1% for each month you went without Part D or other creditable drug coverage — generally paid for as long as you have drug coverage.

I'm still working at 65. Can I delay Medicare?

Often, yes — it depends mainly on the size of your employer. If you have group health coverage from an employer with 20 or more employees (yours or a spouse's), you can usually delay Part B without a penalty, and when that coverage or the job ends, you get an 8-month Special Enrollment Period to sign up. If the employer has fewer than 20 employees, Medicare is generally expected to pay first at 65, so delaying Part B can leave coverage gaps and penalties. Two cautions: COBRA and retiree coverage do not count as employer coverage for delaying Part B, and if you have a health savings account (HSA), enrolling in Part A stops HSA contributions — and because Part A can backdate up to 6 months, timing matters. Check your specific situation before you decide; employer size and coverage type decide the answer.

What's the difference between Medigap and Medicare Advantage?

They are two different answers to the same question: how do you handle the costs Original Medicare doesn't cover? A Medigap policy is extra insurance paired with Original Medicare that helps with out-of-pocket costs; in exchange for a higher monthly premium, you can generally see any doctor who accepts Medicare, and drug coverage is bought separately. A Medicare Advantage plan (Part C) is one private plan that bundles Part A, Part B, and usually drug coverage; the extra premium is often lower, but you use the plan's network, pay copays when you get care, and prior authorization is common. Neither is simply better — it depends on how you get care, which doctors matter to you, and how you prefer to pay. Your first six months with Part B are also your Medigap open enrollment window: during it, insurers generally can't turn you down or charge you more because of your health.

When can I change my Medicare coverage?

The main window is the Annual Enrollment Period, October 15 through December 7 each year, when anyone with Medicare can review their coverage and make changes that take effect January 1. If you're in a Medicare Advantage plan, there's also a Medicare Advantage Open Enrollment Period, January 1 through March 31, when you can make one change — switch Advantage plans or move back to Original Medicare. Outside these windows, major life changes — like losing employer coverage or moving — can open a Special Enrollment Period of your own.

How much does Medicare cost?

It varies, and no honest page can quote you a personal number. Most people pay no premium for Part A, because they or a spouse paid Medicare taxes long enough while working. Part B has a monthly premium that Medicare sets each year, and higher-income households pay more. Part C and Part D are offered by private plans, so their premiums and costs vary by plan and by where you live. What you can control is timing: enrolling late without qualifying coverage adds penalties that follow you for years.

Can Reserve Investment Group tell me which plan to pick?

In our educational materials, no — deliberately. Everything on this page explains how Medicare works, the same for every reader, and it is not a recommendation for anyone's situation. Choosing coverage involves your doctors, your prescriptions, your budget, and your timing, and that conversation belongs one-on-one. If you'd like, we hold no-cost, no-obligation benefits reviews where we walk through how the pieces fit your situation and you keep the notes either way. You can also get free, independent help from Ohio's State Health Insurance Assistance Program (OSHIIP) or from Medicare itself at Medicare.gov or 1-800-MEDICARE (1-800-633-4227).