1. Medicare Part A - Hospital Insurance (The Free Part)

You've likely earned this through 40 quarters of payroll taxes. Part A covers hospital stays, skilled nursing, and hospice care. Most people get this premium-free, but you'll still have deductibles and co-insurance to consider.

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2. Medicare Part B - Medical Insurance (The Monthly Premium)

This covers doctor visits, outpatient care, and medical equipment. You'll pay a monthly premium (around $185+ in 2025, possibly more if you had high income two years prior). This is where the "20% gap" comes from.

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3. The 20% Gap - Why 'Original Medicare' Isn't Complete

Original Medicare (Parts A & B) typically covers 80% of costs, leaving you responsible for 20% co-insurance, deductibles, and no annual out-of-pocket maximum. This is why most people need additional coverage.

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4. Medigap Supplements - Path 1 to Close the Gap

Medicare Supplement (Medigap) plans work WITH Original Medicare to cover most of that 20% gap. You can see any doctor who accepts Medicare, no networks, no referrals needed. Great for travel and premier medical facilities like Johns Hopkins.

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5. Medicare Advantage (Part C) - Path 2, The Alternative Route

These private plans REPLACE Original Medicare and often include prescription drugs. Lower monthly premiums but you'll have provider networks, referrals, potentially 'step care', lesser international health services, and annual out-of-pocket maximums (potentially $7,500+). In addition, Cancer treatments typically have 20% co-insurance.

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6. Part D Prescription Drug Coverage - Don't Forget the Meds

Whether you choose Medigap or Medicare Advantage, you'll need prescription coverage. With Medigap, you add a separate Part D plan. Most Medicare Advantage plans include drug coverage. Maximum out-of-pocket is $2,000 as of 2025.

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7. Timing is Everything - The 65 Birthday Rules

Your Initial Enrollment Period starts 3 months before you turn 65. Miss it, and you may face lifetime penalties. Working past 65? Different rules apply, even by state - reach out 3-4 months early to verify you're meeting requirements and avoiding penalties.

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8. Making It Permanent - Why Your First Choice Matters

Your Medicare plan choice may become your permanent insurance. While you can always switch Medicare Advantage plans, getting back INTO Medigap after leaving -- or not choosing Medigap from the outset -- may require answering 30+ medical underwriting questions. Thus, work with an independent professional before you enroll.