Medicare Cheat Sheet

Medicare Made Simple: Your Quick Cheat Sheet

Everything You Need to Know (Without the Jargon)

Medicare can feel like a maze — Parts A, B, C, D, Medigap, Advantage plans… what does it all mean?! If you’re new to Medicare or trying to help a loved one navigate it, don’t worry — this quick guide breaks it all down step-by-step in plain English.

Let’s get you the coverage you deserve with confidence and clarity.

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What Is Medicare?

Medicare is a federal health insurance program for:

• People 65 and older

• People under 65 with certain disabilities

• People with End-Stage Renal Disease (ESRD) or ALS

Unlike Medicaid (which is income-based), Medicare is based on age or disability status — so income usually doesn’t matter for basic eligibility.

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Medicare at a Glance: The ABCs + D

Part	What It Covers	Think Of It As…
A	Hospital care, nursing facilities, hospice	Your inpatient insurance
B	Doctor visits, tests, outpatient care	Your outpatient insurance
C	Medicare Advantage plans (includes A + B + extras like vision or dental)	A private, bundled plan
D	Prescription drugs	Your medication coverage

💡 If you stick with Original Medicare (Parts A & B), you can add Part D and a Medigap plan to help cover what Medicare doesn’t.

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🧾 Who Can Get Medicare?

You're eligible for Medicare if:

• You’re 65 or older (even if you’re still working!)

• OR you're under 65 with a disability and have received Social Security Disability Insurance (SSDI) for at least 24 months

• OR you have ESRD or ALS

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💰 What Does Medicare Cost?

Part	Premiums	Other Costs
A	Free if you worked & paid Medicare taxes for 10+ years	Deductibles apply
B	~$174.70/month in 2024 (higher if your income is higher)	Deductible + 20% of costs
C	Varies by plan (some as low as $0)	May have copays, network rules
D	Varies based on the plan & drugs	Monthly premiums + copays

🧮 Check your exact costs using Medicare’s calculator:https://www.medicare.gov/basics/costs

🗓️ When Can You Enroll?

• Initial Enrollment: 3 months before you turn 65, the month of, and 3 months after

• General Enrollment: Jan 1 – Mar 31 (if you missed your initial window)

• Open Enrollment (to switch/change plans): Oct 15 – Dec 7

• Medicare Advantage Open Enrollment: Jan 1 – Mar 31

📅 Set reminders — missing a window could mean penalties or gaps in coverage.

💊 Prescription Coverage (Part D)

• Helps pay for prescription medications

• Must be purchased separately unless you have a Medicare Advantage plan that includes it

• Compare plans here:https://www.medicare.gov/plan-compare/

🦷 What’s NOT Covered by Original Medicare?

Original Medicare does NOT cover:

• Dental

• Vision

• Hearing aids

• Long-term care

• Routine foot care

💡 Many Medicare Advantage (Part C) plans include some of these extras!

👨‍⚕️ Medicare Advantage (Part C)

Want a plan that bundles hospital, doctor, drug, and sometimes extra perks like gym memberships, dental, or rides to appointments?

That’s what Medicare Advantage does. It’s offered through private insurance companies but must meet Medicare guidelines.

Compare Advantage plans here:https://www.medicare.gov/plan-compare/

🛡️ What Is Medigap?

Medigap (Medicare Supplement Insurance) helps pay for costs that Original Medicare doesn’t cover (like deductibles and coinsurance).

• You must have Parts A & B

• Medigap is different from Medicare Advantage

• Plans are standardized (Plan A, B, C, etc.), but pricing and availability vary

More on Medigap:https://www.medicare.gov/medigap-supplemental-insurance-plans/

🧩 Helpful Programs That Help You Save

If you’re on a tight income, these programs can help:

• Medicare Savings Programs (MSPs) – help pay Part B premiums

  • Learn more: https://www.medicare.gov/your-medicare-costs/help-paying-costs/medicare-savings-programs

• Extra Help – helps with Part D drug costs

  • Apply here: https://www.ssa.gov/benefits/medicare/prescriptionhelp/

🔎 Medicare Terms to Know

Term	What It Means
Premium	Monthly cost to have coverage
Deductible	What you pay before Medicare starts paying
Copay/Coinsurance	Your share of the cost after deductible
Network	Approved doctors under Medicare Advantage plans
Formulary	The list of covered drugs under a Part D plan

📌 Quick Checklist Before You Enroll

✔️ Know your eligibility date

✔️ Understand the difference between Original Medicare and Advantage

✔️ Decide if you need a Part D plan

✔️ Check if you want a Medigap plan

✔️ Look for coverage extras like dental, vision, transportation

✔️ Check your doctors and prescriptions are covered in your plan

✔️ Apply through Social Security or Medicare.gov

🔗 Helpful Medicare Links

• 🌐 Main Website: https://www.medicare.gov/

• 🧾 Apply Online: https://www.ssa.gov/benefits/medicare/

• 🔍 Compare Plans: https://www.medicare.gov/plan-compare/

• 💊 Drug Cost Help (Extra Help): https://www.ssa.gov/benefits/medicare/prescriptionhelp/

• 🆘 State Health Insurance Assistance Program (SHIP): https://www.shiphelp.org/

• 📞 24/7 Medicare Hotline: 1-800-MEDICARE (1-800-633-4227)

💬 Final Thought

Medicare doesn’t have to be a mystery. With the right info (and maybe a little help from a trusted navigator), you can pick the coverage that truly fits your needs. You’ve earned this coverage — now make it work for you!