Question 1

What is Original Medicare?

Accepted Answer

Original Medicare includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).Part A helps cover inpatient hospital care, skilled nursing facility care, hospice care, and certain home health services. Part B helps cover services from doctors and other healthcare providers, outpatient care, preventive services, durable medical equipment, and certain home health services.Original Medicare is administered by the federal government. You can also choose additional coverage, such as a Medicare Prescription Drug (Part D) plan or Medicare Supplement (Medigap) policy, or choose to receive your Medicare benefits through a Medicare Advantage plan.

Question 2

What are my premiums for Original Medicare?

Accepted Answer

Most people pay no monthly premium for Medicare Part A because they or their spouse paid Medicare taxes while working, generally for at least 10 years.The standard Medicare Part B premium is $202.90 per month in 2026. Some people pay a higher Part B premium based on their income.

Question 3

What are the deductibles and coinsurance costs for Original Medicare in 2026?

Accepted Answer

In 2026, the Part B deductible is $283 per year. After meeting this deductible, you generally pay 20% of the Medicare-approved charges. For Part A, the inpatient hospital deductible is $1,736 per benefits period, covering the first 60 days. From days 61-90, the cost is $434 per day. Beyond 90 days, you pay $868 per "lifetime reserve day" for up to 60 days over your lifetime.Original Medicare does not have an annual out-of-pocket maximum

Question 4

What is Medicare Part D?

Accepted Answer

Medicare Part D is prescription drug coverage offered by private insurance companies approved by Medicare. Coverage can be provided through a stand-alone Medicare Prescription Drug Plan or through many Medicare Advantage plans that include prescription drug coverage.Each plan has a list of covered medications called a formulary. Plans may organize medications into different tiers, and your costs can vary depending on the medications you take, the plan you choose, and the pharmacy you use.It's important to review your Part D coverage each year because plan costs, formularies, and pharmacy networks can change.

Question 5

What is Medicare Part C?

Accepted Answer

Medicare Advantage, also known as Medicare Part C, is another way to receive your Medicare Part A and Part B benefits. Medicare Advantage plans are offered by Medicare-approved private insurance companies and must cover the medically necessary services that Original Medicare covers.Most Medicare Advantage plans include prescription drug coverage, and many offer additional benefits such as dental, vision, hearing, and fitness benefits. Depending on the plan, you may need to use a network of doctors and hospitals, and certain services may require prior authorization.Medicare Advantage plans also have an annual limit on what you pay out of pocket for covered Part A and Part B services. Premiums, copayments, provider networks, prescription coverage, and additional benefits vary by plan.

Question 6

What are the two options for Medicare covage when I am turning 65?

Accepted Answer

In general, you can pick one of two options for Medicare coverage when you are turning 65, or if you currently have original Medicare (Part A+Part B)

Medicare Advantage or Medicare Part C (combines all parts of Medicare into one)
Medicare Supplement with a stand alone Medicare part D plan (prescription coverage)

See flow chart attached.

Question 7

When can I enroll in or change Medicare Advantage or Part D coverage?

Accepted Answer

There are certain times when you can enroll in or make changes to Medicare Advantage and Medicare prescription drug coverage.Initial Enrollment Period: When you first become eligible for Medicare, you have an opportunity to enroll in a Medicare Advantage or prescription drug plan.Annual Enrollment Period (October 15–December 7): You can join, switch, or drop a Medicare Advantage or Medicare prescription drug plan. Changes generally take effect January 1.Medicare Advantage Open Enrollment Period (January 1–March 31): If you're already enrolled in a Medicare Advantage plan, you can switch to another Medicare Advantage plan or return to Original Medicare. You may also be able to enroll in a stand-alone Part D plan if you return to Original Medicare.Special Enrollment Periods: Certain life events or changes in circumstances may give you an additional opportunity to change coverage. Examples include moving, losing other coverage, or becoming eligible for certain assistance programs.Enrollment rules can vary depending on your circumstances. NC Senior Solutions can help you determine what enrollment opportunities may be available to you.

FAQ

MEDICARE MADE EASY

What is Original Medicare?

What are my premiums for Original Medicare?

What are the deductibles and coinsurance costs for Original Medicare in 2026?

What is Medicare Part D?

What is Medicare Part C?

What are the two options for Medicare covage when I am turning 65?

When can I enroll in or change Medicare Advantage or Part D coverage?

NC SENIOR SOLUTIONS

"Medicare simplified"

MEDICARE SUPPLEMENT

What is a Medicare Supplement or Medigap?

When can I apply for a Medicare Supplement?

Do my rates increase as I get older?

Does everyone need a Medicare Supplement plan?

Does a Medicare Supplement plan cover prescription drugs?

Can I visit any doctor with a Medicare Supplement plan?

Can I have a Medicare Advantage plan and a Medicare Supplement plan at the same time?

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