Medicare Eligibility and Enrollment Basics

Andrew Powell

Understanding Medicare in 2025

Medicare is the federal health insurance program for people age 65 and older, as well as certain younger individuals with disabilities. In 2025, more than 67 million Americans are enrolled (KFF).

Medicare is divided into four parts:

  • Part A: Hospital insurance (inpatient, skilled nursing, hospice)
  • Part B: Medical insurance (outpatient care, doctor visits, preventive care)
  • Part C: Medicare Advantage (private plans covering at least Parts A & B, often with extras)
  • Part D: Prescription drug coverage (private, optional)

Together, Parts A and B are known as Original Medicare. Private insurers offer Part C and Part D plans.

Key Costs for 2025

Medicare Part A

  • Deductible: $1,676 per benefit period
  • No coinsurance for first 60 inpatient days
  • Days 61–90: $419 per day
  • Days 91+: $838 per day, using limited lifetime reserve days

Medicare Part B

  • Monthly premium: $185 (income-based adjustments possible)
  • Annual deductible: $257

Medicare Part C (Medicare Advantage)

  • Offered by private insurers
  • Must cover the same services as Original Medicare
  • Often includes extras like drug coverage, dental, or vision

Medicare Part D

  • Private prescription drug plans
  • Costs and covered drugs vary by provider

Eligibility & Enrollment

Most seniors are automatically enrolled in Original Medicare at 65 if they qualify for Social Security benefits. Others can apply during designated enrollment periods. Some individuals under 65 qualify through disability.

Learn more about Medicare eligibility and enrollment.

Medicare Supplement (Medigap)

While Original Medicare covers many services, it leaves out-of-pocket costs like deductibles, coinsurance, and copayments. Medicare Supplement Insurance (Medigap) helps fill these gaps.

Most states offer up to 10 standardized Medigap plans (A–N). Popular options include Plan G and Plan N, each with different benefit levels and costs.

Use our comparison tool below to see which plan works best for your coverage and budget:

Benefits offered by each Medigap plan

Compare the benefits of each lettered plan to help you find one that meets your needs now and in the future. You might not be able to switch Medigap policies later.

= Plan covers 100%    = Plan doesn’t cover    % = Amount the plan covers

Benefits A B C D F G K L M N
Part A coinsurance & hospital costs
Part B copays/coinsurance 50% 75%
Blood (first 3 pints) 50% 75%
Part A hospice 50% 75%
Skilled nursing facility 50% 75%
Part A deductible 50% 75% 50%
Part B deductible
Part B excess charges
Foreign travel emergency 80% 80% 80% 80% 80%
  $7,220 $3,610

Next Steps

Medicare is complex, but you don’t have to navigate it alone. Review our guides to compare Medigap plans, or contact a licensed agent to find coverage that meets your needs.