Guides
Plain answers before you call anyone
How Medicare works, what it covers and costs, and how to choose and check an agent. General information, never advice about a particular plan.
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Choosing an agent
- How to find a good Medicare agent near youWhere to look for a local Medicare agent, how to narrow the list to one or two, and the five-minute checks to do before you share anything.
- Medicare agent vs. broker: what's the difference?Agent, broker, producer: what the words mean, the one difference that really matters (how many companies they work with), and how to tell before you meet.
- A local Medicare agent or a 1-800 number: what's the difference?The TV ads and the agent down the street are both licensed. How they differ in who you talk to, what happens to your phone number, and who's there next year.
- SHIP counselor or Medicare agent: who should you call?Both help with Medicare for free, but they do different jobs. What a SHIP counselor does, what an agent does, and when to use each (or both).
- How to find a Medicare agent who speaks your languageSpanish, Chinese, Vietnamese, Korean or another language: how to find a licensed agent who speaks it, and the free interpreter and translation help you're entitled to.
- What to bring to your first meeting with a Medicare agentA one-page checklist: the cards, doctor list and prescriptions an agent needs to compare plans for you, plus what you should never hand over.
- Can you change your Medicare agent? Yes. Here's howYou're never locked in to the agent who enrolled you. How switching agents works, what changes and what doesn't, and how to stop calls from the old one.
Your rights and staying safe
- What Medicare agents can and can't do: the rules for 2026–2027Can an agent call you? Is there still a 48-hour wait? What must they tell you? The federal marketing rules for Medicare Advantage and drug plans, in plain English, as of October 2026.
- Do Medicare agents charge a fee? How agents get paidAgents are paid by insurance companies, not by you, and a plan costs the same with or without one. How that works, where the rules differ for Medigap, and what to do if someone asks you for money.
- What is an NPN? The number that proves an agent is licensedEvery licensed insurance agent has a National Producer Number. What it is, how it differs from a state license number, and how to use it to check an agent in two minutes.
- Medicare scams: how to spot them, and what to doThe calls, texts and offers scammers use around Medicare, the signs that give them away, and exactly who to call if you think you've been targeted.
- "Medicare flex card" and "giveback" ads: what's real and what isn'tThere's no Medicare flex card from the government. What the ads are actually selling, which plans offer allowance cards or a Part B "giveback," and what to check before switching for one.
- How to report a Medicare agent: who to call and what to sayPressured, misled, or switched to a plan you didn't choose? Where to report a Medicare agent (your state, Medicare, the plan), what to include, and how to fix your coverage.
- How to appeal a Medicare denial: steps and deadlinesYour plan or Medicare said no. The first step and its deadline for Original Medicare, Medicare Advantage and Part D, fast appeals when care is ending, the 2026 prior-authorization deadlines, and who can help for free.
Choosing coverage
- Medicare Advantage or Medigap? The questions that decide itNeither is better for everyone. How the two common Medicare set-ups differ, the questions that point to one or the other, and why the first choice is the hardest to undo.
- HMO, PPO or Special Needs Plan? Medicare Advantage plan types explainedWhat the letters after a Medicare Advantage plan's name mean for your doctors, referrals and costs, plus the Special Needs Plans built for people with certain conditions, Medicaid or nursing home care.
- How a good agent compares Medicare drug plans (and how to check their work)The premium is the smallest part of a drug plan's cost. What an agent should check for each of your prescriptions, the 2025 changes that cap your costs, and how to double-check the comparison.
- Medigap Plan G vs. Plan N (and the other letters), explainedWhat each Medigap letter covers, the real differences between Plan G, Plan N and high-deductible G, why Plans C and F are closed to people new to Medicare, and how pricing works.
- Medigap birthday rule: which states let you switch plans each yearFifteen states now give Medicare Supplement holders a yearly window to switch without health questions, and several more have year-round rights. The full list for 2026, with how each state's rule works.
- Medigap if you're under 65: what each state requiresFederal law doesn't guarantee Medigap to people under 65 with Medicare, but many states do. Every state's rule for people on Medicare because of a disability, ESRD or ALS, with what they can charge.
- Have Medicare and Medicaid? What changes, and how an agent can helpIf you qualify for both Medicare and Medicaid, you have extra help with costs, special plans, and more chances to change coverage. What to know, the 2025 rule changes, and what to watch for.
- Medicare with VA or TRICARE benefits: what veterans should knowShould a veteran with VA health care sign up for Part B? How TRICARE For Life works with Medicare, whether you need a drug plan, and what to check before joining a Medicare Advantage plan.
- Medicare with retiree, COBRA or a spouse's job coverageWho pays first, whether you need Part B, and the mistakes that cost people their retiree benefits or a lifelong penalty. For anyone with retiree coverage, COBRA, or a working spouse's plan.
- Medicare when you travel or live in two statesHow Original Medicare, Medicare Advantage, drug plans and Medigap work when you spend winters in another state or travel abroad, the 6-month rule that can end a Medicare Advantage plan, and coverage on cruises.
What Medicare covers
- What Medicare covers for a hospital stay (and why "observation" matters)What Part A pays for a hospital stay, the 2026 deductible and daily costs, the difference between being an inpatient and "under observation," and the notices and appeal rights you have.
- Does Medicare cover nursing home care? Skilled nursing vs. long-term careMedicare covers short-term skilled nursing facility care after a qualifying hospital stay, up to 100 days, but not long-term nursing home care. The 3-day rule, 2026 costs, and what to do when coverage ends.
- Does Medicare cover home health care? Who qualifies and what's includedMedicare pays in full for part-time skilled care at home if you're homebound and need skilled nursing or therapy. What "homebound" means, what's covered and not, and what to do if an agency stops your care.
- How the Medicare hospice benefit worksWho qualifies for hospice under Medicare, what it covers at home or in a facility, what it costs (usually nothing), what happens to your other care and Medicare Advantage plan, and your right to change your mind.
- Medicare's free preventive care and yearly wellness visit, explainedWhat the "Welcome to Medicare" and yearly Wellness visits include (and why they aren't a physical), the screenings and vaccines Medicare covers at no cost, and when a "free" visit can still lead to a bill.
- What Medicare covers for mental health careTherapy, counseling, psychiatric care, telehealth from home, intensive programs, hospital stays and medications: what Medicare covers for mental health, who can treat you, and what it costs in 2026.
- Does Medicare cover medical equipment? Walkers, wheelchairs, CPAP, oxygen and moreWhat Part B pays for walkers, wheelchairs, hospital beds, CPAP machines, oxygen and glucose monitors, the rent-or-buy rules, how to avoid paying more at the supplier, and what isn't covered.
- Does Medicare cover dental, vision and hearing?Original Medicare doesn't cover routine dental care, glasses or hearing aids, with a few important exceptions. What is covered, what Medicare Advantage plans add, and your other options.
- Does Medicare cover long-term care? What it pays for, and what doesn'tMedicare doesn't pay for help with daily living if that's all you need. What it does cover, and how people pay for long-term care: Medicaid, PACE, insurance and veterans' benefits.
Costs and help paying
- What Medicare costs in 2026, and what's already set for 2027The 2026 Part B premium and deductible, Part A hospital costs, the income-based IRMAA surcharges, Part D drug limits and Medicare Advantage's yearly cap, plus the 2027 figures already announced.
- Paying for prescriptions with Medicare: the yearly cap, the payment plan and $35 insulinThe yearly limit on what you pay for covered drugs, how the Medicare Prescription Payment Plan spreads costs out, the $35 insulin cap, $0 vaccines, negotiated prices and coupons.
- IRMAA: Medicare's income surcharge, and how to get it loweredWho pays Medicare's income-related surcharge, the 2026 amounts, why it's based on income from two years ago, and how to ask Social Security to lower it after a life change.
- Extra Help and Medicare Savings Programs: who qualifies and how to applyTwo programs that cut Medicare costs for people with limited income: Extra Help for drug costs and state Medicare Savings Programs for premiums. The 2026 limits, what they pay, and how to apply for both at once.
- Medicare late enrollment penalties: how they work and how to avoid themHow the Part B, Part D and Part A penalties are figured, with 2026 examples, the situations that let you sign up late without one, and how to challenge a penalty you think is wrong.
Signing up, dates and words
- Turning 65: a Medicare checklist, month by monthWhat to do before and after your 65th birthday: when to sign up, what to do if you're still working, your one-time Medigap window, and the deadlines that carry lifelong penalties.
- How to sign up for Medicare Part A and Part B, step by stepWhether you'll be signed up automatically, when to apply, how to apply online, by phone or in person, when coverage starts, and what to choose next.
- Medicare if you keep working past 65: what to sign up for, and whenWhether you need Part A and Part B while you're covered at work, why employer size matters, what to do about an HSA, and how to sign up without a penalty when you retire.
- Medicare under 65: disability, kidney failure and ALSWhen Medicare starts if you get disability benefits, have kidney failure or ALS, what happens if you go back to work, and the choices that work differently before 65.
- Medicare enrollment periods: when you can sign up or switchEvery Medicare enrollment window in one place: turning 65, the fall Annual Enrollment Period, the January–March change, Medigap open enrollment, special periods and late penalties.
- Medicare Open Enrollment checklist: what to check before December 7A step-by-step checklist for the October 15 to December 7, 2026 Open Enrollment Period: what to read in your plan's letter, what's changing for 2027, what you can switch, and what happens if you do nothing.
- Moving to another state with Medicare: what changes and what to doOriginal Medicare moves with you; most Medicare Advantage and drug plans don't. What happens to each kind of coverage when you move, your window to switch, and why your agent must be licensed in your new state.
- Medicare insurance words, in plain EnglishWhat Part C, Medigap, NPN, line of authority, Scope of Appointment and other words you'll hear from agents actually mean, in one or two sentences each.
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