Medicare has four parts, a handful of enrollment windows, and two basic ways to get your coverage. Once you see how those pieces fit, most of the confusion goes away. This guide walks through each one, with 2026 figures.
The four parts of Medicare
Part A is hospital insurance. It covers inpatient hospital stays, limited skilled nursing facility care, hospice and some home health care. Most people pay no premium for Part A because they paid Medicare taxes while working. In 2026 the Part A deductible is $1,736 per benefit period.
Part B is medical insurance. It covers doctor visits, outpatient care, preventive services and durable medical equipment. The standard premium in 2026 is $202.90 a month, and people with higher incomes pay more. Parts A and B together are called Original Medicare.
Part C is Medicare Advantage. These are private plans approved by Medicare that provide your Part A and Part B benefits, usually with drug coverage and some extras, and with their own networks and costs.
Medicare Part D is prescription drug coverage, sold by private insurers. In 2026 no plan can have a deductible above $615, and your out-of-pocket spending on covered drugs is capped at $2,100 for the year.
When you can enroll
Your Initial Enrollment Period lasts seven months. It starts three months before the month you turn 65 and ends three months after it. If you sign up before your birthday month, coverage begins that month. If you wait until your birthday month or later, coverage begins the following month. People who started Social Security at least four months before turning 65 are enrolled in Parts A and B automatically.
The Annual Enrollment Period runs from October 15 to December 7 each year. You can join, drop or switch a Medicare Advantage or Part D plan, and the change takes effect January 1.
A Special Enrollment Period applies when your circumstances change. The most common case is leaving a job. If you delayed Part B because you had coverage through a current employer, you have eight months to sign up after the job or the coverage ends.
If you miss all of these, the General Enrollment Period runs January 1 through March 31, and you may owe a penalty. The Part B penalty adds 10% to your premium for each full 12 months you could have had Part B and didn’t, and it usually lasts as long as you have Part B.
Choosing a plan
Start with your doctors. If you’re looking at a Medicare Advantage plan, confirm that your primary care doctor, your specialists and your hospital are in its network.
Then check your prescriptions. Each plan has its own drug list, and the same medication can cost very different amounts from one plan to the next. If you have been prescribed a GLP-1 drug, see what Medicare beneficiaries need to know about GLP-1 weight loss medications.
Look at total cost, not only the premium. Add the deductible, the copays for the care you actually use, and the plan’s out-of-pocket maximum.
If you travel often or live part of the year in another state, check what the plan covers away from home. And look at the plan’s star rating. Medicare rates plans on a five-star scale for quality and service.
Where to get help
Medicare.gov has a plan comparison tool that shows costs for your specific prescriptions.
Connecticut’s State Health Insurance Assistance Program is called CHOICES. It offers free, unbiased Medicare counseling, and you can reach it at 1-800-994-9422.
A licensed agent can compare plans from the insurers they represent and help you enroll. The Jones Group works with Medicare beneficiaries across Connecticut. Call us at (860) 529-3788 if you’d like to go through your options together.
