Aging with good health and financial security means having robust health care coverage. Medicare is a federal health insurance program designed for older adults and younger people with certain disabilities. Its purpose is to make sure you can afford the medical care you need to age well—such as doctor visits, hospital stays, and medications.

While Medicare is important, it’s not always straightforward. In this article, we explain the different parts of Medicare, the costs to consider, and how to decide what coverage is right for you.

Original Medicare and Part D vs. Medicare Advantage

When you enroll in Medicare, there are two basic options that will provide you with broad medical and prescription drug coverage:

• Original Medicare (Parts A and B), with or without:
  • Part D (prescription drug coverage)
  • Medigap (supllemental coverage)
• Medicare Advantage (Part C)
  • Includes Parts A and B
  • Most plans include Part D
  • Most plans include extra benefits

When comparing coverages, it is important to look at the two main options first: original Medicare and Medicare Advantage. Note that Medicare Advantage plans are sold by private insurers and come in many types (the most common are HMO and PPO). These plans must cover the same benefits as original Medicare and often cover additional services not covered by original Medicare (e.g., dental care and hearing care). 

You'll also want to consider the potential benefits of adding a Medigap policy to original Medicare, since it can help you cover some of the out-of-pocket costs of Parts A and B. It is not possible to have both a Medigap policy and a Medicare Advantage plan.

Part D is the Medicare standalone prescription drug benefit that, like Medicare Advantage, is sold by private insurers.

Costs and coverages differ between the various Medicare plans. It's a good idea to take a "big picture" look at all your options, taking into account desired coverage, premiums, and routine out-of-pocket costs. When deciding which Medicare coverage option to choose, here are some questions to ask: 

Which option is more stable from year to year? 

Each year, Medicare Advantage plans choose if they want to stay in the Medicare program. They can also change their costs, in-network health care providers, and benefits each calendar year. Original Medicare will always be there, but its deductibles and premiums may increase each year. 

How can I measure quality for the various plans? 

Medicare uses a five-star rating system to review the quality of Medicare Advantage and Part D plans:

• Five stars is "excellent"
• Four stars is "above average"
• Three stars is "average"

These ratings are based on a variety of factors, including how well the plans help members manage chronic diseases, member satisfaction and how often members get screening exams and vaccines, among others. The ratings are posted on the Medicare plan finder at Medicare.gov.

What are the cost differences? 

If you have original Medicare, your out-of-pocket costs include the Medicare Part A deductible and coinsurance and the Part B premium (the monthly premium in 2025 is $185), deductible, and coinsurance. Part B coinsurance is generally 20% of the cost for a service. Many beneficiaries purchase supplemental Medigap insurance to cover some of their out-of-pocket costs. 

If you’re enrolled in Part D, your costs may include the Part D premium ($46.50 monthly in 2025), deductible ($590 maximum in 2025), and copayments. In 2025, the Part D coverage gap is eliminated, and annual out-of-pocket costs are capped at $2,000.

If you're enrolled in a Medicare Advantage plan, your out-of-pocket costs may include the Medicare B premium, Medicare Advantage premium (average estimated to be $17 per month in 2025), copayments, and deductibles. The costs of these plans vary, as do the benefits they offer.

Medicare Advantage plans may have lower out-of-pocket costs than original Medicare because they have a cap on annual out-of-pocket spending. But limits vary by plan and can be fairly high. The maximum out-of-pocket limit is $9,350 in 2025. This limit generally does not include Part D prescription drugs costs. 

How do I get fair, unbiased Medicare advice?

If you’re wondering, “Who can help me choose the right Medicare plan?”, the good news is there are ways to get free, impartial guidance from people who know the ins and outs of the Medicare program. We’ve included two options below:

• Your State Health Insurance Assistance Program (SHIP): SHIPS offer personalized insurance counseling and assistance to Medicare beneficiaries and Medicare-eligible adults. To speak to a counselor, call 1-877-839-2675 or visit the SHIP website. 
• Medicare: Call 1-800-MEDICARE (1-800-633-4227 / TTY 1-877-486-2048) to connect with a customer support representative. You can also start a live chat on the Medicare website.