Four parts, two paths, a handful of deadlines that actually matter — and a mailbox full of ads trying to rush you. This page walks through how Medicare really works in 2026: what each part does, when to enroll, what it costs, and how to think about the one decision that's hard to undo. Educational first; call only if you want help.
Required disclosures: Smooth Health Solutions is not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent 0–78 organizations which offer 0–2,613 products in your area. The exact number of organizations and products depends on your ZIP code, county, and plan year. Please contact Medicare.gov, 1‑800‑MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. This page is educational — it describes how Medicare works, not any specific plan.
Inpatient hospital stays, skilled nursing after a hospital stay, hospice, and some home health. Premium-free for most people who worked (or whose spouse worked) 10+ years paying Medicare taxes.
Doctor visits, outpatient care, lab work, durable equipment, and preventive services. In 2026 the standard premium is $202.90/month with a $283 annual deductible; after that, Original Medicare generally pays 80% and you pay 20% — with no cap unless something else picks it up. That uncapped 20% is the entire reason the next section exists.
Private plans that replace how you receive Parts A and B (and usually D), often adding dental, vision, or hearing extras. Lower monthly cost in exchange for provider networks, prior authorizations, and benefits that can change every year.
Private drug plans, either stand-alone or built into an Advantage plan. In 2026, your out-of-pocket spending on covered drugs is capped at $2,100 for the year. Skipping Part D without other credible drug coverage triggers a lifelong late penalty — estimate yours with the penalty calculator.
Once you have Parts A and B, nearly everyone takes one of two paths to handle that uncapped 20%. Medicare Advantage bundles everything into a private plan — often $0 additional premium, usually with drug coverage and extras, always with a network and plan rules. Original Medicare plus a Medigap supplement costs more per month but lets you see nearly any doctor in the country that accepts Medicare, with little paperwork and predictable bills.
Neither is "the good one." The honest answer depends on your doctors, how you travel, your budget today versus your risk tolerance later — and one asymmetry most ads never mention: switching from Advantage back to Medigap later usually means passing medical underwriting, so the path is easier to enter than to exit. We wrote a full decision framework, not a table: Medicare Advantage vs. Medigap — how to actually decide. If you land on the Medigap side, the next question is almost always Plan G vs. Plan N.
Bring your doctor list and your prescriptions. We'll walk through both paths against what's actually available in your county — no pressure, no obligation, and no cost for the help.
No cost. No obligation to enroll. We do not offer every plan available in your area.
| Window | When | What it's for |
|---|---|---|
| Initial Enrollment Period | 7 months around your 65th birthday | First sign-up for Parts A, B, and D — missing it can mean lifelong penalties |
| Medigap open enrollment | 6 months from your Part B start date | Buy any Medigap plan with no health questions — the window that doesn't come back |
| Annual Enrollment Period | October 15 – December 7, every year | Switch Advantage or Part D plans for January 1 |
| MA Open Enrollment | January 1 – March 31 | One switch out of an Advantage plan that isn't working |
| Special Enrollment Periods | Event-based | Moving, losing employer coverage, and other life events |
Still working at 65 with group coverage from an employer with 20+ employees? You may be able to delay Part B without penalty — but confirm your situation before you delay anything. Turning 65 soon in South Florida? See Turning 65 in Palm Beach County: your 2026 timeline.
Everything is educational, free, and built by a licensed agent:
Your Initial Enrollment Period runs seven months: three before your 65th-birthday month, your birthday month, and three after. Already drawing Social Security? Parts A and B start automatically. Still working with group coverage from a 20+ employee company? You may be able to delay Part B without penalty — confirm first. Local? The Palm Beach County turning-65 timeline lays it out month by month.
No. You keep paying your Part B premium ($202.90/month in 2026), and you pay copays and coinsurance as you use care, up to the plan's out-of-pocket maximum. "$0 premium" means the plan adds nothing on top of Part B — it says nothing about what care costs when you need it.
Every September, Advantage and Part D plans mail an Annual Notice of Change — what your plan's premiums, drug list, network, and benefits will look like next year. Most people never open it, then get surprised in January. Read it, and if anything moved against you, the October 15 – December 7 Annual Enrollment Period is your chance to switch.
You can always return to Original Medicare during an enrollment window — but buying the Medigap policy usually requires medical underwriting once your initial 6-month Medigap window has passed, and carriers in most states can decline or surcharge you based on health. Limited exceptions ("trial rights") exist, mostly in your first 12 months in an Advantage plan. This asymmetry is the single most important thing to understand before choosing — the decision framework covers it in depth.
No. Premiums are the same whether you enroll directly or through an agent — carriers pay the agent. What you get is a person who knows the local networks and will still answer the phone in February when a claim needs fixing. We don't offer every plan in your area; for a complete list of options, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Important: Smooth Health Solutions is not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent 0–78 organizations which offer 0–2,613 products in your area. The exact number of organizations and products depends on your ZIP code, county, and plan year. Please contact Medicare.gov, 1‑800‑MEDICARE (1‑800‑633‑4227; TTY 1‑877‑486‑2048), or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. This page is for general education, reflects 2026 amounts published by CMS, and is not a complete description of benefits or a recommendation of any specific plan. Enrollment cannot be guaranteed until an application is accepted by the applicable insurance company or program. Plan availability, benefits, premiums, and eligibility vary by plan, carrier, location, and individual circumstances.