Can I drop my Medigap plan's prescription drug coverage and enroll in Part D?

You can drop just your Medigap prescription coverage and keep the other coverage provided by your current Medigap plan. And you’ll have the option to enroll in a Part D plan during the annual Medicare open enrollment period that runs from October 15 to December 7. But you’ll have to pay a late enrollment penalty for Part D, if the Medigap plan has been providing your only prescription drug coverage and it didn’t qualify as creditable coverage.³

Your Medigap plan can tell you whether the drug benefits it provides are creditable,² but CMS noted in 2005 that “Plans H and I would never meet the definition of creditable coverage and that Plan J was unlikely to.”⁴

Will I owe a Part D penalty if I drop my Medigap prescription drug coverage?

If you didn’t enroll in Part D when you were first eligible and instead relied on drug coverage that wasn’t considered creditable, you’ll owe a late enrollment penalty if and when you eventually switch to a Part D plan.

As noted above, CMS did not expect Medigap drug coverage to be considered creditable. So it’s likely that if you’ve kept Medigap Plan H, I, or J and used that plan’s drug coverage, you’ll owe a late enrollment penalty if you’re switching to Part D.

The penalty is 12% for each year that enrollment was delayed and is calculated in one-month increments. It is based on the nationwide base Part D premium, so your penalty won’t be higher if you enroll in a more expensive plan.³

Am I eligible for Extra Help?

Your income and resources determine the level of help you receive. You’ll automatically receive Extra Help if you have both Medicare and Medicaid, are enrolled in a Medicare Savings Program, or receive Supplemental Security Income. Even if you don’t fit into one of those categories, you might qualify for Extra Help if you have limited income and assets.²

To be eligible for Extra Help in 2026:³

• Your income cannot exceed $23,940 for an individual or $32,460 for a married couple living together, AND
• Your resources/assets must not exceed $18,090 for an individual and $36,100 for married couples

The financial limits are higher if you have dependents living with you, or if you live in Alaska or Hawaii. The limits are adjusted annually, usually in the early spring, after updated federal poverty level guidelines are published.

Resources do not include the value of your car or home, but do include stocks, bonds, and bank accounts.² (The Social Security Administration has more details about what does and doesn’t count as resources).

Will Extra Help reduce my out-of-pocket costs?

Yes, Extra Help will reduce your out-of-pocket costs when you fill prescriptions, and it will also reduce your Part D premium costs.

If you have Extra Help in 2026, you’ll pay no more than $5.10 for each generic drug and $12.65 for brand-name drugs.⁴ And for Extra Help enrollees with income below the poverty level who are also enrolled in Medicaid, copays in 2026 are limited to $1.60 for generics and $4.90 for brand-name drugs.⁵

In addition to having lower copayments, Extra Help enrollees also have their Part D plan deductibles reduced or eliminated altogether (depending on their income). The federal government pays Part D premiums on behalf of Extra Help enrollees – up to a benchmark amount. This amount is different in each state;⁶ the number of plans with no premium for Extra Help enrollees in each state ranges from one to four in 2026.⁷

Extra Help also eliminates the Part D late enrollment penalty for beneficiaries who would otherwise have to pay it.⁸

Does Extra Help allow me to change my Part D coverage?

Yes. If you qualify for Extra Help, you can switch your Part D coverage up to once per month.¹⁰ This used to be a quarterly enrollment opportunity, but it became monthly starting in 2025.¹¹

What are Medicare Savings Programs?

Medicare Savings Programs (MSP) can pay Medicare Part A and Medicare Part B premiums, deductibles, copays, and coinsurance for enrollees with limited income and limited assets. There are four different types of MSPs, and they provide varying benefits. Two of the MSPs only help to pay Medicare Part B premiums (but not Part A premiums or Medicare cost sharing), and one MSP helps disabled working individuals pay their Part A premiums.

How do Medicare Savings Programs differ?

The four types of Medicare Savings Programs each have different requirements in terms of the financial situation that will make a person eligible, including income limits and asset (resource) limits.¹ These are federal standards; states can have more generous guidelines for MSPs, and several don’t use asset limits (in other words, they base eligibility on income alone).²

As of 2026, the federal asset limits for most MSPs are $9,950 for an individual, and $14,910 for a couple³ (these amounts are indexed for inflation each year, and again, states can set higher limits or not impose an asset limit). Your home, one car, a burial plot, and household items are not counted as assets.

But the federal income limits are different for each type of MSP. As of 2026, the following income limits are used in the continental U.S. (income limits are higher in Alaska and Hawaii):⁴

• Qualified Medicare Beneficiary Program (QMB). Helps pay premiums for Part A and Part B, as well as copays, deductibles, and coinsurance. This is the most robust MSP, and has the lowest income limits for eligibility. A single person can qualify in 2026 with an income of up to $1,350 per month ($1,824/month for a couple).⁴
• Specified Low Income Medicare Beneficiary Program (SLMB). Helps to pay premiums for Part B. A single person can qualify in 2026 with an income of up to $1,616 per month ($2,184/month for a couple).⁴
• Qualified Individual Program (QI). Helps to pay premiums for Part B. A single person can qualify in 2025 with an income of up to $1,816 per month ($2,455/month for a couple).⁴
• Qualified Disabled and Working Individuals Program (QDWI). Helps to pay Part A premiums. This MSP is for people who are disabled but have returned to work, and lost their premium-free Medicare Part A. The income limits are higher (up to $5,405/month for an individual, and $7,299 for a couple in 2026), but the asset limit is lower, at $4,000 for an individual and $6,000 for a couple.³

Note: The income limits are adjusted annually to keep pace with the federal poverty level guidelines, which are updated each year in mid-January. Most states start using the updated MSP eligibility limits in April,⁵ but some switch to the new numbers in March.⁶ So applicants should check with their own state’s Medicaid office to understand the current eligibility limits that apply in their state.

If you qualify for QMB, SLMB, or QI, you’ll also receive Extra Help,⁷ a federal program that lowers prescription drug and premium costs under Medicare Part D. Learn more about qualifying for Medicare’s Extra Help.

Here’s more information about MSPs, including the federal income and asset limits that apply to each type of MSP. Note that assets include money in the bank, and investments in stocks and bonds. But your primary residence and one car are not counted as assets, nor are your household and personal items.⁴

How do I apply for Medicare Savings Programs?

Eligibility for MSPs is determined by your state Medicaid office, as the funding for MSPs comes from the Medicaid program (not the Medicare program).⁸ If you think you might be eligible, you can apply for an MSP at your local Medicaid or social services office (contact information for each state is available here).

Do you have to apply for an MSP during Medicare's annual election period?

No. You can apply for MSP assistance anytime. As noted above, you’ll do this through your state’s Medicaid office, which accepts applications year-round.

But the marketing and outreach before and during Medicare’s annual election period can be a good reminder to seek help if you need it. You might decide to make a change to your coverage during the annual open enrollment period, and simultaneously check with your state’s Medicaid office to see if you might be eligible for an MSP or Extra Help with your drug coverage.

Is it possible to get Medicare Part B for free if I'm not eligible for a Medicare Savings Program?

As described above, Medicare Savings Programs cover the cost of Part B for eligible Medicare beneficiaries, but they’re generally only available to people with low incomes and asset levels. If you’re not eligible for a Medicare Savings Program, you’ll likely have to pay the premium for Medicare Part B.

But there are a couple of exceptions: If you or your spouse are continuing to work and the employer offers an ICHRA or QSEHRA, they can reimburse you for the cost of Part B. And if you select a Medicare Advantage program with a “giveback” benefit, your premium for Part B will be reduced or eliminated. (It’s more common for these programs to offset just a portion of the Part B premium, but it’s possible for them to cover all of it. Note that most Medicare Advantage plans do not offer giveback rebates, but some do).

Is there financial help for Medicare Part D coverage?

Medicare offers Extra Help (Low-Income Subsidy) for Medicare enrollees who can’t afford their Part D prescription drug coverage. If you’re a single person earning less than $23,940 in 2026 ($32,460 for a couple), with financial resources that don’t exceed $18,090 ($36,100 for a couple), you may be eligible for Extra Help (note that these income and asset limits change annually).¹³ The program will reduce or eliminate your Part D plan’s premium and deductible, and also lower the cost of prescription drugs to a very small amount.

Through the end of 2023, Extra Help was available either partially or in full, depending on the person’s financial situation. But under the Inflation Reduction Act, starting in 2024, everyone who qualifies for Extra Help receives the full benefits, including people who would previously only have qualified for partial Extra Help.

Here’s more information about Extra Help, including details about the type of notice you might receive from Medicare or Social Security, that you can then send to your Part D plan.

Certain MSP enrollees automatically receive Extra Help,⁴ as do Medicare enrollees who receive full Medicaid or Supplemental Security Income (SSI).

Is anything changing with Medicare telehealth coverage in 2026?

No telehealth changes are taking effect in 2026 for Original Medicare beneficiaries.¹ Beneficiaries can continue using telehealth the same way they have since the pandemic, including receiving many services from home and accessing care regardless of whether they live in a rural or urban area.¹

Congress passed a spending bill on February 3, 2026, that retroactively extended Original Medicare telehealth access through December 31, 2027.³ The restrictions that were previously expected to return in 2026—such as limits based on location, provider type, or technology—are not being reinstated at this time.²

What telehealth services does Medicare cover?

Under the current extended rules, Original Medicare allows many healthcare visits to take place via telehealth.¹ These options reflect the expanded telehealth access that has been in place since the COVID-19 pandemic and remains available through December 31, 2027.

Telehealth services covered by Original Medicare include:¹

• Office visits with primary care providers and specialists
• Mental health services, including therapy and counseling
• Depression screenings
• Cognitive assessments
• Advance care planning
• Diabetes management and education
• Nutrition counseling
• Cardiac and pulmonary rehabilitation
• Speech therapy
• Caregiver training

Additional services may also qualify for telehealth coverage.¹ You can reach out to Medicare (or your Medicare Advantage plan, if applicable) or your healthcare provider to find out which of your appointments can be conducted remotely.

Are in-person visits required for mental health telehealth under Medicare?

No. Through December 31, 2027, Original Medicare will not require in-person visits to start or continue mental health telehealth services.⁴ You can begin telehealth therapy or counseling without seeing your provider in person first, and you don’t need periodic in-person appointments to maintain coverage.

Original Medicare has also made certain mental health telehealth benefits permanent. These protections will remain in place even after other telehealth flexibilities expire. Here’s what stays permanent:⁵

• Mental health services can be received from home, regardless of where you live.
• Audio-only (phone) visits are allowed for mental health care.
• There are no geographic restrictions for accessing mental health telehealth services.

Does Medicare cover audio-only (phone) telehealth visits?

Yes. Original Medicare covers audio-only (phone) telehealth visits for most services when you’re at home through December 31, 2027.⁴ You don’t need video capability to access telehealth care under Original Medicare during this time.

Will these rule changes apply to Medicare Advantage coverage of telehealth?

The extended telehealth coverage described above applies to Original Medicare.¹ Medicare Advantage plans are required to cover the same services that are covered under Original Medicare, but there can be significant differences in terms of prior authorization, provider network access, and out-of-pocket costs. And Medicare Advantage plans can also cover additional telehealth services that aren’t covered by Original Medicare.⁶

Your best bet is to contact your Medicare Advantage plan directly to find out what telehealth services are available to you, whether prior authorization is required, and what provider you can see via telehealth.

If you have Original Medicare and your provider participates in an Accountable Care Organization (ACO), you may also have access to additional telehealth options.¹ It’s worth checking with your provider about what telehealth services they can offer.

How many Medicare beneficiaries have used telehealth?

Telehealth use among Medicare beneficiaries surged during the COVID-19 pandemic and has since leveled off at rates well above what they were before. According to the Centers for Medicare & Medicaid Services (CMS) data, about 48% of Original Medicare beneficiaries (approximately 14.8 million people) used telehealth services in 2020, accounting for 52.7 million total Medicare telehealth visits that year.^{7 8} That represented a 63-fold increase from (before the telehealth flexibilities were put in place), when there were approximately 840,000 Medicare telehealth visits.⁸

Usage has since declined but remains significantly higher than pre-pandemic levels. By 2024, about 25% of Original Medicare beneficiaries (6.7 million people) were using telehealth.⁷

How has telehealth affected provider visits?

Even with millions more Medicare beneficiaries using telehealth, research shows that the expansion did not lead to more overall provider visits. A University of Michigan analysis of 60 million beneficiaries found that total visit volume remained stable or even declined through mid‑2024.⁹

This was true even in specialties that used telehealth the most, such as behavioral health.¹⁰ Overall, telehealth appears to have replaced in-person appointments, rather than increasing how often beneficiaries see healthcare providers.

Which Medicare plans or parts cover hearing aids?

Original Medicare (including Part A and Part B) does not cover routine hearing tests or hearing aids. But most Medicare Advantage plans (Part C) do offer at least some coverage for hearing aids.

What does Medicare Advantage's hearing aid coverage include?

The hearing coverage through Medicare Advantage can include some or all of the following: a hearing exam, a hearing aid evaluation, a hearing aid fitting, and of course, the hearing aids themselves. Each of these services may have their own copay, though some plans may offer the exams with no out-of-pocket cost. Sorry to say, the cost of hearing aids themselves is not always covered.

Your plan may require you to get a physician referral before your hearing coverage kicks in. When it comes to the hearing aids, each Medicare Advantage plan may have preferred brands it will cover and the plan may also have limits as to how much it will pay. There’s a great deal of variation from one plan to another in terms of restrictions that apply to hearing aid coverage.

A KFF analysis found that about a third of plans in 2021 had dollar limits on how much they would pay for hearing aids (ranging from $66 to $4,000, and averaging $960 – a fraction of the cost of hearing aids), while most of the rest have a frequency limit on how often they’ll cover hearing aids. The KFF review found only 1% of Advantage plans paid for hearing aids with no dollar limit or frequency limit.¹²

How much do hearing aids cost with Medicare Advantage?

Like most insurance plans, your Medicare Advantage plan will likely have a deductible. If so, you may have to pay the deductible before your plan starts to pay for hearing aids or other hearing-related care. But the details vary from one plan to another, and the hearing aid benefit on a specific plan may or may not count toward the deductible; be sure to read the details of your plan so that you know what to expect. You may also have a copay or coinsurance when you get a hearing exam, hearing aid exam/fitting, or hearing aid(s).

How can I find Medicare Advantage plans that cover hearing aids?

If you want to shop for Medicare plans, you can use the Medicare Plan Compare site to get a sense of what plans are available in your area. When you do this, pay close attention to the Extra Benefits section. Here you will find the copays for the different hearing services.

As helpful as Medicare Plan Compare is as a first step, it does not include all the information you will need. What kinds of hearing aids are covered? What brands are covered? What are the plan’s limits on hearing services? You may then want to reach out to the plan directly or find an insurance broker in your area to find out more.

Can I get hearing aids over the counter?

In August 2022, the FDA finalized a rule that allowed adults with mild to moderate hearing loss to purchase hearing aids over-the-counter starting in October 2022.¹³ Like prescription hearing aids, over-the-counter hearing aids require FDA approval to confirm “reasonable assurance of safety and effectiveness.”

The U.S. Government Accountability Office released an analysis of the impact of OTC hearing aids in 2024.¹⁴ On average, they noted costs ranging from $200 to $1,000 depending on the type of hearing aid. Unfortunately, they also noted that as many as 17% of Medicare beneficiaries may be unable to afford hearing aids costing $500 or more.

OTC hearing aids may be convenient, but they may not be for everyone.¹⁵ Because they can be purchased without evaluation by an audiologist, it is possible that someone could buy the wrong kind for the type of hearing loss they have. Unless they pay out of pocket, they will not have the benefit of a fitting by an audiologist, which could make the hearing aids more comfortable. It is also important to keep in mind that not all OTC hearing aids will be returnable. Buyers should only choose a hearing aid that can be returned, if necessary.

And Original Medicare still won’t cover the cost. So although OTC hearing aids will be cheaper than prescription hearing aids, it will still be an out-of-pocket expense. For Medicare beneficiaries who still have money remaining in a health savings account (HSA), the OTC hearing aids will be an HSA-eligible expense, just like prescription hearing aids.¹⁶

What was the Medicare ‘donut hole’?

Since the Medicare Part D program took effect in 2006, there was a gap in Part D coverage for enrollees – commonly called the “donut hole” – which functioned like this:

• After an enrollee in a standard plan¹ met their Part D deductible, they paid 25% of their drug costs until they reached a certain spending threshold. (This limit was adjusted annually by CMS.)
• At that point, they entered the “donut hole” – during which they paid much more out of pocket – until they reached catastrophic coverage. Initially, enrollees paid 100% of the cost of their drugs while in the donut hole. But the Affordable Care Act gradually closed the donut hole over several years.
• Then, after reaching another spending threshold while in the “donut hole,” the enrollee entered “catastrophic coverage,” at which point their costs dropped again. (The beneficiary would pay 5% of the costs, or a nominal copay, at this point.)

When did the Part D ‘donut hole’ close?

Starting in 2010, the ACA started closing the donut hole, and through 2019, the percentage that beneficiaries paid out of pocket for medications while in the donut hole gradually decreased.

The ACA had called for the donut hole to close by 2020, but it closed a year early, in 2019, for brand-name drugs, as a result of the Bipartisan Budget Act of 2018.)²

How does Part D coverage work now that the ‘donut hole’ has been eliminated?

In 2025 and future years, the coverage gap phase (the “donut hole”) no longer exists. Instead there are these three phases:

The deductible phase: During this phase, you pay 100% of the cost of your prescriptions until your deductible is met. In 2026, the maximum deductible allowed is $615.³

The initial coverage phase: You remain in this phase until your total out-of-pocket spending reaches the maximum out-of-pocket – $2,100 in 2026.³ Your out-of-pocket costs will depend on the specific drugs you take, and whether you have a Part D plan that follows the standard plan design. Plans can offer coverage that’s more robust than the standard design, so there is some plan-to-plan variation.

The catastrophic phase: At this point, you’ll pay nothing for covered prescriptions for the rest of the year. Your Part D plan pays the full cost of covered drugs.

Enrollees who need expensive medications should also be aware of the new option, which became available starting in 2025, to spread out their drug costs in equal payments throughout the year, instead of having to meet the $2,100 out-of-pocket maximum in the first few months of the year. (This program can be used regardless of the cost of your drugs, but it’s most beneficial to those who fill high-cost prescriptions early in the year.)⁴

What is a hospital readmission?

According to Medicare,¹ a hospital readmission occurs when you have an unplanned return to the hospital within 30 days of being discharged.² To qualify as a “readmission,” you must be hospitalized as an inpatient for both stays. Care that is provided while you are under observation is not considered a readmission, even if you stay in the hospital overnight.

The Centers for Medicare & Medicaid Services (CMS) created the Hospital Readmissions Reduction Program (HRRP) with the goal of decreasing avoidable readmissions. The program reviews readmissions for a number of medical conditions, including but not limited to chronic obstructive respiratory disease (COPD), heart attack, and heart failure.

When a patient is readmitted for the same medical problem within 30 days, the hospital could be at risk for decreased payment from Medicare.² This incentivizes a hospital to make sure patients are stable before they are discharged and helps to optimize care.

What are common reasons for a hospital readmission?

Hospital readmissions can occur for a number of reasons. This can range from discharge before the patient is stable to insufficient patient education about after-hospital care to a lack of follow-up services. Social determinants of health can also play a role. It may be difficult for some people to afford their medications or to adhere to recommended care plans, and these patients may relapse. In some cases, people may have food insecurity or housing insecurity that can affect their after-hospital recovery.

CMS offers a Transitional Care Management Program that can help to temporarily mitigate the impact of some of these factors. The goal of this program is to support a patient during the first 30 days after they leave the hospital and go back into the community. This can help to decrease any gaps in care.

The Transitional Care Management Program includes direct communication between the provider and the patient in the first two days following discharge, education for the patient and their caregivers, and a review of the patient’s discharge information and follow-up care needs, including assistance with scheduling those services. It also includes communication with other medical professionals who are involved in the patient’s care, and if needed, referrals to those professionals.

Am I eligible for rehabilitation services after my hospital stay?

While most people are eager to return home, many may benefit from more intensive extended care and rehabilitation services. These services may be provided in a hospital or in a skilled nursing facility and can help to decrease the risk for readmission.

• Inpatient rehabilitation care: Inpatient rehab allows around-the clock nursing care and therapy services at least 3 hours per day five days per week or 15 hours within seven days and no more than three days between sessions. Rehabilitation services can include physical therapy, occupational therapy, and speech-language pathology. Medicare Part A covers these services when the provider determines they are medically necessary. The days you are in inpatient rehab are an extension of your hospital stay where hospital days 1-60 are covered by a $1,736 deductible in 2026.³ You will pay more for subsequent days: $434 per day for days 61-90 and $868 per day for days 91+ up to 60 lifetime reserve days.⁴³
• Skilled nursing facility care: Some people may not qualify for inpatient rehab but can get supervised rehabilitation services in a skilled nursing facility (SNF). For Medicare Part A to cover these services, you will need to have been treated as an inpatient for at least three days before being moved to the SNF, not counting the day you are transferred to the SNF. (So to clarify, it you have a two-day inpatient stay, Medicare will not pay for subsequent SNF care.) The three-day requirement could be waived in some cases if you receive care through an Accountable Care Organization (ACO) or if you have a Medicare Advantage (MA) plan. The first 20 days you are in a SNF are covered by Part A without a copay but SNF days 21-100 will cost you $217 per day in 2026⁵
  

Am I a candidate for home health services?

If you are not a candidate for inpatient or skilled nursing facility rehabilitation, you may be able to get physical therapy, occupational therapy, and speech-language pathology services at home. To qualify for home health services, Medicare requires that you be considered homebound.⁶ This means that it is challenging or impossible to leave your home. This could be the case after a recent hospital stay, at least in the short term.

Other services covered by home health care include nursing care, a home health aide, medical equipment and supplies, and social services. These services are covered on a part-time or intermittent schedule and are not intended for full-time use.

When and how will my medical provider provide discharge instructions?

Ask your doctor or discharge nurse for concise but thorough discharge instructions in layman’s terms. A healthcare provider should review these instructions with you to make sure you understand them. If possible, try to have a patient advocate or family member present when these instructions are explained.

You should have the opportunity to ask any questions about anything that is unclear. Make sure the information from your hospital stay is communicated to your primary care physician and other providers.

Take your new medication list to any follow-up appointments.

What questions should I ask before I leave the hospital?

Poor coordination and communication between healthcare providers, administrators, and patients can play a role in readmissions, so it is helpful if patients and their advocates know what questions to ask before they leave the hospital.

• What is my hospital diagnosis?
• What symptoms do I need to watch for? Are there any “red flags” to monitor?
• When (and with whom) is my follow-up appointment?
• What medications should I be taking?
• What do I do and who do I contact if I notice a concern or change?
• Has my primary care provider been notified about my stay?

To learn more, the author suggests the following articles: Hospital Discharge Planning Checklist, Tips for a Better Hospital Stay, and A Safe Return Home from the Hospital. If you believe you are being discharged too soon and do not have adequate support to care for yourself, talk to your doctor or discharge planner about your options. You have the right to appeal the decision to discharge you.

What is the Medicare phone number?

Medicare beneficiaries can call an easy-to-remember toll-free number – 1-800-MEDICARE – for information such as specific billing questions and questions about claims. (That’s 1-800-633-4227.)

When can I call Medicare for help?

The toll-free phone line is staffed 24 hours a day, seven days a week. Before you dial though, remember that almost all Medicare-related questions can be answered through easily accessible and authorized sources, including official web resources, health plan navigators, and consumer advocates. In most cases, the representatives at 1-800-MEDICARE only have access to the same information that’s available on Medicare.gov.

When should I call 1-800-MEDICARE?

Beneficiaries can call the toll-free Medicare number to:

• ask whether certain services are covered,
• get detailed information about Medicare health and prescription drug plans in your area, including costs and services,
• choose and enroll in a Medicare health or prescription drug plan,
• find a Medigap policy in the area,
• request a list of Original Medicare physicians, healthcare providers, and suppliers,
• request information and forms necessary for filing a Medicare appeal – or begin an appeal verbally,
• authorize someone to speak with Medicare on your behalf,
• compare quality ratings for skilled nursing facilities, hospitals, home health agencies, and dialysis facilities,
• request Medicare publications.
  

How else can I contact Medicare?

You can mail your questions or hard copies of documents to:

Medicare Contact Center Operations
PO Box 1270
Lawrence, KS 66044

Or fax Medicare at 1-844-530-3676.

Medicare also has a live chat service that you can use to seek help or information in a text format online. This service is available 24/7.

Currently, Medicare does not offer an email option for general information and questions. But you can log into your Medicare account for additional online assistance.

To request information in an accessible format (Braille, large print, data/audio files, relay services and TTY communications) call 1-877-486-2048 or email Medicare at altformatrequest@cms.hhs.gov. (This email fields requests for accessible format information only.)

What information can I find at Medicare.gov?

Medicare.gov contains a treasure trove of contact information and details about Medicare coverage. For contact information, visit the contact page of the website and enter your state or territory; then choose the organization or topic from a dropdown menu.

Where else can I get Medicare advice?

State Health Insurance Assistance Programs (SHIPs) are free volunteer-based Medicare counseling services available in each state. These programs provide unbiased counseling about Medicare questions – including details about coverage, benefits, and costs (such as premiums, deductibles, and coinsurance). SHIPs can also assist beneficiaries with complaints or appeals. Importantly, SHIPs can also assist with coverage changes like choosing the right Medicare Advantage or Part D plan for your needs.

When should I call Social Security instead of 1-800-MEDICARE?

Although Social Security and Medicare are linked in many ways, the Social Security Administration manages enrollment and eligibility for Medicare benefits. These are the times when you should call Social Security (1-800-772-1213) instead of Medicare:

• to verify your Medicare eligibility,
• to report a death,
• to request a replacement Medicare card,
• to report address, name, or phone number changes,
• to enroll in Medicare Part A and Part B,
• to discuss Medicare Part B (or Part A) billing issues,
• to apply for the Extra Help program for assistance with prescription drug costs,
• to appeal an Income-Related Monthly Adjustment Amount (IRMAA) decision, if you are told you owe an income-based Part B and/or Part D premium.
  

When should I not call 1-800-MEDICARE?

Do not call 1-800-MEDICARE if you have specific questions about your Medicare Advantage (Part C) or Part D plan. Because these policies are administered by private insurers, you must contact your plan insurer directly (or your agent/broker). This includes questions on plan premiums, deductibles, claims status, and other issues that are plan-specific.

Medigap plans are also issued by private insurers, and you can reach out to the insurer if you have a question or concern about your Medigap coverage. But 1-800-MEDICARE can sometimes assist with Medigap claims issues, if the problem is that your Medigap plan is not receiving claims once they’ve been processed by Original Medicare.

You can also call 1-800-MEDICARE for general Medicare questions not mentioned in this article.

What does Medicare Part A cost enrollees?

Although most Medicare beneficiaries receive Part A with no premium, if you do have to pay for it, the premium in 2026 is $565 per month if you worked less than 7.5 years, and $311 per month if you worked between 7.5 and 10 years.⁴

If you’re hospitalized, Medicare Part A has a deductible of $1,736 in 2026⁴ (per benefit period). There is also a copay amount that is charged on a per-day basis after a patient has spent 60 days in the hospital during a single benefit period. In 2026, it’s $434 per day for days 61-90. Each beneficiary has 60 “lifetime reserve days” which can be used if the person still needs to be hospitalized after 90 days in a single benefit period. In 2026, the lifetime reserve coinsurance is $868 per day.⁴ All Medigap plans cover these coinsurance charges, plus up to another 365 days of inpatient care after Medicare benefits are exhausted.⁵

(Medicare Advantage plans can have different plan designs in terms of cost-sharing, so the deductible and coinsurance for Medicare Part A isn’t the same as the out-of-pocket costs that a beneficiary pays if they’re hospitalized while enrolled in a Medicare Advantage plan.)

What does Medicare Part B cost enrollees?

Medicare Part B has a standard monthly premium of $202.90 in 2026, for people who earn up to $109,000 a year¹ ($218,000 for a married couple; note that this is based on income reflected on 2024 tax returns). The premiums are higher if your income exceeds that amount. If an enrollee receives care that’s covered under Medicare Part B, they’ll first pay an annual deductible, which is $283 in 2026.⁴

Some Medigap plans pay the Part B deductible. For people who become eligible for Medicare on or after January 1, 2020, Medigap plans that cover the Part B deductible are no longer available, but people who became eligible for Medicare before that date can continue to have coverage under Medigap Plans C or F, both of which cover the Part B deductible⁵ (these beneficiaries can keep those plans if they already have them, or they can apply for coverage under them if they want to change their plan, keeping in mind that medical underwriting is used in most states if you’re applying for a Medigap plan after your initial enrollment period ends).

(As noted above, Medicare Advantage plans can have different plan designs in terms of cost-sharing, so the out-of-pocket costs that an enrollee will pay for outpatient care will be different if they’re enrolled in a Medicare Advantage plan.)