How does Medicare work?

Orientation
Last updated: 
April 10, 2026
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Smiling elderly man with pre existing conditions is grateful for medicare insurance and woman enjoying tea together indoors with plants in the background.
Older couple smiling wondering about their drug formulary and dancing outdoors among green trees, enjoying a healthy aging lifestyle.

The short answer

Medicare is the federal health insurance program for people 65 and older, and for some people with disabilities. It is split into parts that cover hospital stays, doctor visits, prescription drugs, and more.

The full explanation

Medicare is run by the federal government and covers most Americans once they turn 65. It is divided into parts, and each part covers something different.Part A covers inpatient hospital care, skilled nursing facility stays, hospice, and some home health services. Most people do not pay a monthly premium for Part A if they or their spouse worked and paid Medicare taxes for at least 10 years.Part B covers doctor visits, outpatient care, preventive services, and medical equipment. Part B does have a monthly premium, and the amount can vary based on your income.Part D covers prescription drugs. It is offered through private insurance companies approved by Medicare, and premiums and covered medications vary by plan.There is also Part C, better known as Medicare Advantage, which lets you get all of your Medicare benefits bundled through a private insurer instead of through Original Medicare directly.Original Medicare (Parts A and B) covers a lot, but it does not cover everything, and it has no out-of-pocket maximum. That is why many people add either a Medigap supplement policy to cover cost-sharing gaps, or choose a Medicare Advantage plan that caps what they could owe in a year.Plan details and costs change annually, so it is worth reviewing your coverage each year.

Related Medicare Resources

Smiling elderly couple on social security benefits misunderstand medicare advantage are outdoors with man presenting a bouquet of yellow flowers to the woman.Smiling elderly couple disappointed at their doctor for not accepting medicare sitting on a bench outdoors holding a colorful bouquet of flowers.A group of six older adults enjoy discussion with primary care physician covered by medicare sitting together indoors, smiling and enjoying conversation with drinks.
Two elderly men in a nursing home paid for by medicare sitting at a wooden table outdoors, one showing the other something on a tablet, with drinks on the table.

In 

 specifically

In Utah, free one-on-one Medicare counseling is available through the Aging and Disability Resource Centers (ADRC). They can help you compare plans and understand your options without trying to sell you anything.

What this means for you

For you, this means Medicare gives you a solid foundation of health coverage, but understanding how the parts fit together helps you avoid surprise costs and choose the right add-ons for your situation.

Related Questions

Still have questions about Medicare?

Book a review with a licensed Medicare advisor.

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