Medicare and Medicaid: The Complete Guide

Key numbers at a glance

Medicare and Medicaid: two different programs

Medicare and Medicaid have similar names, were created in the same law in 1965, and are both overseen by the Centers for Medicare & Medicaid Services (CMS). After that, they are very different. Medicare is federal health insurance based mainly on age or disability. If you are 65 or older, or younger with a qualifying disability, you can usually get it no matter what your income is. Medicaid is a joint federal and state program for people with limited income and resources. Each state runs its own Medicaid program within federal rules, so eligibility, benefits and even the program name can differ from one state to the next.

The difference matters because the two programs answer different questions. Medicare asks "Are you old enough, or disabled?" Medicaid asks "Is your income and, in some cases, your savings low enough?" Many people qualify for one and not the other, and some people qualify for both. People who have both are called dual eligible, and for them Medicaid can fill in many of the costs Medicare leaves behind.

The Children's Health Insurance Program (CHIP) sits alongside Medicaid. It covers children in families that earn too much for Medicaid but cannot easily afford private insurance. Like Medicaid, it is run by each state, and you can apply at any time of year. Many parents never check because they assume a working household earns too much, yet income limits for children are usually higher than for adults. In some states, CHIP also covers pregnant people.

This guide walks through each program in turn: what it covers, what it costs, when you can sign up, and what to do when something goes wrong. Throughout, one piece of advice comes up again and again: get free, unbiased help from your State Health Insurance Assistance Program (SHIP) before making a decision that is hard to undo. SHIP counselors are trained staff and volunteers who do not sell insurance, and they know the rules in your state.

• Medicare: federal, mainly for people 65 and older and some younger people with disabilities, end-stage renal disease (ESRD) or ALS
• Medicaid: federal and state, for people with limited income; rules differ by state
• CHIP: federal and state, for uninsured children up to age 19 in families with modest incomes
• Dual eligible: people who have both Medicare and Medicaid

Who qualifies for Medicare

Most people become eligible for Medicare when they turn 65. You can also qualify earlier if you have received Social Security disability benefits for a set period, if you have end-stage renal disease (permanent kidney failure needing dialysis or a transplant), or if you have ALS (amyotrophic lateral sclerosis, also called Lou Gehrig's disease). People with ALS get Medicare as soon as their disability benefits begin.

Being eligible for Medicare is not the same as getting Part A for free. Most people pay no premium for Part A because they or their spouse paid Medicare taxes while working for at least 10 years. If you did not, you may still be able to buy Part A by paying a monthly premium. Part B, the medical insurance part, has a monthly premium for almost everyone, and people with higher incomes pay more. The exact premium and deductible amounts change every year, so check Medicare.gov for the current figures rather than relying on last year's numbers.

Some people are signed up automatically. If you are already getting Social Security or Railroad Retirement Board benefits when you turn 65, you are usually enrolled in Parts A and B and your card arrives in the mail a few months beforehand. If you are not yet getting those benefits, you generally need to sign up yourself through Social Security. Many people assume a reminder will arrive. It may not, which is one of the most common ways people end up with a late penalty.

What Original Medicare covers, and what it does not

Original Medicare is the traditional program run directly by the federal government. It has two parts. Part A (hospital insurance) covers inpatient hospital stays, care in a skilled nursing facility after a qualifying hospital stay, hospice care and some home health care. Part B (medical insurance) covers doctor visits, outpatient care, many preventive services, ambulance rides, lab tests and durable medical equipment such as walkers and oxygen.

With Original Medicare you can see any doctor or hospital in the country that accepts Medicare, with no network and usually no referral needed to see a specialist. That freedom is one of its main strengths. The tradeoff is cost-sharing. After you meet the yearly Part B deductible, you typically pay 20 percent of the Medicare-approved amount for most Part B services. There is no yearly limit on what you can pay out of pocket. For most people that is manageable in a healthy year, but a serious illness, a long course of cancer treatment or repeated hospital stays can add up quickly.

It also helps to know about doctors who "accept assignment". These doctors agree to take the Medicare-approved amount as full payment, so you only owe your deductible and coinsurance. Doctors who do not accept assignment can charge somewhat more, and a few opt out of Medicare entirely. Asking this question before a visit can save you a surprise bill. You can check whether a provider accepts Medicare, and whether they accept assignment, by asking the office directly or by using the provider search tools on Medicare.gov.

Common gaps in Original Medicare

Original Medicare does not cover most dental care, routine eye exams for glasses, hearing aids or most care outside the US. Most importantly, it does not pay for long-term custodial care: help with everyday activities such as bathing, dressing and eating, whether at home, in assisted living or in a nursing home. Medicare covers short stays in a skilled nursing facility for rehabilitation after a hospital stay, but not ongoing care when the main need is help with daily living. Many families learn this only when a parent needs a nursing home. Medicaid, long-term care insurance or personal savings usually pay for that kind of care.

Inpatient or observation?

Being in a hospital bed overnight does not always mean you are an inpatient. Hospitals sometimes keep people under "observation status", which is billed as outpatient care under Part B. This affects what you pay and whether Medicare later covers a skilled nursing facility stay, which normally requires a prior inpatient stay. If you are kept in the hospital, ask whether you have been formally admitted. Hospitals must give you a written notice if you are under observation for more than a short period.

Medicare Advantage, Part D and Medigap: filling in the picture

Once you have Parts A and B, you face a basic choice. You can stay with Original Medicare and add separate coverage for drugs and gaps, or you can join a Medicare Advantage plan, also called Part C, which bundles your benefits through a private insurance company approved by Medicare. Neither choice is right for everyone. The best fit depends on your health, your doctors, your medicines, where you live and how much financial risk you are comfortable with.

Medicare Advantage plans must cover everything Original Medicare covers, except hospice, which Original Medicare still pays for. Most include Part D drug coverage, and many add extras such as dental, vision or hearing benefits. Every plan has a yearly out-of-pocket limit for covered Part A and B services, which Original Medicare does not. In return, most plans are HMOs or PPOs with provider networks, and many require prior authorization before certain services. If you go out of network, an HMO may not pay at all and a PPO usually charges more. Emergency care must be covered in or out of network.

If you stay with Original Medicare, two add-ons fill the gaps. A stand-alone Part D plan covers prescription drugs. A Medigap policy (Medicare Supplement Insurance) helps pay your deductibles, copays and the 20 percent coinsurance. Together they give you predictable costs and freedom to see any provider who takes Medicare, usually for higher monthly premiums than many Medicare Advantage plans. People who travel often, live in more than one state, or want to keep a particular specialist sometimes prefer this route, while people comfortable with a local network may find Medicare Advantage simpler.

• Make a list of your doctors, hospitals, pharmacies and every medicine with its dose
• Check each plan's network, drug list and out-of-pocket maximum, not just the premium
• Ask which services need prior authorization
• Use the Medicare Plan Finder on Medicare.gov to compare plans side by side
• Call your SHIP for free, unbiased help before you decide

Part D prescription drug coverage

Part D is offered by private plans, either on its own or built into a Medicare Advantage plan. Each plan has its own list of covered drugs (a formulary), its own pharmacy network and its own pricing tiers. Recent changes have made drug costs more predictable: out-of-pocket spending on covered Part D drugs is now capped each year. The cap was $2,000 in 2025 and is adjusted yearly. Covered insulin costs no more than $35 for a month's supply. The Medicare Prescription Payment Plan also lets you spread your out-of-pocket drug costs into monthly payments across the year instead of paying large amounts at the pharmacy counter early in the year.

If you go without Part D or other creditable drug coverage (coverage at least as good as Part D) for 63 days or more after you first become eligible, you may pay a late enrollment penalty added to your premium for as long as you have Part D. If you have drug coverage from an employer or union, they must tell you each year whether it counts as creditable. Keep that letter.

Medigap policies

Medigap plans are standardized and identified by letters. In most states, a Plan G from one company has the same basic benefits as a Plan G from another; only the price and customer service differ. That makes shopping simpler: choose the letter that fits your needs, then compare prices. Medigap works only with Original Medicare and cannot be used with a Medicare Advantage plan. Policies sold today do not include drug coverage, so you will also want Part D. Plans C and F are not available to people who became newly eligible for Medicare on or after January 1, 2020.

Timing is everything with Medigap. Your Medigap Open Enrollment Period lasts 6 months and starts the first month you have Part B and are 65 or older. During that window, companies cannot refuse to sell you a policy or charge you more because of health problems. After it ends, in most states insurers can ask medical questions and turn you down. That is why a decision to start with Medicare Advantage and "switch later" can be harder to reverse than people expect.

Enrollment periods and late penalties

Medicare runs on fixed calendars. Signing up late, or changing plans outside the allowed windows, can leave you without coverage for months and with penalties that last for life. The most important window is your Initial Enrollment Period: 7 months that include the 3 months before the month you turn 65, the month itself, and the 3 months after. Signing up during the first 3 months means your coverage usually begins the month you turn 65.

If you miss your Initial Enrollment Period and do not qualify for a Special Enrollment Period, you can sign up during the General Enrollment Period, January 1 to March 31 each year. You may then owe a Part B late penalty of 10 percent of the standard premium for each full 12-month period you could have had Part B but did not. That penalty generally lasts as long as you have Part B.

If you or your spouse are still working and covered by a group health plan from that current job, you can usually delay Part B without a penalty and sign up later during a Special Enrollment Period. The rules depend on the size of the employer and whether the coverage is based on current work. COBRA and retiree coverage do not count as coverage from current employment for this purpose, which is a common and costly misunderstanding. Ask your employer's benefits office how its plan works with Medicare, and get the answer in writing.

• Initial Enrollment Period: 7 months around your 65th birthday
• Open Enrollment: October 15 to December 7, for changes that start January 1
• Medicare Advantage Open Enrollment: January 1 to March 31, for people already in a Medicare Advantage plan to switch plans or return to Original Medicare
• General Enrollment Period: January 1 to March 31, if you missed your first chance to sign up
• Special Enrollment Periods: in certain situations, such as losing job-based coverage or moving

Review your coverage every fall

Plans change their premiums, drug lists, pharmacy networks and provider networks every year. Each fall your plan sends an Annual Notice of Change describing what will be different on January 1. Read it, and then spend an hour during Open Enrollment rechecking your options with your current medicine list. Staying in the same plan year after year without looking is one of the easiest ways to overpay.

Preventive care and wellness visits under Medicare

Part B covers many preventive services with no cost to you when your provider accepts assignment, including many cancer screenings, vaccines such as flu shots, and screenings for conditions like diabetes and depression. These services are worth using, because finding a problem early often makes it easier to treat. Your doctor can tell you which screenings fit your age, health and history; not every test is recommended for everyone, and some screenings are not useful after a certain age. If a preventive test leads to a follow-up test, the follow-up may have costs.

Within the first 12 months you have Part B, Medicare covers a one-time "Welcome to Medicare" preventive visit. After you have had Part B for more than 12 months, you can have an Annual Wellness Visit once every 12 months. These visits include a health risk assessment, a review of your medicines, a check for memory or thinking problems, and a personalized prevention plan listing the screenings and vaccines you are due for.

An important detail: a wellness visit is not a head-to-toe physical exam and does not include routine lab tests. If you raise a new problem during the visit, such as a painful knee or a new symptom, your provider may address it and bill it separately, which can mean a copay or coinsurance. That is fine, but it is reasonable to ask in advance. And do not wait for a wellness visit if something new or worrying is happening; book a regular appointment.

• Bring every medicine, vitamin and supplement you take, or a complete list
• Bring your family health history and the names of your other doctors
• Mention any falls, memory changes, low mood or trouble hearing
• Ask which screenings and vaccines are due and what, if anything, they will cost

Medicaid: who qualifies and what it covers

Medicaid covers tens of millions of Americans, including many children, pregnant people, older adults, people with disabilities and adults with low incomes. Because each state runs its own program within federal rules, the most important first step is to check your state's limits rather than assuming you earn too much. In states that have expanded Medicaid, adults under 65 can qualify with income up to 138 percent of the federal poverty level. In states that have not expanded, adults without children often cannot qualify on income alone, though children, pregnant people, people with disabilities and older adults may qualify under other rules.

Medicaid generally covers doctor visits, hospital care, lab tests, prescription drugs, maternity care, mental health and substance use treatment, and comprehensive care for children. Unlike Medicare, Medicaid can also pay for long-term care services, both in nursing homes and, in many states, at home and in the community. Out-of-pocket costs are usually low or nothing. Many states deliver Medicaid through managed care plans, so you may choose or be assigned a health plan that has its own network of doctors and its own member services line. Your Medicaid card or plan card will tell you who to call.

You can apply for Medicaid at any time of year, either through your state Medicaid agency or through HealthCare.gov, which will send your information to the state if you appear to qualify. Some states can cover medical bills from the months before you applied, so if you have recent unpaid bills, ask whether retroactive coverage is available where you live.

Keeping Medicaid once you have it

States check Medicaid eligibility at least once a year. Many people lose coverage not because they stopped qualifying, but because a renewal notice went to an old address or a form was returned late. Keep your mailing address, phone number and email up to date with your state agency, open every piece of mail from it, and answer renewal requests by the deadline. If your coverage ends, you usually have a special enrollment period to buy a Marketplace plan on HealthCare.gov, often with financial help, so act quickly rather than going uninsured.

Medicaid and long-term care

Medicaid is the largest payer for long-term nursing home care in the US. Eligibility for long-term care is based on both income and assets, and the rules are more detailed than for regular Medicaid. States look back at asset transfers made during the 5 years before you apply, and giving money or property away during that time can delay coverage. Because these rules are complex and vary by state, families planning for long-term care often benefit from talking with the state Medicaid agency, a SHIP counselor or an elder law attorney well before care is needed.

CHIP and coverage for children and pregnancy

Children are among the people most likely to qualify for public coverage, and also among those most often left uninsured even when they qualify. Medicaid and CHIP together cover uninsured children up to age 19 in families with low and moderate incomes. Income limits for children are usually higher than for adults, so a family whose parents do not qualify may still have children who do.

CHIP covers checkups, vaccines, doctor visits, prescriptions, dental and vision care, and hospital care. Costs are low or nothing; where states charge premiums or copays, federal rules limit how much they can be. Children enrolled in Medicaid get a broad benefit that includes regular well-child checkups and the screening, diagnosis and treatment they need, often called EPSDT. Well-child visits matter even when a child seems healthy, because they track growth and development and keep vaccines on schedule.

Pregnancy is another point at which many people newly qualify. Medicaid covers a large share of births in the US, and some states also use CHIP to cover pregnant people. Coverage typically includes prenatal visits, delivery and care after birth. If you become pregnant and are uninsured or underinsured, apply right away rather than waiting; early prenatal care is linked to healthier pregnancies.

• Apply through your state Medicaid or CHIP agency, HealthCare.gov, or by calling Insure Kids Now at 1-877-543-7669 (1-877-KIDS-NOW)
• Use the dental coverage, which CHIP includes for children
• Keep up with well-child visits and recommended vaccines
• Update your address so renewal notices reach you

Dual eligibility and help with costs

If you have both Medicare and Medicaid, Medicare pays first for services both programs cover, and Medicaid pays after that. Medicaid may also cover services Medicare does not, such as long-term care, and help with Medicare premiums and cost-sharing. For many people with limited income, being dual eligible means very low out-of-pocket health costs. Show both cards every time you get care.

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program. These are run by state Medicaid agencies and can help pay Medicare premiums and, for some people, deductibles, coinsurance and copays. The most generous is the Qualified Medicare Beneficiary (QMB) program. Providers are not allowed to bill people in the QMB program for Medicare cost-sharing. If you are in QMB and receive such a bill, do not pay it; tell the provider you are a QMB and call 1-800-MEDICARE if the problem continues.

Extra Help is a separate federal program that lowers Part D premiums, deductibles and copays for people with limited income and resources. People with full Medicaid, Supplemental Security Income (SSI) or a Medicare Savings Program qualify automatically. Others can apply through Social Security. Many people who qualify never apply, so if money is tight, it is worth checking. Dual eligible people may also be able to join a Dual Eligible Special Needs Plan, a kind of Medicare Advantage plan designed to coordinate Medicare and Medicaid benefits, and they have more flexible rules for changing plans during the year.

Denials, appeals and protecting your rights

Coverage decisions are not always right, and you have the right to challenge them. Every denial notice should explain why the service was denied, how to appeal and the deadline. Read it carefully, because the deadlines are strict and a phone call alone usually does not count as a formal appeal. Follow the written instructions exactly and keep copies of everything you send and receive.

For Original Medicare, you ask for a redetermination within 120 days of receiving the Medicare Summary Notice that shows the denial. For a Medicare Advantage plan, you ask the plan for reconsideration within 65 days of its decision, and for a Part D plan, you ask for a redetermination within 65 days of its coverage decision. Medicare appeals have 5 levels, and if you keep disagreeing, the process can end in federal court. Many people get a decision changed at the first or second level, especially with a supporting letter from their doctor.

If waiting for a standard decision could seriously harm your health, ask for a fast (expedited) appeal, and ask your doctor to support the request. If you are in the hospital and think you are being discharged too soon, you have the right to a fast appeal to an independent reviewer; the hospital must give you a notice explaining how. Similar fast-appeal rights apply when skilled nursing, home health or hospice services are ending. For Medicaid, you have the right to a state fair hearing, and deadlines vary by state. In some cases, if you ask quickly, your benefits can continue while you wait.

• Find the reason and the deadline on the denial notice
• Ask your doctor for a letter explaining why the service is medically needed
• Ask for an expedited appeal if delay could seriously harm your health
• Keep copies and a log of every call, with the date and the name of the person you spoke with
• Get free help from your SHIP or, for Medicaid, your state's legal aid organization

Myths and facts about Medicare and Medicaid

A lot of what people "know" about these programs is half true or out of date. Getting the facts straight before you turn 65, or before a family member needs care, can prevent expensive mistakes. The myths below are among the most common misunderstandings, and each one can cost money or coverage. If something in your own situation does not fit neatly into these answers, that is a good reason to call 1-800-MEDICARE or your SHIP before you act.

• Myth: Medicare is free. Fact: most people get Part A without a premium, but Part B, Part D, Medigap and many Medicare Advantage plans have premiums, and there are deductibles and coinsurance.
• Myth: Medicare pays for nursing homes. Fact: it covers short skilled nursing stays after a qualifying hospital stay, not long-term custodial care.
• Myth: Original Medicare caps what you pay each year. Fact: it has no out-of-pocket limit; Medigap or a Medicare Advantage plan provides one.
• Myth: I can delay Part B if I have COBRA or retiree coverage. Fact: those do not count as coverage from current employment, and delaying can lead to a lifelong penalty.
• Myth: I can always switch from Medicare Advantage back to Original Medicare and buy Medigap. Fact: you can usually switch back during certain periods, but outside your Medigap Open Enrollment Period insurers in most states can deny you or charge more.
• Myth: I earn too much for Medicaid. Fact: limits differ by state and by group, and children often qualify when parents do not.
• Myth: Emergency rooms can turn me away without insurance. Fact: hospital emergency departments must screen and stabilize anyone with an emergency, regardless of insurance.

A practical year-round plan

Health coverage works best when you treat it as a yearly routine rather than a crisis to handle when a bill arrives. The plan below works whether you are about to turn 65, already on Medicare, enrolled in Medicaid, or helping a parent or child. Adjust it to your own situation, and use your SHIP whenever a step feels unclear; the help is free and the counselors do not sell insurance.

If you are approaching 65, start about six months before your birthday. Find out whether you will be enrolled automatically, ask your employer how its coverage works with Medicare, list your doctors and medicines, and mark your Initial Enrollment Period and Medigap Open Enrollment Period on a calendar. Decisions made in this first year shape your options for many years afterward.

• January to March: check that your new plan year started correctly, your drugs are covered at the price you expected, and your cards work; if you are in Medicare Advantage and unhappy, this is the window to switch once
• Spring: book your Annual Wellness Visit and any screenings or vaccines due
• Summer: update your medicine list, and check whether you might qualify for Extra Help or a Medicare Savings Program
• September: read your plan's Annual Notice of Change
• October 15 to December 7: compare plans on the Medicare Plan Finder with your current drug list
• All year: answer Medicaid renewal mail on time, keep your address current, and appeal denials before the deadline

Every guide in this topic

• Original Medicare (Parts A and B): What Published Guidance Supports
• The Evidence on Medicare Advantage Plans, Without the Hype
• What the Guidance Really Says About Part D and Extra Help
• Medicare Enrollment Periods: What the Evidence Actually Says
• The Evidence on Medigap Policies, Without the Hype
• Medicaid Eligibility: Sorting the Evidence From the Noise
• CHIP Coverage for Children: What the Evidence Actually Says
• Medicare Wellness Visits: What the Evidence Actually Says
• What the Guidance Really Says About Dual Eligibility
• Medicare and Medicaid Appeals: What the Evidence Actually Says

Frequently asked questions

What is the difference between Medicare and Medicaid?

Medicare is federal health insurance mainly for people 65 and older and some younger people with disabilities, end-stage renal disease or ALS, regardless of income. Medicaid is a joint federal and state program for people with limited income and, in some cases, limited savings. Rules for Medicaid differ by state. Some people qualify for both and are called dual eligible.

Do I have to sign up for Medicare at 65 if I am still working?

Not always. If you or your spouse have group health coverage based on current employment, you may be able to delay Part B without a penalty and sign up later during a Special Enrollment Period. The rules depend on the employer's size. COBRA and retiree coverage do not count. Ask your employer and Social Security before your Initial Enrollment Period ends.

Should I choose Original Medicare or Medicare Advantage?

It depends on your doctors, medicines, health and budget. Original Medicare lets you see any provider who takes Medicare but has no out-of-pocket limit unless you add Medigap. Medicare Advantage plans have a yearly limit and often extra benefits, but usually use networks and prior authorization. Compare both on the Medicare Plan Finder and ask your SHIP for free help.

Does Medicare pay for a nursing home?

Medicare covers short stays in a skilled nursing facility for care such as rehabilitation after a qualifying inpatient hospital stay. It does not pay for long-term custodial care, meaning help with daily activities like bathing and dressing. Medicaid, long-term care insurance or personal savings usually pay for that kind of care.

When can I change my Medicare plan?

Anyone with Medicare can change plans during Open Enrollment, October 15 to December 7, with changes starting January 1. If you are in a Medicare Advantage plan, you can also switch plans or return to Original Medicare once between January 1 and March 31. Special Enrollment Periods allow changes after certain events, such as moving or losing other coverage.

How much will I pay for prescription drugs under Part D?

It depends on your plan and your medicines, but out-of-pocket costs for covered Part D drugs are now capped each year. The cap was $2,000 in 2025 and is adjusted yearly. Covered insulin costs no more than $35 for a month's supply. If your income is limited, Extra Help can lower your premiums, deductibles and copays further.

How do I know if I qualify for Medicaid?

Check your state's rules, because eligibility varies. In expansion states, adults under 65 can qualify with income up to 138 percent of the federal poverty level, and children, pregnant people, older adults and people with disabilities may qualify under other rules everywhere. You can apply any time through your state Medicaid agency or HealthCare.gov, which will tell you if you appear eligible.

My child is uninsured. What are my options?

Your child may qualify for Medicaid or CHIP even if you do not, because income limits for children are usually higher. CHIP covers checkups, vaccines, doctor visits, prescriptions, dental and vision care and hospital care at low or no cost. Apply any time through your state agency, HealthCare.gov, or by calling Insure Kids Now at 1-877-543-7669.

What should I do if Medicare or my plan denies coverage?

Read the notice for the reason and deadline, then file an appeal in writing as instructed. For Original Medicare you have 120 days from your Medicare Summary Notice; for Medicare Advantage and Part D plans, 65 days from the decision. Ask your doctor for a supporting letter, and request a fast appeal if waiting could seriously harm your health.

Where can I get free, unbiased help with Medicare?

Your State Health Insurance Assistance Program (SHIP) offers free one-on-one counseling from trained staff and volunteers who do not sell insurance. You can also call 1-800-MEDICARE (1-800-633-4227) any time, or use the tools on Medicare.gov. For Medicaid and CHIP questions, contact your state Medicaid agency or HealthCare.gov.

When to speak to a doctor

Coverage questions should never delay medical care. Call 911 for a medical emergency such as chest pain, sudden weakness or numbness, trouble speaking or severe trouble breathing; Medicare and Medicaid cover emergency care, Medicare Advantage plans must cover it in or out of network, and emergency rooms must screen and stabilize anyone regardless of insurance. See your doctor promptly for new or worsening symptoms rather than waiting for a wellness visit, and tell your doctor or pharmacist if you cannot afford a medicine before you stop taking it. Call Poison Control at 1-800-222-1222 for a medicine overdose or accidental swallowing. For coverage questions, call 1-800-MEDICARE (1-800-633-4227) or your State Health Insurance Assistance Program.

Where this comes from

• Medicare.gov — Parts of Medicare
• Medicare.gov — Understanding Medicare Advantage Plans
• Medicare.gov — How Medicare drug coverage works
• Medicare.gov — When does Medicare coverage start?
• Medicare.gov — What's Medicare Supplement Insurance (Medigap)?
• Medicare.gov — Appeals
• Medicare.gov — Medicare Savings Programs
• Medicaid.gov — Eligibility
• Medicaid.gov — Children's Health Insurance Program (CHIP)
• CMS — Dual Eligible Beneficiaries under Medicare and Medicaid

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.