Understanding Medicare plans

When you turn 65, you are eligible to enroll in original Medicare. And while that sounds simple, weighing your Medicare options can be confusing. You are asked if you want to sign up for Medicare Part A and Medicare Part B – and if you want to enroll in options like Medicare Part C and Medicare Part D. It's hard to keep it all straight as you try to find is the coverage that’s best for you and your needs. Learn more about what each part of Medicare covers, as well as eligibility, plan options and potential costs.

Parts of Medicare

There are four parts of Medicare that make up your Medicare options. Watch our Basics of Medicare video for a short description on the parts of Medicare.

Part A

Medicare Part A is offered through the federal government and helps pay for hospital expenses. For example, Part A helps cover your inpatient care in hospitals, hospice, and skilled nursing facilities, including critical-access hospitals and long-term care hospitals. Most people automatically get Part A without having to pay a monthly premium.

Part B

Medicare Part B helps cover medical services like doctors’ visits and outpatient care when they are medically necessary, including:

• Services from doctors and providers
• Outpatient care
• Home healthcare
• Durable medical equipment (e.g., wheelchairs, walkers)
• Preventive care services (e.g., screenings, annual wellness visits and vaccines)

You pay a monthly premium for Part B. If you don’t sign up for Part B during your Initial Enrollment Period, you may pay a permanent late-enrollment penalty for every year that you delay. Visit Medicare.gov for details.

Part C

Medicare Part C coverage is provided by Medicare Advantage (MA) plans, which are offered by private insurance companies, and includes Part A and Part B coverage, as well as extra benefits. For some plans, you pay a monthly premium.

Check out our MA plans to see what benefits are available.

Part D

Medicare Part D coverage is designed to help lower your prescription drug costs. Part D coverage is available separately or may be included with an MA plan (Part C). If you do not enroll in Part D prescription coverage when you first become eligible for Medicare, you may have to pay a late enrollment penalty of 1% for each month that you didn’t have Part D coverage (e.g., 12% for a full year). The cost of the penalty depends on how long you went without Part D or creditable prescription drug coverage.

If you have Medicare Part D coverage, you are eligible to sign up for the Medicare Prescription Payment Plan, or M3P. Learn more about M3P and how you can sign up for it.

Your Medicare plan options

Here's how the different parts of Medicare come together.

Original Medicare plan

Original Medicare combines Part A and Part B and is offered to you through the federal government. Original Medicare only covers about 80% of your medical and hospital expenses. You are responsible for paying the other 20% – and 100% of your prescription drug costs.

Original Medicare doesn’t include a limit on your out-of-pocket expenses, so it’s difficult to know what your healthcare costs will be. It also doesn’t include Part D prescription drug coverage, so you’ll have to buy a separate plan that covers prescription drugs.

Medicare Advantage (MA) plan

MA plans are offered by private health insurers and include both Part A and Part B coverage, as well as extras that original Medicare doesn’t offer. Many MA plans also include Part D prescription drug coverage. With an MA plan, you must continue to pay a Part B premium, plus the private plan’s monthly premium, but MA premiums are generally lower than what you might pay for Medicare.

Plus, with an MA plan, all your healthcare ID cards are combined into one, so you don’t need to carry multiple cards with you. You’ll only need your Blue Cross of Idaho member ID card for all your medical services and for filling your prescriptions, if you have Part D included in your plan.

Browse our MA plan options to see which of our plans may work for you.

Medicare Supplement plan

Medicare Supplement plans, sometimes called Medigap, work with original Medicare to fill the gaps not covered by Medicare alone. You’ll usually need original Medicare coverage, including Part A and Part B, before you can get a Medicare Supplement plan. These plans do not include prescription drug coverage. For prescription drug coverage, you must buy a separate Medicare Part D drug plan.

How much does a Medicare plan cost in 2025?

Medicare costs can vary depending on whether you have an original Medicare plan, a Medicare Advantage plan, and whether you pay any late enrollment penalties on your premiums. Visit the Medicare.gov site for more information on what your Medicare costs may be in 2025.

When to enroll in a Medicare plan

There are a couple of ways to enroll in a Medicare plan, as well as opportunities to make changes to your existing plan.

Initial Enrollment Period

The Initial Enrollment Period is your first chance to sign up for a Medicare plan. Your Initial Enrollment Period kicks in when you’re about to turn 65 and lasts seven months: three months before your birth month, your birth month, and three months after your birth month. When you sign up during the Initial Enrollment Period, your coverage start date will depend on when you signed up. Your Part A coverage starts the month you turn 65 (or the month before if your birthday is on the first of the month).

Important: If you don’t sign up for Medicare during your Initial Enrollment Period, you may have to wait to sign up and will then have to pay a permanent late enrollment penalty, which is added to your monthly Part B premium. Additionally, if you have to pay a Part A premium, you may also have to pay a penalty (most people don’t have to pay a Part A premium).

General Open Enrollment Period

The General Open Enrollment period is between October 15 and December 7 each year. You can sign up for a Medicare plan or make changes to an existing plan during this time. However, if you sign up during this timeframe and it falls outside your Initial Enrollment Period, then you will pay a monthly late enrollment penalty.

Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period is from January 1 to March 31 and is only for people who already have a Medicare Advantage Plan. Our Medicare for Idaho guide has information about the kinds of changes you can make to your plan during this time.

Special Enrollment Period

After your Initial Enrollment Period, there are events that trigger a Special Enrollment Period, which is when you can sign up for Medicare Part B and premium-Part A without paying a late enrollment penalty. Special Enrollment Periods are only open for a short time, and if you don’t sign up for Medicare during your Special Enrollment Period, you may pay a late enrollment penalty.

Medicare.gov has more information about what qualifies as a Special Enrollment Period.

How to enroll in a Medicare plan

There are a couple of ways to enroll in a Medicare plan, depending on which kind of plan you want.

Original Medicare

You’re automatically enrolled in Medicare Part A and Part B when you turn 65 if you’re already getting Social Security benefits and have been for at least four months before turning 65. Medicare.gov also has a quiz that can help you find out how to sign up for Medicare.

Medicare Advantage

You’ll need both Medicare Part A and Medicare Part B to join a Medicare Advantage plan. Medicare Advantage plans are offered by private health insurance companies, so you’ll need to sign up by visiting their websites.

You can find out more about Blue Cross of Idaho’s Medicare Advantage plans, including what benefits are available, on our Medicare Advantage plans page.

Choose a Blue Cross of Idaho Medicare Advantage plan

If you’d like to learn more about Blue Cross of Idaho’s Medicare Advantage plans, visit medicare.bcidaho.com for more information and frequently asked questions or download our Medicare for Idaho booklet.

If you’re thinking about purchasing a Blue Cross of Idaho Medicare Advantage plan, you can call our team at 888-492-2583 (TTY: 711) Monday through Friday from 8 a.m. – 6 p.m.

 

Posted: May 12, 2022

Updated: April 29, 2025

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