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Understanding Medicare

Your complete Medicare 101 introduction

When you’re just getting started with Medicare, it can feel like there’s so much to keep track of. But at the same time, you want to gather as much information as possible so you can feel confident in picking the right plan for you.

That’s where we come in: We’ve helped thousands of people learn the basics of Medicare to make choosing a plan as simple as possible. We’re here to help you, too.

On this page, you can find information about:

Get to know Original Medicare

Medicare is a federal health insurance program that helps cover health care costs for those who qualify. The basic coverage you can receive directly from the U.S. government is called Original Medicare – also known as Medicare Parts A and B.

Medicare Part A

Medicare Part A covers certain hospital-related expenses you may be charged during a traditional hospital stay, through home health care or in a skilled nursing facility. These can include costs like room fees, meals and more. Part A also covers necessary medical supplies and drugs that are provided at these facilities.

Medicare Part A does not cover doctor fees, or hospital fees considered medically unnecessary, such as private duty nursing, the television or telephone in your room (if separate charges apply), or personal care items such as razors and slippers.

Most people don’t pay a monthly premium for Part A.

Medicare Part B

Medicare Part B covers medical expenses like routine doctor visits, outpatient services and some diagnostic screenings. Part B may cover some medication administered during your visit but not drugs that are prescribed for you to take after the visit.

Most people pay a monthly premium for Part B. And when you need care, you’re also responsible for deductibles, copays and coinsurance .

Original Medicare covers the basics, but not much more. There are many important services that Original Medicare doesn’t include, like prescription drug coverage, hearing exams and eye care.

When you need more coverage than you get with Original Medicare, consider enrolling in a plan with additional coverage from a private insurer like HealthPartners UnityPoint Health.

Here are some things to keep in mind about private Medicare plans:

  • Your choice of plans will depend on where you live – different plans are offered in different counties.
  • Each plan has its own premium, deductible, copay and out-of-pocket maximum amounts. It’s a good idea to compare plans to make sure you choose one that meets your needs.
  • Once you enroll in a private Medicare plan, you don’t need to renew it each year, but you’ll have opportunities to switch plans if your needs change.

Types of private Medicare plans

Most people who sign up for a private Medicare plan choose from these options:

  • Medicare Advantage plans – Provide the same coverage as Original Medicare, and they often offer extra benefits like dental and Part D prescription drug coverage
  • Medicare Part D plans – Help cover the cost of your prescriptions
  • Medicare Supplement plans – Help bridge the gaps of Original Medicare

Medicare eligibility

To be eligible for Medicare (either Original Medicare or most private Medicare plans), you must be a United States citizen or lawfully present in the United States. You must also:

  • Be age 65 or over; OR
  • Be under age 65 with certain disabilities; OR
  • Have end-stage renal disease (eligible for Medicare Advantage plans only)

When you can enroll in Medicare

Starting when you turn 65, you’ll have several opportunities to enroll in Medicare. But if you don’t enroll during your first enrollment window (around your 65th birthday), you may have to pay a late-enrollment penalty for Part B or Part D (unless you have health insurance through your or your spouse’s employer).

How to enroll in Medicare

Many people are automatically enrolled in Original Medicare (Part A and Part B) once they're eligible. But not everyone is.

You'll be automatically enrolled in Original Medicare if:

  • You're receiving Social Security benefits or Railroad Retirement Board benefits when you turn 65; OR
  • You're eligible for Medicare because of a disability or medical condition

You must enroll yourself in Original Medicare if you're not receiving Social Security benefits when you become eligible for Medicare.There are three ways you can enroll yourself in Original Medicare:

  1. Enroll online through the Social Security Administration
  2. Call the Social Security Administration at 800-772-1213 (TTY 800-325-0778), 8 a.m. to 7 p.m., Monday - Friday
  3. Enroll in person at your local Social Security office

For private Medicare plans, you can enroll at the same time as your automatic enrollment or self-enrollment in Original Medicare. If you first enrolled in Original Medicare but later want to enroll in a private Medicare plan, you can do so during the Annual Enrollment Period (AEP).

Tips for comparing and choosing a plan

If you’re not sure which kind of Medicare plan will meet your needs, answering a few questions may help you compare plan details.

HealthPartners and UnityPoint Health have teamed up to deliver options that fit your lifestyle. You can make sure we have a Medicare Advantage plan in your county by selecting the

You’ll find a list of counties here.

Available in many counties

Plans available in these counties:

  • Benton
  • Black Hawk
  • Boone
  • Bremer
  • Buchanan
  • Butler
  • Cedar
  • Cherokee
  • Clarke
  • Clayton
  • Clinton
  • Dallas
  • Delaware
  • Fayette
  • Greene
  • Grundy
  • Guthrie
  • Hamilton
  • Hardin
  • Humboldt
  • Ida
  • Iowa
  • Jackson
  • Jasper
  • Johnson
  • Jones
  • Linn
  • Madison
  • Mahaska
  • Marion
  • Marshall
  • Muscatine
  • Plymouth
  • Polk
  • Poweshiek
  • Scott
  • Sioux
  • Story
  • Tama
  • Warren
  • Washington
  • Webster
  • Woodbury
  • Wright
Available in select counties

Plans available in these counties:

  • Henry
  • Jo Daviess
  • Rock Island

Legal information

Last updated October 2023

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