Plain-English Medicare answers

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Medicare · Cornerstone

Medicare Part A, hospital coverage

What Medicare Part A covers in 2026: inpatient hospital, skilled nursing, hospice, the $1,736 deductible and the per-day cost ladder, the observation-status trap, and the long-term-care gap.

6 min read

Medicare · Cornerstone

How to sign up for Medicare

How to sign up for Medicare: automatic vs. on-you enrollment, applying through Social Security, what to have ready, the HSA trap, and the Special Enrollment Period vs. penalty path if you missed your window.

4 min read

Medicare · Cornerstone

Medicare enrollment periods

Every Medicare enrollment period and what it is for: the IEP at 65, AEP (Oct 15 to Dec 7), MA-OEP, the penalty-prone GEP, and the life-event SEPs, plus the AEP-does-not-guarantee-Medigap myth.

5 min read

Medicare · Cornerstone

Medicare vs. Medicaid

Medicare vs. Medicaid: age-based vs. income-based, what each pays for, why Medicaid (not Medicare) covers long-term custodial care, and dual eligibility, full vs. partial, when you qualify for both.

4 min read

Medicare · Cornerstone

Medicare Part B, doctor and outpatient coverage

What Medicare Part B covers in 2026: doctors, outpatient, preventive care and the screening-to-diagnostic flip, the $202.90 premium and $283 deductible, and the uncapped 20% that drives Medigap and Advantage.

5 min read

Medicare · Cornerstone

Medigap Plan G, the default supplement

Medigap Plan G: what standardized coverage means, the one gap it leaves (the annual Part B deductible), the high-deductible version, why Plan F closed, the six-month buy-without-underwriting window, and the three pricing methods.

5 min read

Medicare · Cornerstone

The Part B late enrollment penalty

The Part B late enrollment penalty is permanent: 10% per full 12 months you delayed, about $61/month on a 3-year delay. How it works, the 20-employee exception, why COBRA and retiree coverage do not protect you, and the 8-month SEP.

4 min read

Medicare · Cornerstone

HMO vs. PPO Medicare Advantage plans

HMO vs. PPO Medicare Advantage: HMOs cost less but keep you in network with referrals; PPOs cost more for out-of-network freedom. Emergencies are covered anywhere on both, prior authorization applies to both, and how to choose.

4 min read

Medicare · Cornerstone

Medicare, dental, vision, and hearing

Original Medicare does not cover routine dental, vision, or hearing, but it does cover medically necessary exceptions like cataract surgery and doctor-ordered diagnostics. The three ways to fill the gap, and why the allowance is a cap.

3 min read

Medicare · Cornerstone

Medicare IRMAA, the income brackets explained

Medicare IRMAA: the income-related surcharge on Part B and Part D above roughly $109,000 single / $218,000 joint. The two-year lookback that catches new retirees, the cliff structure, what counts as income, and when you can appeal.

3 min read

Medicare · Cornerstone

SilverSneakers and Medicare fitness

SilverSneakers is a real fitness program, but not a Medicare benefit: it comes from the plan, some Medicare Advantage plans and a few Medigap carriers, alongside Silver&Fit and Renew Active. How to check for it and keep it.

3 min read

Medicare · Cornerstone

Your Medicare card and your online account

What your Medicare card shows, why your Medicare Number is not your Social Security number, the scam red flags to watch for, and how the free Medicare.gov account lets you replace a lost card and review claims.

3 min read

Medicare · Cornerstone

Medicare eligibility, who qualifies and when

Who qualifies for Medicare and when: the three doors (turning 65, 24 months of SSDI, ALS/ESRD), automatic vs. on-you enrollment, the seven-month IEP and its timing, and the working-at-65 exception.

5 min read

Medicare · Cornerstone

Help paying for Medicare

Programs that lower Medicare costs and stack: Extra Help for drug costs, the Medicare Savings Programs (QMB, SLMB, QI) that cover the roughly $2,400-a-year Part B premium, the QMB balance-billing protection, and dual eligibility.

5 min read

Medicare · Cornerstone

Original Medicare or Medicare Advantage?

Original Medicare plus Medigap or Medicare Advantage: freedom and predictable cost vs. low premiums and a capped worst case, the uncapped 20%, and the underwriting asymmetry that makes switching back hard.

4 min read

Medicare · Cornerstone

Medigap Plan N, the lower-premium option

Medigap Plan N vs. Plan G: the same standardized coverage for a lower premium, the three differences (office copay, ER copay waived if admitted, excess charges), and the arithmetic of choosing between them.

4 min read

Medicare · Cornerstone

Medigap Plan F, why it closed

Medigap Plan F closed to anyone Medicare-eligible on or after January 1, 2020 (MACRA). What it covered, keeping it vs. the closed-pool premium risk, and why Plan G is the near-identical substitute, the one Part B deductible apart.

3 min read

Medicare · Cornerstone

Special Needs Plans, D-SNP, C-SNP, and I-SNP

Medicare Special Needs Plans: D-SNP for dual-eligibles, C-SNP for qualifying chronic conditions, I-SNP for institutional care, what every SNP must include, and the enrollment timing that cuts both ways.

4 min read

Medicare · Cornerstone

Does Medicare cover long-term care?

Medicare does not cover long-term custodial care, the daily help someone may need for years. What it does cover (skilled nursing, home health, hospice), the skilled-vs-custodial line, and who pays: out of pocket, Medicaid, or LTC insurance.

4 min read

Medicare · Cornerstone

Medicare Savings Programs, QMB, SLMB, and QI

The Medicare Savings Programs pay your Part B premium (worth roughly $2,400 a year), and QMB covers deductibles and coinsurance too. The three tiers, the higher-than-expected income limits, the QMB billing protection, and the Extra Help link.

4 min read

Medicare · Cornerstone

Home health, hospice, nursing home, and long-term care

What Medicare covers across care settings: home health when homebound, a skilled-nursing stay after a hospital admission, hospice in full, and the long-term custodial care it does not cover. The skilled-vs-custodial line that decides it.

3 min read

Medicare · Cornerstone

New to Medicare, the four things to know before you sign up

New to Medicare: your seven-month enrollment window and its lifelong penalty, the Original-vs-Advantage path decision that is hard to undo, why nothing is automatic, and the gaps (no out-of-pocket cap, dental, vision, hearing, long-term care).

3 min read

Medicare · Cornerstone

Medicare and employer coverage, when to delay Part B

Whether you can safely delay Part B at 65 turns on the 20-employee rule: 20+ employees lets you delay penalty-free, under 20 means Medicare is primary at 65. The HSA exception, the 8-month SEP, and why COBRA and retiree coverage do not protect you.

3 min read

Medicare · Cornerstone

Medicare late enrollment penalties, in actual dollars

Medicare has three late-enrollment penalties. Part B adds 10% per full 12 months for life; Part D adds 1% of the base per month after 63 days without creditable coverage; Part A rarely applies. How each works, and how to avoid all of them.

3 min read

Medicare · Cornerstone

Finding a doctor with Medicare, networks and referrals

Provider access on Medicare: Original Medicare has no network (but assignment vs. non-participating vs. opted-out changes your bill), while Advantage uses networks and sometimes referrals. The smarter question to ask, and how to verify.

2 min read

Medicare · Cornerstone

Working past 65, Medicare, COBRA, and the SEP trap

Working past 65: when delaying Part B is safe (a 20+ employer), the HSA trap and the six-month Part A backdating, why COBRA and retiree coverage do not protect your window, and timing the 8-month SEP so protection does not leave a coverage gap.

3 min read

Medicare · Cornerstone

Medicare Part D, prescription drug coverage

How Medicare Part D drug coverage works in 2026: formularies and tiers, the coverage phases and the $2,100 out-of-pocket cap, the late-enrollment penalty, and how to pick a plan by your actual drug list.

6 min read

Medicare · Coverage choices

Medigap (Medicare Supplement), explained

How Medigap fills Original Medicare’s gaps: the standardized plan letters, why Plan G and Plan N lead, the three pricing methods, and the open-enrollment window that protects you.

5 min read

Medicare · Cornerstone

Medicare Advantage (Part C), explained without the marketing

What Medicare Advantage really is in 2026: plan types, networks, prior authorization, the MOOP cap, star ratings, and how it compares to Original Medicare.

16 min read

Medicare · Cornerstone

Original Medicare, the unbundled federal program

What Original Medicare Parts A and B cover, the 80/20 gap and why Medigap exists, how to enroll, and when Original beats Medicare Advantage in 2026.

14 min read

Medicare · Cornerstone

Medicare, in plain English.

Medicare is the federal health-insurance program for Americans 65 and older, plus some younger people with specific disabilities. Most enrollees face…

9 min read

Medicare · Costs

How to appeal an IRMAA decision

Got an IRMAA letter? You can appeal. The qualifying life-changing events, Form SSA-44, the documents you need, and the step-by-step process for 2026.

3 min read

Medicare · Costs

How much does Medicare actually cost in 2026?

There is no single Medicare price tag. There is a base premium that almost everyone pays, a means-tested surcharge that one in five enrollees pays on…

3 min read

See all 33 Medicare articles →