Important decisions about your new Medicare coverage

Welcome to Medicare! You now have Medicare Part A and/or Part B. Your enclosed 

Medicare card shows when your coverage starts.

• Medicare Part A (Hospital Insurance)—helps cover hospital care, skilled nursing care, 

and more. Most people don’t need to pay a premium for Part A.

• Medicare Part B (Medical Insurance)—helps cover doctors’ services, outpatient care, and 

more. Part B is optional, and you pay a monthly premium for it.

Make these 2 important decisions now:

Decision 1: Should I sign up for Part B?

• If you’re already signed up for Part B—you don’t need to do anything. If you’re getting 

Social Security benefits, the premium will be deducted automatically from your monthly 

Social Security benefit payments. If your benefits aren’t enough to cover your premium or 

you don’t get benefits, you’ll get a bill for your Part B premium every 3 months.

• If you want Part B—contact Social Security to find out when you can sign up. 

• If you don’t want Part B now—you can sign up later. However, you may have to wait for 

your coverage to start and pay a monthly penalty.

Read pages 3–8 in the booklet to see if you should sign up for Part B (based on 

your situation).

Decision 2: If I signed up for Part B, how do I want to get my Medicare coverage?

You can choose how to get your Medicare coverage:

• Original Medicare—includes Part A and Part B. You can buy supplemental coverage to 

help pay your out-of-pocket costs. You can also get Medicare prescription drug coverage 

(Part D).

• Medicare Advantage—a Medicare-approved plan from a private company that bundles 

your Part A, Part B, and usually Part D coverage into one plan. 

Read the other side of this letter and pages 8–14 in the booklet for additional and 

important information to make your decision.

Soon we’ll mail your official “Medicare & You” handbook with more information. You can 

also visit Medicare.gov anytime for details about getting started with Medicare. 

Enclosures

CMS Publication Number: 12020

December 2019

DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services

7500 Security Boulevard

Baltimore, Maryland 21244 -1850
Your Medicare options

There are 2 main ways to get your Medicare coverage:

Original Medicare

• Original Medicare includes Medicare 

Part A (Hospital Insurance) and Part B 

(Medical Insurance).

• If you want drug coverage, you can join a 

separate Part D plan.

• To help pay your out-of-pocket costs 

in Original Medicare (like your 20% 

coinsurance), you can also shop for and 

buy supplemental coverage.

• Can use any doctor or hospital that takes 

Medicare, anywhere in the U.S.

Part A

Part B

 You can add:

Part D

 You can also add:

Supplemental 

coverage

(Some examples include

coverage from a Medicare

Supplement Insurance

(Medigap) policy, or coverage

from a former employer or

union.)

Medicare Advantage

(also known as Part C)

• Medicare Advantage is an “all in one” 

alternative to Original Medicare. These 

“bundled” plans include Part A, Part B, 

and usually Part D.

• Plans may have lower out-of-pocket costs 

than Original Medicare.

• In most cases, you’ll need to use doctors 

who are in the plan’s network.

• Most plans offer extra benefits that 

Original Medicare doesn’t cover—like 

vision, hearing, dental, and more.

Part A

Part B

 Most plans include:

Part D

Extra benefits

 Some plans also include:

Lower out-of-pocket-costs
If you, or someone you’re helping, has questions about Medicare, you have the right to get help 

and information in your language at no cost. To talk to an interpreter, call 1-800-MEDICARE

(1-800-633-4227).

ُساعده أسئلة بخصوص Medicare فإن من حقك الحصول على المساعدة و 

العربیة (Arabic (إن كان لدیك أو لدى شخص ت

المعلومات بلغتك من دون أي تكلفة. للتحدث مع مترجم إتصل بالرقم MEDICARE1-800- ) 1-800-633-4227( .

հայերեն (Armenian) Եթե Դուք կամ Ձեր կողմից օգնություն ստացող անձը հարցեր ունի

Medicare-ի մասին, ապա Դուք իրավունք ունեք անվճար օգնություն եւ

տեղեկություններ ստանալու Ձեր նախընտրած լեզվով։ Թարգմանչի հետ խոսելու

համար զանգահարեք 1-800-MEDICARE (1-800-633-4227) հեռախոսահամարով։

中文 (Chinese-Traditional) 如果您,或是您正在協助的個人,有關於聯邦醫療保險的問

題,您有權免費以您的母語,獲得幫助和訊息。與翻譯員交談,請致電 1-800-MEDICARE 

(1-800-633-4227).

فارسی (Farsi (اگر شما، یا شخصی کھ بھ او کمک میرسانید سوالی در مورد اعلامیھ مختصر مدیکردارید، حق این را 

دارید کھ کمک و اطلاعات بھ زبان خود بھ طور رایگان دریافت نمایید. برای مکالمھ با مترجم با این شماره تماس زیر

بگیریدMEDICARE1-800-) 1-800-633-4227(.

Français (French) Si vous, ou quelqu'un que vous êtes en train d’aider, a des questions au sujet 

de l'assurance-maladie Medicare, vous avez le droit d'obtenir de l'aide et de l'information dans 

votre langue à aucun coût. Pour parler à un interprète, composez le 1-800-MEDICARE (1-800-

633-4227)

Deutsch (German) Falls Sie oder jemand, dem Sie helfen, Fragen zu Medicare haben, haben Sie 

das Recht, kostenlose Hilfe und Informationen in Ihrer Sprache zu erhalten. Um mit einem 

Dolmetscher zu sprechen, rufen Sie bitte die Nummer 1-800-MEDICARE (1-800-633-4227) an. 

Kreyòl (Haitian Creole) Si oumenm oswa yon moun w ap ede, gen kesyon konsènan Medicare, se 

dwa w pou jwenn èd ak enfòmasyon nan lang ou pale a, san pou pa peye pou sa. Pou w pale 

avèk yon entèprèt, rele nan 1-800-MEDICARE (1-800-633-4227). 

Italiano (Italian) Se voi, o una persona che state aiutando, vogliate chiarimenti a riguardo del 

Medicare, avete il diritto di ottenere assistenza e informazioni nella vostra lingua a titolo 

gratuito. Per parlare con un interprete, chiamate il numero 1-800-MEDICARE (1-800-633-4227). 

日本語 (Japanese) Medicare (メディケア) に関するご質問がある場合は、ご希望の言語で情報を取

得し、サポートを受ける権利があります (無料)。通訳をご希望の方は、1-800-MEDICARE (1-800-633-

4227) までお電話ください。

Help in other languages

If you, or someone you’re helping, has questions about Medicare, you have the right to get help and 

information in your language at no cost. To talk to an interpreter, call 1-800-MEDICARE (1-800-633-4227).
한국어(Korean) 만약 귀하나 귀하가 돕는 어느 분이 메디케어에 관해서 질문을 가지고

있다면 비용 부담이 없이 필요한 도움과 정보를 귀하의 언어로 얻을 수 있는 권리가

귀하에게 있습니다. 통역사와 말씀을 나누시려면 1-800-MEDICARE(1-800-633-4227)로

전화하십시오. 

Polski (Polish) Jeżeli Państwo lub ktoś komu Państwo pomagają macie pytania dotyczące

Medicare, mają Państwo prawo do uzyskania bezpłatnej pomocy i informacji w swoim języku. 

Aby rozmawiać z tłumaczem, prosimy dzwonić pod numer telefonu 1-800-MEDICARE (1-800-

633-4227).

Português (Portuguese) Se você (ou alguém que você esteja ajudando) tiver dúvidas sobre a

Medicare, você tem o direito de obter ajuda e informações em seu idioma, gratuitamente. Para

falar com um intérprete, ligue para 1-800-MEDICARE (1-800-633-4227).

Русский (Russian) Если у вас или лица, которому вы помогаете, возникли вопросы по поводу

программы Медикэр (Medicare), вы имеете право на бесплатную помощь и информацию на 

вашем языке. Чтобы воспользоваться услугами переводчика, позвоните по телефону 1-800-

MEDICARE (1-800-633-4227). 

Spanish (Español) Si usted, o alguien que está ayudando, tiene preguntas sobre Medicare, usted 

tiene el derecho a obtener ayuda e información en su idioma sin costo alguno. Para hablar con 

un intérprete, llame al 1-800-MEDICARE (1-800-633-4227).

Tagalog (Tagalog) Kung ikaw, o ang isang tinutulungan mo, ay may mga katanungan tungkol sa 

Medicare, ikaw ay may karapatan na makakuha ng tulong at impormasyon sa iyong lenguwahe 

ng walang gastos. Upang makipag-usap sa isang tagasalin ng wika, tumawag sa 1-800-MEDICARE 

(1-800-633-4227). 

Tiếng Việt (Vietnamese) Nếu quý vị, hay người mà quý vị đang giúp đỡ, có câu hỏi về Medicare, 

quý vị sẽ có quyền được giúp và có thêm thông tin bằng ngôn ngữ của mình miễn phí. Để nói 

chuyện qua thông dịch viên, gọi số 1-800-MEDICARE (1-800-633-4227). 

You have the right to get Medicare information in an accessible format, like large print, Braille, or 

audio. You also have the right to file a complaint if you feel you’ve been discriminated against. Visit 

Medicare.gov/about-us/accessibility-nondiscrimination-notice, or call 1-800-MEDICARE (1-800-633-4227) 

for more information. TTY users can call 1-877-486-2048.
Important decisions about 

your Medicare coverage

2 0 2 0

Welcome

toMedicare
2

Now’s the time to make some important 

decisions about your Medicare coverage.

Read this booklet carefully before you 

make any decisions.

Medicare Overview

Medicare Part A (Hospital Insurance)

helps cover inpatient care in hospitals, 

skilled nursing facility care, hospice care, 

and home health care. 

Medicare Part B (Medical Insurance)

helps cover services from doctors and 

other health care providers, outpatient 

care, durable medical equipment (like 

wheelchairs, walkers, hospital beds, and 

other equipment), and many preventive 

services (like screenings, shots or vaccines, 

and yearly “Wellness” visits). 

Visit Medicare.gov/coverage, or use our 

“What’s covered” mobile app to find out 

if your test, item, or service is covered. 

It’s available for free on both the App 

Store and Google Play. You can also call 

1-800-MEDICARE (1-800-633-4227). 

TTY users can call 1-877-486-2048.

Note: If you’re not lawfully present in the 

U.S., Medicare won’t pay for your Part A 

and Part B claims, and you can’t enroll in 

a Medicare Advantage Plan or a Medicare 

Prescription Drug Plan.
3

What does Part B cost?

You’ll pay a monthly premium for Part B. 

In 2020, the standard Part B premium is 

$144.60. You’ll pay more if you have a higher 

income. The premium amount can change 

each year. (See page 9 for more on costs.)

If you have limited income and resources, 

you may be able to get help from your state 

to pay your Part B premium if you meet 

certain conditions. (See page 14.)

Decision 1: Should I sign up for 

Part B if I haven’t already?

If you signed up for Part B, skip to Decision 2 

on page 8. If you don’t sign up for 

Part B and you don’t have other coverage 

based on active or current employment, 

there are some risks:

• You most likely will have to pay all of the 

costs for doctors’ services, outpatient care, 

medical supplies, and preventive services.

• If you change your mind and want to get 

Part B later, you’ll have to wait until the 

General Enrollment Period (January 1– 

March 31 each year) to sign up, and your 

coverage won’t start until July 1 of that 

year. This may cause a gap in your health 

coverage.

• In most cases, if you decide you want 

Part B later, you’ll also have to pay a late 

enrollment penalty for as long as you 

have Part B coverage. The penalty
4

amount is added to your monthly Part B 

premium, and it goes up the longer you go 

without Part B coverage. (See page 8 for the 

cost of the penalty.)

Whether it’s best for you to sign up for 

Part B depends on your situation. The next 

few pages cover common situations and 

explain the risks for not signing up for Part B.

Common Situations

I’m still working and have coverage 

through my employer. Or, my spouse 

(or my family member, if I’m disabled) 

is still working and I’m covered through 

his or her employer:

• You may need to sign up for Part B right 

away if your employer has less than 20 

employees. Check with your benefits 

administrator to see if they require you to 

enroll in Part B. If your employer has 20 or 

more employees, you can sign up for 

Part B later during a Special Enrollment 

Period without a late enrollment penalty if:

– You’re 65 or older, you or your 

spouse is currently working, and 

you’re covered by an employer or 

union group health plan based on 

that current employment.
5

– You’re under 65 and disabled, you 

or a family member is currently 

working, and you’re covered 

by an employer or union group 

health plan based on that current 

employment. (If the group health 

plan coverage is based on the 

current employment of a family 

member, the employer must have 

100 or more employees.)

If you’re eligible for a Special Enrollment 

Period, you can sign up for Part B:

• Anytime while you’re covered by the 

employer or union group health plan 

based on current employment.

• For up to 8 months after the group health 

plan coverage or the employment ends, 

whichever happens first.

I’m retired and have coverage through 

a former employer, or I have COBRA or 

VA coverage:

• You may need both Part A and Part B 

to get full benefits from this coverage, 

and your current coverage might not pay 

your medical costs once you’re eligible 

for Medicare.

• You’re also not eligible for a Special 

Enrollment Period when this coverage 

ends. This means:

– You’ll have to wait until the General 

Enrollment Period (January 1–

March 31 each year) to sign up for
6

Part B, and your coverage would 

start July 1 of that year.

– In most cases, you’ll pay a late 

enrollment penalty added to your 

monthly premium for as long as 

you have Part B coverage.

I have coverage through the Health 

Insurance Marketplace for individuals 

or families:

You should consider signing up for 

Part B and stopping your Marketplace plan 

when your Medicare starts.

• You won’t be eligible for premium 

tax credits or cost-sharing reductions 

for a Marketplace plan once you’re 

considered eligible for Part A coverage, 

and you might have to pay back any 

credits you got for coverage after that 

time when you file your taxes.

• If you choose to enroll in Part B later, 

you won’t be eligible for a Special 

Enrollment Period, so you’ll have to wait 

for the General Enrollment Period to 

sign up. Also, you may have to pay a late 

enrollment penalty for as long as you 

have Part B coverage. (See page 8.)

• Plans may not be allowed to renew 

your Marketplace coverage (for you 

and your family) at the end of the year 

you become eligible for Medicare. This 

means you could have a gap in your 

coverage starting on January 1.
7

I have employer coverage through the 

Marketplace (sometimes called Small 

Business Health Options Program or 

“SHOP” coverage): 

You may be able to wait until you stop 

working or no longer have SHOP coverage 

to enroll in Part B under a Special 

Enrollment Period without a penalty. 

(See page 4.) Visit HealthCare.gov and 

Medicare.gov to learn more.

I have coverage through a private 

insurance plan, (not through the 

Health Insurance Marketplace or an 

employer):

• If you get Part B, Medicare will pay 

its part of the costs for any health 

care services you get, and then any 

amount Medicare doesn’t cover can be 

submitted to your private plan.

• If you choose to enroll in Part B later, 

you won’t be eligible for a Special 

Enrollment Period, so you’ll have to wait 

to sign up. Also, you may have to pay 

a late enrollment penalty for as long as 

you have Part B coverage. (See page 8.)

I have TRICARE coverage (insurance 

for active-duty military, military 

retirees, and their families) or 

CHAMPVA coverage:

You must have Part B to keep your 

coverage. However, if you’re an active-duty 

service member or the spouse or dependent 

child of an active-duty service member, you 

don’t have to get Part B right away.
8

I have Medicaid:

You should sign up for Part B. Medicare 

will pay first, and Medicaid will pay second. 

Your state may also help pay for your 

Medicare premiums. (See page 14.)

I don’t have other health coverage:

You should sign up for Part B, so you have 

coverage for things like doctors’ services or 

preventive services. Be aware of the risks 

for not signing up for Part B. (See page 3.)

How much is the penalty if I 

enroll later?

If you sign up for Part B later and you 

aren’t eligible for a Special Enrollment 

Period, you’ll pay 10% more for each full 

12-month period you could’ve had Part B 

but didn’t take it. In most cases, you’ll have 

to pay this late enrollment penalty each 

time you pay your premiums, for as long as 

you have Part B. The penalty increases the 

longer you go without Part B coverage.

Decision 2: How should I get 

my Medicare coverage?

If you signed up for Part B, you have 2 

main ways to get your Medicare coverage:

Original Medicare

 or

Medicare Advantage
9

Original Medicare

Original Medicare includes Part A and 

Part B. When you get services, you’ll pay 

a deductible, and you usually pay 20% of 

the cost of the Medicare-approved service, 

called coinsurance.

The deductible for Part B is $198 in 2020.

With Original Medicare, you:

• Can go to any doctor or hospital that 

takes Medicare, anywhere in the U.S.

• Generally pay a portion of the cost for 

each covered service. There’s no yearly 

limit on what you pay out-of-pocket, 

unless you have supplemental coverage 

(like a Medigap policy).

• Can join a Medicare Prescription Drug 

Plan (Part D) to get drug coverage. 

(See page 11.)

• Can get supplemental coverage (like 

a Medigap policy) to help pay your 

remaining out-of-pocket costs (like your 

20% coinsurance). (See page 13.)

When you sign up for Part B, you’ll have 

Original Medicare unless you enroll in a 

Medicare Advantage Plan.
10

Medicare Advantage (also 

known as Part C)

Medicare Advantage is an “all-in-one” 

alternative to Original Medicare. These 

“bundled” plans include Part A, Part B, and 

usually Part D (drug coverage). These plans 

are approved and follow the rules set by 

Medicare. The costs in plans vary and plans 

may have lower out-of- pocket costs than 

Original Medicare. You must have both 

Medicare Part A and Part B to join.

You can join a Medicare Advantage Plan 

when you first become eligible for Medicare. 

For most, this period starts 3 months before 

you turn 65 and ends 3 months after the 

month you turn 65. (See page 12 for other 

times you can join.)

With Medicare Advantage, you:

• Can get extra benefits that Original 

Medicare doesn’t cover—like vision, 

hearing, dental, and more.

• Need to use doctors who are in the 

plan’s network (for non-emergency or 

non-urgent care).

• May pay a premium for the plan in 

addition to the monthly Part B premium. 

Plans may have a $0 premium or may help 

pay all or part of your Part B premiums.

• Can’t buy or use separate supplemental 

coverage (like Medigap).
11

Do I need Medicare 

prescription drug coverage 

(Part D)?

If you don’t have prescription drug 

coverage, or the coverage you have 

isn’t at least as good as Medicare drug 

coverage (called creditable coverage), you 

should consider enrolling in a Medicare 

Prescription Drug Plan (also called 

Part D). Your plan must tell you each year 

if your drug coverage is creditable coverage. 

If you need prescription drug coverage, 

you have to sign up for it. You can get drug 

coverage by joining a Medicare Prescription 

Drug Plan or a Medicare Advantage Plan 

that includes drug coverage.

You have up to 3 months after your 

Medicare coverage first starts to join a 

Part D plan.

If you don’t join a Medicare drug plan 

when you’re first eligible for Medicare, and 

you don’t have creditable prescription drug 

coverage or Extra Help, you may have to 

pay a late enrollment penalty, if you join 

later. Generally, you’ll pay this penalty for 

as long as you have Medicare prescription 

drug coverage. And, the penalty goes up the 

longer you wait to enroll.
12

Choosing and joining a plan

You can compare ways to get your 

Medicare coverage and explore how 

different plans work together. You can 

also shop and compare plans to find ones 

that meet your needs. Visit Medicare.gov/

plan-compare, call 1-800-MEDICARE, or 

contact the plan directly.

If you didn’t join a Medicare Advantage 

Plan or a Medicare drug plan when you 

were first eligible, you’ll have at least one 

chance each year to make changes to your 

Medicare coverage:

October 15-December 7: You can join, 

switch, or leave a Medicare Advantage 

Plan or a Medicare drug plan during this 

period each year. Your new coverage will 

begin on January 1 of the following year.

January 1-March 31: If you’re in a 

Medicare Advantage Plan, you can 

make one change to a different Medicare 

Advantage Plan or switch base to Original 

Medicare (and join a stand-alone 

Medicare Prescription Drug Plan) once 

during this time.

Special Enrollment Periods: In certain 

situations, you may be able to join, switch, 

or drop Medicare Advantage or Medicare 

drug plans when certain events happen in 

your life. 

Your enrollment generally lasts for a 

calendar year.
13

Do I need a Medicare 

Supplement Insurance 

(Medigap) policy?

Original Medicare pays for much, but 

not all, of the cost for covered health 

care services and supplies. If you choose 

Original Medicare, you may be able to 

buy a Medicare Supplement Insurance 

(Medigap) policy from a private company 

to help pay your out-of-pocket costs 

in Original Medicare (like your 20% 

coinsurance). You need both Part A and 

Part B to buy a Medigap policy.

Medigap policies:

• Can cover costs like coinsurance, 

copayments, and deductibles.

• May offer coverage for services that 

Original Medicare doesn’t cover, like 

medical care when you travel outside 

the U.S.

When can I get a Medigap policy?

The best time to buy a Medigap policy is 

during your Medigap Open Enrollment 

Period. This 6-month period begins on 

the first day of the month in which you’re 

65 or older and enrolled in Part B. (Some 

states have additional Open Enrollment 

Periods.) After this enrollment period, 

you may not be able to buy a Medigap 

policy. If you’re able to buy one, it may 

cost more.
14

Tip: If you buy a Medigap policy during 

this time, you can buy any Medigap policy 

sold in your state, even if you have health 

problems

If you’re under 65, you might not be able 

to buy the Medigap policy you want, or 

any Medigap policy, until you turn 65. 

If you’re able to buy one when you’re 

under 65, it may cost more.

Visit Medicare.gov to learn more and 

compare Medigap policies in your area, or 

call 1-800-MEDICARE.

Help for People with Limited 

Income and Resources

You may be able to get help paying for 

some of your health care and prescription 

drug costs.

• Medicaid and Medicare Savings 

Programs—States have programs that 

pay Medicare costs for people with 

limited income and resources. Visit 

Medicare.gov to learn more. You can 

also call 1-800-MEDICARE 

(1-800-633-4227) to get the number for 

your state Medicaid office. TTY users 

can call 1-877-486-2048.
15

• Extra Help with Part D prescription 

drug costs—If you have limited income 

and resources, you may qualify to get 

help paying your drug costs. To apply 

for this program, visit socialsecurity.

gov/i1020, or call Social Security at 

1-800-772-1213. TTY users can call 

1-800-325-0778.

• Supplemental Security Income (SSI)— 

SSI is a monthly benefit paid by Social 

Security to people with limited income 

and resources who are disabled, blind, 

or 65 or older. For more information, 

call Social Security.

Note: If you live in a U.S. Territory, 

there are different programs to help you 

pay your Medicare costs. Call your local 

Medical Assistance (Medicaid) office to 

learn more.

Get answers to your Medicare 

questions:

For questions about enrolling in Medicare, 

visit socialsecurity.gov, or call Social 

Security at 1-800-772-1213. 

For information about Medicare in general, 

and Medicare health and prescription

drug plans choices in your area, visit 

Medicare.gov, or call 1-800-MEDICARE.
CMS Product No. 12020 

December 2019

Paid for by the U.S. Department of 

Health and Human Services.

“Welcome to Medicare” isn’t a legal 

document. Official Medicare Program 

legal guidance is contained in the relevant 

statutes, regulations, and rulings.

You have the right to get Medicare 

information in an accessible format, like large 

print, Braille, or audio. You also have the right 

to file a complaint if you feel you’ve been 

discriminated against. Visit Medicare.gov/

about-us/accessibility-nondiscriminationnotice, or call 1-800-MEDICARE 

(1-800-633-4227) for more information. 

TTY users can call 1-877-486-2048.