All Coverage FAQs
A general roundup of the Medicare questions people search for most — covering enrollment, cost, and coverage. If you don't see your question here, browse the rest of the site's sections for a deeper dive on that topic.
Does Medicare cover prescription drugs automatically?
No. Original Medicare (Part A and Part B) does not include prescription drug coverage. You have to add a standalone Part D drug plan, or choose a Medicare Advantage plan that bundles drug coverage in. If you go without any drug coverage and don't have another creditable source (like employer coverage), you can face a late enrollment penalty later if you sign up for Part D down the road.
Can I have both Medicare and employer coverage?
Yes. It's common to have both Medicare and coverage through your own or a spouse's current employer. Which one pays first ("primary payer") depends mainly on the size of the employer. Generally, if the employer has 20 or more employees, the employer plan usually pays first and Medicare pays second; for smaller employers, Medicare is usually primary. It's worth checking with the employer's benefits administrator and Medicare directly, since the rules can vary by situation.
What's the difference between Medicare and Medicaid?
Medicare is a federal health insurance program based mainly on age (65+) or certain disabilities, and it's available regardless of income. Medicaid is a joint federal-and-state program based on income and financial need, with rules that vary by state. Some people qualify for both at once — this is often called being "dual eligible" — and in that case Medicaid can help cover Medicare premiums, deductibles, and services Medicare doesn't cover.
Does Medicare cover care outside the US?
Generally, no. Original Medicare does not cover health care received outside the United States except in a few narrow situations, such as certain emergencies near the US border. Some Medicare Advantage plans and some Medigap policies offer limited foreign travel emergency coverage, so it's worth checking a specific plan's documents before traveling, and travelers often look into supplemental travel insurance for trips abroad.
What happens if I move to a different state?
Moving can affect your coverage, especially with Medicare Advantage and Part D plans, which have specific service areas. Moving outside your plan's service area typically triggers a Special Enrollment Period, letting you switch to a new plan available in your new location. Original Medicare (Part A and Part B) and most Medigap policies generally travel with you nationwide, though Medigap pricing and availability can differ by state.
Can I switch from Medicare Advantage back to Original Medicare?
Yes. You can switch back to Original Medicare during the Annual Enrollment Period (October 15 to December 7) or during the Medicare Advantage Open Enrollment Period (January 1 to March 31), among other qualifying situations. Keep in mind that switching back doesn't automatically guarantee you can also buy a Medigap policy without medical underwriting — that depends on whether you have a Guaranteed Issue right or are within a Medigap enrollment window at the time.
Does Medicare cover long-term nursing home care?
No, not the ongoing custodial kind. Medicare Part A covers a limited stay in a skilled nursing facility, but only after a qualifying hospital stay, and only for skilled nursing or rehabilitation needs — not indefinite custodial care (help with daily activities like bathing and dressing). Long-term custodial nursing home care is generally paid for out of pocket, through long-term care insurance, or through Medicaid for those who qualify financially.
What is a Medicare Summary Notice?
A Medicare Summary Notice (MSN) is a statement mailed (or available online) every three months to people with Original Medicare. It lists the services and supplies billed to Medicare on your behalf, what Medicare paid, and what you may owe. It is not a bill — it's a summary for your records, and a useful way to check for billing errors or unfamiliar charges.
Is Medicare free?
Not entirely. Most people don't pay a premium for Part A because they or a spouse paid Medicare taxes while working, but Part B has a standard monthly premium (higher for those with higher incomes), and most people also pay something for drug coverage and any supplemental coverage. There are also deductibles, copays, and coinsurance depending on the services used. So while parts of Medicare can be premium-free, it is not a completely free program for most people.
What is Extra Help / the Low-Income Subsidy?
Extra Help (also called the Low-Income Subsidy, or LIS) is a federal program that helps people with limited income and resources pay for Medicare Part D prescription drug costs — including premiums, deductibles, and copays. Eligibility is based on income and asset limits that are updated periodically. People who qualify can apply through the Social Security Administration.
Can I be denied Medicare because of a health condition?
No. Once you're eligible for Medicare, Original Medicare and Medicare Advantage plans cannot deny you enrollment or charge you more because of your health history or pre-existing conditions. The main exception involves buying a Medigap (Medicare Supplement) policy outside your protected enrollment window, where insurers in most states can medically underwrite. See the pre-existing conditions page in this section for the full picture.
Do I need to re-enroll in Medicare every year?
No, once you're enrolled you stay enrolled — you don't have to sign up again each year. However, it's a good idea to review your coverage every year during the Annual Enrollment Period (October 15 to December 7), since plan costs, drug formularies, and networks can change from year to year even if your own health hasn't.