Navigating Your Medicare Journey
An interactive tool to help you understand your options and estimate potential costs with confidence.
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The Foundation: Original Medicare
Original Medicare is your starting point, managed by the federal government. It has two parts and specific costs you need to know.
- Inpatient hospital care
- Skilled nursing facility stays
- Hospice & home health care
- Doctor's visits
- Outpatient care & preventive services
- Durable medical equipment
Key Costs for 2026
Note: 2026 rates are subject to change. Contact us at 401-287-2737 for the most current information.
Part A Premium
$0
Standard Monthly Premium
(For most people)
Most people get premium-free Part A if they or their spouse worked and paid Medicare taxes for 10+ years (40 quarters).
If you have 30-39 work quarters, your premium is $311/mo.
If you have less than 30 work quarters, your premium is $565/mo.
The Part A deductible for a hospital stay is $1,736 per benefit period.
Part B Premium
$202.90
Standard Monthly Premium
(Or higher depending on income)
Everyone pays the Part B premium. The standard amount is shown above, but it increases for individuals with higher incomes based on their tax returns from 2 years prior (IRMAA).
You also have a $283 annual deductible. After it's met, you typically pay 20% of medical costs.
2026 Part B IRMAA (Income-Related Monthly Adjustment Amount)
| Individual Tax Return | Joint Tax Return | Your Monthly Part B Premium |
|---|---|---|
| $106,000 or less | $212,000 or less | $202.90 |
| $106,001 - $133,000 | $212,001 - $266,000 | $259.00 |
| $133,001 - $167,000 | $266,001 - $334,000 | $370.00 |
| $167,001 - $200,000 | $334,001 - $400,000 | $480.90 |
| $200,001 - $499,999 | $400,001 - $749,999 | $591.90 |
| $500,000 or more | $750,000 or more | $628.90 |
Part D Prescription Drug Coverage
Part D Premiums
Part D is optional prescription drug coverage offered by private companies.
Monthly premiums vary widely by plan, from as low as $10-$20 per month to over $150 for plans with more extensive drug coverage.
Extra Help Program
This federal program helps people with limited income pay for their Part D costs.
2026 Qualification Limits:
- Resources: Below $17,220 (individual) or $34,360 (couple)
- Income: Below $21,870 (individual) or $29,580 (couple)
If you qualify, you could pay no more than $4.50 for each generic drug and $11.20 for each brand-name drug.
Have Questions or Feel Stuck?
Choosing the right path is a big decision. A licensed agent can help you sort through it all.
Call NowA Fork in the Road: Covering the Gaps
To cover the 20% gap and other costs Original Medicare doesn't, you have two primary paths. This is your first and most important decision.
Your Journey Starts With
Path 1: Supplement
Keep Original Medicare and add separate private plans to cover the gaps.
- Pro: Go to any doctor or hospital that accepts Medicare, anywhere in the U.S.
- Pro: Highly predictable out-of-pocket costs. Medigap plans cover most of the 20% gap.
- Con: Higher total monthly premiums (Part B + Medigap + Part D premiums).
- Con: No extra benefits like routine dental, vision, or hearing aids.
Path 2: Advantage
Replace Original Medicare with an all-in-one private plan that bundles all benefits.
- Pro: Lower (often $0) monthly plan premiums.
- Pro: All-in-one convenience. Often includes extra benefits (dental, vision, etc.)
- Con: Must use a network of doctors and hospitals (HMO/PPO).
- Con: Pay-as-you-go costs (copays/coinsurance) can add up if you need frequent care.
How to Choose?
Path 1 (Supplement) may be better if...
- You want the freedom to choose any doctor nationwide.
- You travel often or are a "snowbird."
- You prefer predictable monthly payments over variable costs per visit.
- You have chronic health issues and anticipate needing more frequent care.
Path 2 (Advantage) may be better if...
- You want the lowest possible monthly premium.
- You are generally healthy and don't visit the doctor often.
- You value the convenience of an all-in-one plan with extra benefits.
- You are comfortable with using a local network of providers.
Interactive Medigap Cost Estimator
This tool focuses on Path 1. Use the sliders to see how your healthcare usage might affect your total annual costs under the most popular Medigap plans. Costs are for illustration only.
Plan G
Maximum predictability. Higher premium, but your costs are fixed after the Part B deductible.
Plan N
Balance. Lower premium with small, predictable copays for doctor and ER visits.
High-Deductible G
Lowest premium, but you pay all costs until a large deductible is met.
Interactive Advantage Cost Estimator
This tool focuses on Path 2. Use the sliders to see how your healthcare usage could affect your costs with a typical HMO/PPO plan. Costs are for illustration only.
Estimated Annual Cost
Based on your usage, plus your standard Part B premium.
Your Financial Safety Net
Advantage plans have a maximum out-of-pocket (MOOP) limit. Once your spending on copays and coinsurance reaches this limit, the plan pays 100% of covered services for the rest of the year.
Ready to Enroll? Here’s How.
Signing up for Medicare involves a few key steps. Here are your options for getting started.
Automatic Enrollment
If you're already receiving Social Security or Railroad Retirement benefits at least 4 months before you turn 65, you'll be enrolled in Part A and B automatically. Your card will arrive about 3 months before your 65th birthday.
DIY Enrollment
If you're not automatically enrolled, you can sign up yourself through the Social Security Administration. The fastest way is online at SSA.gov/medicare. You can also call or visit a local office.
Guided Enrollment
An agent from Life Catlin Insurance can walk you through the entire process, from your initial Part A & B enrollment to selecting and applying for the right supplemental plan for your needs—at no extra cost to you.
Call NowThe Enrollment Process & Timeline
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1
Know Your Window
Your Initial Enrollment Period (IEP) lasts 7 months: the 3 months before your 65th birthday month, your birthday month, and the 3 months after. This is the best time to enroll to avoid penalties.
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2
Enroll in Part A & B
Complete your enrollment with Social Security. You will receive your Medicare card in the mail, typically within 3-4 weeks.
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3
Choose Your Path
Decide if Path 1 (Medigap) or Path 2 (Advantage) is right for you. An agent can help you compare local plans and find the best fit for your budget and health needs.
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4
Apply for Coverage
Once you've chosen a plan, you'll submit an application to the private insurance company. The effective date of your new plan will be coordinated with your Medicare start date.