Understand Medicare, Medicaid, and managed care

Plain-English explanations of how publicly funded and subsidized health coverage really works — for the people who rely on it, the people who help them, and the people who work in it.

Government-sponsored health coverage is a maze of programs, deadlines, and acronyms. MediPrimer organizes it into clear, honest reference material. We don't sell insurance, we're not affiliated with any agency or plan, and no page here steers you toward a particular product — we just explain how it works so you can act with confidence.

Start here

Most people come here to make sense of their own coverage. If that's you, start with one of these:

New to Medicare

I'm turning 65 soon

A plain-language walkthrough that assumes you know nothing and takes you step by step to your specific decisions. Veterans, people still working, and anyone helping a spouse get a path that fits.

Planning Ahead

I'm in my early 60s and planning ahead

Not 65 yet? Good — the years before matter. What to line up at 62, 63, and 64 so the real deadlines don't catch you off guard.

Couples

I'm planning for me and my spouse

Medicare has no family plan — two premiums, two timelines. What a couple really pays, and what happens when one of you retires first.

Changing Coverage

I'm retiring or losing job coverage

What happens to your health insurance when you leave work. Bridge coverage options, Medicare eligibility, COBRA, ACA marketplace, and timing rules you need to know.

Social Security Disability

I'm on disability or SSDI

How Medicare works for people on Social Security Disability Insurance. Waiting periods, coverage timing, and how disability affects your options.

State Programs

I'm low-income or on Medicaid

Understanding state Medicaid programs and how they connect to Medicare. Income limits, what's covered, and how enrollment works in your state.

Both Programs

I have both Medicare and Medicaid (or think I might)

How Medicare and Medicaid work together when you qualify for both. Coordination rules, coverage gaps, and why it matters for your costs and options.

Helping Someone Else

I'm helping a parent, spouse, or friend

A guide for people managing coverage for someone else. What you need to know, how to help with enrollment, and where to find free counseling.

Deciding

I'm choosing between plans

Original Medicare, Medicare Advantage, and Medigap compared even-handedly — with tools to match the choice to what you value.

Denied or Appealing

Something was denied or I need to appeal

What to do when coverage is denied. How appeals work, deadlines, your rights, and how to get help from free advocates.

Assistance

I need help paying

Free, unbiased counseling and programs that lower premiums, drug, and coverage costs — and how to reach them.

Want the big picture first? See all member & caregiver guides or how the programs work.

Most-used pages

For Members

Enrollment & Deadlines

The windows that trip everyone up — and the penalties for missing them.

For Everyone

Policy & Rule Changes

Major legislative and regulatory changes explained plainly — and what each one means for you.

For Members

Getting Help Paying

Free counseling and programs that lower premiums, drug, and coverage costs.

Reference

Plain-English Glossary

Search any term you run into, defined in everyday language.

Why MediPrimer is different

There is no shortage of Medicare and Medicaid information online. Most of it is either trying to sell you a plan, written like a federal regulation, or buried on the site of one program at a time. We built this to be the thing that was missing:

No sales

We have nothing to sell

No plans, no ads, no lead forms, no data collection. Most "free help" is a sales funnel that steers you to specific plans. We steer you to nothing — just the facts and your free official options.

Clear

Government-accurate, plain English

Official sites are authoritative but dense. We keep the accuracy and add clarity, aiming for about an eighth-grade reading level.

You-first

Organized around your situation

A veteran with a working spouse? Retiring early? We start where you are and walk you to the decisions — instead of making you assemble the answer from a dozen program pages.

Whole picture

All the programs, and how they connect

Medicare, Medicaid, Medicare Advantage, the Marketplace, CHIP, and VA in one place — including how they interact — not one program per website.

Honest

We name the traps

The decisions that are hard to reverse and the mistakes that cost people — the Medigap "one-way door," the HSA and Part A gotcha, the COBRA penalty — stated neutrally, so you see them coming.

Free help

We point you to real help

Your SHIP counselor and your state agencies — free and unbiased — not a call center that earns a commission.

How the programs relate

It helps to keep three questions straight for any coverage program: who funds it, who administers it, and who delivers the benefits.

The same insurers often participate in all three markets, which is why the terminology overlaps so much. Coverage Basics keeps the boundaries clear.

Work in managed care? MediPrimer also has a full reference section for professionals — health-plan operations, providers and billing, brokers and advisors, and case managers and navigators.
Verify before you act. MediPrimer is general educational information. Program rules, eligibility, and costs change frequently and vary by state and plan. Always confirm specifics against official program materials and your own plan documents before relying on them.