For Members & Caregivers

Help navigating your coverage

Plain-language guides for people managing their own Medicare or Medicaid — and for anyone helping a parent, spouse, or friend with theirs.

Health coverage comes with deadlines, dense paperwork, and a lot of jargon. These pages break the common situations into plain steps, explain what the words mean, and point you to free, unbiased help. Nothing here recommends a specific plan — it helps you understand your options and act on them.

Brand new to this? Start with Turning 65: Start Here. It assumes you know nothing and walks you — step by step — from where you are today to the specific decisions you'll make and the actions to take. If you're a veteran, retiring, still working, or on a tight budget, it routes you to the guide that fits your situation.

Start with the essentials

Deadlines

Enrollment & Deadlines

The enrollment windows for Medicare, the Marketplace, and Medicaid — what you can do in each, and the penalties for missing them.

Money

Understanding Your Costs

Premiums, deductibles, copays, coinsurance, and out-of-pocket maximums — what each term means and when you pay it.

Decisions

Choosing Coverage

Original Medicare, Medicare Advantage, and Medigap compared even-handedly, with questions to ask yourself.

Get things done

Step by step

How Do I…

Appeal a denial, choose a doctor, replace a lost card, read your EOB, switch plans, and arrange a ride to care.

Protections

Your Rights & Protections

Your right to appeal, coverage-decision deadlines, privacy, non-discrimination, and protection from surprise bills.

Assistance

Getting Help Paying

Free counseling and programs that help with premiums, drug costs, and full coverage — and how to reach them.

Helping someone else

Caregivers

For Caregivers

Getting authority to act for someone, talking to plans on their behalf, and organizing the essentials.

Overview

The Member Journey

From enrollment and the ID card through choosing a provider, getting care, claims, and appeals.

Reference

Plain-English Glossary

Look up any term you run into — searchable, in everyday language.

Guides for your situation

Start here

Turning 65

The zero-to-decisions walkthrough: what to understand, gather, and decide.

Veterans

Veterans & Medicare

VA health care + Medicare: the Part B trap, VA pharmacy vs. Part D, and how a spouse's coverage fits.

Life event

Retiring or Losing Job Coverage

COBRA vs. Medicare vs. Marketplace — and the Part B penalty trap to avoid.

Life event

Working Past 65

Employer coverage, delaying Part B, and the HSA warning.

Life event

Medicare Under 65

Disability (SSDI), ESRD, and ALS pathways to Medicare.

Life event

Both Medicare & Medicaid

How the two programs work together for dual-eligible members.

Life event

Moving to a New State

What transfers, what doesn't, and what to do first.

Tools

Dates

Enrollment Calendar

Every key window at a glance.

Print

Printable Checklists

Turning-65, annual-review, appeal-prep, and caregiver kits.

Links

All Resources

Every official link and help line, organized by function.

Gotchas

Edge Cases & Complications

The situations that trip people up: the Medigap one-way door, HSA + Part A, IRMAA appeals, and more.

Get straight answers

Questions to Ask

The sharp questions that cut through a sales pitch — for a plan, an agent, or a denied claim.

Not sure where to start? If you have Medicare, your State Health Insurance Assistance Program (SHIP) gives free, unbiased, one-on-one help. For Medicaid, contact your state Medicaid agency. Neither sells anything.
Verify before you act. MediPrimer is general educational information and is not affiliated with any agency or insurer. Program rules, costs, and eligibility change and vary by state and plan. Always confirm the specifics with the official source and your own plan documents.