Medicare at a glance
Medicare is a federal health insurance program that has been helping Americans access healthcare since 1965. It currently covers more than 65 million people nationwide — including over 900,000 Colorado residents.
The program is administered by the Centers for Medicare & Medicaid Services (CMS), a part of the U.S. Department of Health and Human Services. While Medicare is a federal program, the plans available to you depend on where you live in Colorado.
Key fact: Medicare is not free. Most beneficiaries pay monthly premiums, deductibles, and cost-sharing. However, Part A (hospital insurance) is premium-free for most people who have worked and paid Medicare taxes for at least 10 years.
Who qualifies for Medicare?
You are eligible for Medicare if you meet one of the following criteria:
- Age 65 or older — You are a U.S. citizen or permanent legal resident who has lived in the U.S. for at least five continuous years.
- Under 65 with a disability — You have received Social Security Disability Insurance (SSDI) benefits for 24 months.
- Any age with ESRD — You have End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).
- Any age with ALS — You have been diagnosed with Amyotrophic Lateral Sclerosis (Lou Gehrig's disease).
The four parts of Medicare
Medicare is divided into four parts, each covering different types of healthcare services.
Part A — Hospital insurance
Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services.
Part B — Medical insurance
Covers doctor visits, outpatient care, preventive services, ambulance services, and durable medical equipment.
Part C — Medicare Advantage
An all-in-one alternative offered by private insurers. Bundles Parts A, B, and usually D into one plan.
Part D — Prescription drugs
Covers outpatient prescription medications through private insurance plans approved by Medicare.
Original Medicare vs. Medicare Advantage
When you first enroll in Medicare, you'll need to make a fundamental choice between two paths:
Original Medicare (Parts A & B) is the traditional program run directly by the federal government. You can see any doctor or hospital that accepts Medicare. You may want to add a Medigap (supplement) policy to help cover out-of-pocket costs, and a separate Part D plan for prescription drugs.
Medicare Advantage (Part C) is offered by private insurance companies approved by Medicare. These plans must cover everything Original Medicare covers, and most include prescription drug coverage and extra benefits like dental, vision, and hearing. However, they typically use provider networks, meaning you may need to use specific doctors and hospitals.
Colorado tip: The Medicare Advantage plans available to you depend on your county. Urban areas like Denver and Colorado Springs generally have more plan options than rural areas like the Western Slope.
Medicare in Colorado
While Medicare is a federal program, several Colorado-specific factors affect your coverage:
- Health First Colorado — Colorado's Medicaid program. If you qualify for both Medicare and Medicaid (dual eligible), you may receive additional benefits and help with Medicare costs.
- Colorado SHIP — The State Health Insurance Assistance Program provides free, unbiased counseling to help you understand your Medicare options. Available statewide.
- Medigap rules — Colorado follows federal Medigap regulations but has some state-specific protections for beneficiaries.
- Plan availability — Medicare Advantage and Part D plan options vary by county. Front Range residents typically have more choices than those in mountain or rural communities.
Next steps
Now that you understand the basics of Medicare, here's what to explore next:
- Learn about Part A — what hospital insurance covers and what it costs.
- Learn about Part B — what medical insurance covers and the 2026 premium.
- Understand enrollment periods — when you can sign up and what deadlines to watch.
- See 2026 costs — premiums, deductibles, and out-of-pocket amounts.