Medicare is NOT and insurance company. It's government run socialized healthcare for senior citizens that have paid into the program for at least 10yrs of working life. There is a lot to it. The money is administered by Social Security, as dictated by Medicare. So you deal with two government agencies when you have a problem with something. There are numerous styles or types of "supplement" plans that deal with Medicare for you for a price. Most employment pays into Medicare. There are some places of employment that doens't. So you pay a tax every month and your employer pays something on your behalf. Then when you turn 65 yrs of age you can go on Medicare if you have paid into it for approximately 10 yrs. It's not free. You pay a premium every month for part "B" and maybe part "D". Part "B" is your DR visits, part "D" is your prescription drugs. then you MAY also buy some sort of supplement that pays what Medicare doesn't. The price for part "B" and "D" are set every year by congress. Most people pay the basic fee, but if you have been somewhat financially successful and saved for your retirement, you can easily get into the MAGI and IRMAA traps. Lots of people who sell assets after retirement find themselves in those traps. The supplements are varied and confusing, probably a good (if you can find one) consultant to help is a good idea. Hope that is a good intro into Medicare.

I should include.......Part "A" is hospitalizations, you paid that while you worked through pay roll taxes.
Be careful with Medicare. You MUST go on it when you hit 65 yrs of age or you will pay a fine the rest of your life. The exception, (and document this) is if you still are working for a company that supplies medical coverage.

it's a mess, but it does work for most people. It's just unnecessarily complicated and confusing and expensive.

That's not really possible. For most people, its Medicare, no choice. You pay for it no matter if you want it or not. And if you decide not to do it, then at a later date change your mind, the penalty is huge. Health care is a mess, Medicare makes it worse.

This isn't a good forum for discussing Medicare. There are others with better information. I'll add my anecdotal experience and information

I have been on Medicare since I retired in 2013. I have never had a problem using it. I was eligible in 2012 but if you have other insurance (I was still working and covered by my employer's insurance plan) there is no penalty if you don't join while you are still covered elsewhere. But if you are eligible for Medicare and have no other insurance plan to cover you, then yes, there is a penalty, also for the prescription drug program, and it's a lifetime penalty. It's a percentage increase in your payment for coverage. The longer you don't have any medical coverage (Medicare or other), the higher the penalty percentage. The reason is that they don't want you to not pay into the plan for your insurance until such time that you are seriously ill and have big bills. They want to collect from you over time, into Medicare or other insurance plan. When you turn 65 get your Medicare card for Part A. There is no cost to you if you have been paying into the plan from your work.

Parts
There are 4 parts to Medicare:

Part A - Major medical/hospitalization (you paid into this from your employment)

Part B - Wellness care (doctor appointments for ongoing care) This payment is subtracted from your Social Security. Everyone has the same deductible and payment.

Part C - Advantage plans - These are the plans hawked on TV for months on end. You go with an insurance company and they provide the benefits. You pay them and they collect from Medicare. There are different plans with different benefits. You may or may not have a payment but the more options you take, the more you pay. They are HMO plans, so be careful where you are covered. If you choose an Advantage plan you don't have to be concerned with Parts A,B,D and I think supplemental. I have always used regular Medicare with a supplemental plan.

Part D - Prescription drug programs - You pay for these from your Social Security, just like the Part B coverage. You go on the Medicare site and look at the available, standardized plans. Coverage and costs vary. I chose one with a low monthly payment because I never have reached the deductible for my medications. I'm 76, exercise 5 days a week for 30-60 minutes. I ran a marathon at 65 and I'm planning on walking a 200 mile trek in Spain this summer. Your mileage may vary. I work at staying young

Supplemental Insurance -
This is not part of Medicare. It's a separate policy you get with an insurance company from standardized plans you choose from at the Medicare website. Medical bills are submitted to Medicare, who will forward them to your supplemental insurance (after they pay or not pay their part) for the supplemental insurance company to pay or not pay. These plans are not required and there is no penalty for joining later, but you will pay more as you age. They are a good benefit to have but make sure your doctor accepts the company you choose.

Re-enrollment
Whatever you choose, every year there is re-enrollment. You can choose to go back to regular Medicare or switch to an Advantage plan. If you are on regular Medicare you can change your prescription drug provider/plan and supplemental insurance plan. If you do not re-enroll your coverage automatically rolls over to the new year.
There are other times/conditions when you can change/start enrollment. My wife's birthday is December so her old insurance terminated at the end of November and she enrolled in Medicare for that one month in that one year and also enrolled for the next year. We opted for a different supplemental plan for each, but the same prescription plan for both.

MEDICAID
If you are below a certain annual income level (I don't know what it is) you may also qualify for a Medicaid benefit, particularly to help pay for your prescription drugs

Donut Hole
The donut hole is when you have received the maximum benefit for your prescriptions, as directed by the Part D coverage (each plan is different). When you reach the maximum benefit, coverage stops and you pay for all of your medications. At some point you will possibly be eligible for Medicaid to assist you with these payments. That's when you have reached the other side of the donut.

TRAVEL
Medicare does not follow you outside of the USA; nowhere. You can get temporary medical and travel insurance from other companies. If you have an Advantage plan you can select that as a benefit if you want, like dental and vision, but costs extra.

Advantage plans are HOAs, so your coverage is local. If you are traveling in the USA and have an emergency then the Advantage plan may cover you, depending on the emergency.

Medicare covers you anywhere in the USA for any facility that accepts Medicare. (I have never found a place that didn't.)

DENTAL and VISION

Medicare, at present, has no coverage for dental or vision. Advantage plans can cover these at extra cost. My dentist has a plan that we each pay into, about $275/year, that covers 2 cleanings and 1 set of full x-rays. There is a 20% discount on other dental work.

This has been my experience with regular Medicare. I have been very pleased with how everything is handled and while it was somewhat confusing at first, it's helpful to know that every year you can change and take a different option. It did take me several years to discover that I was paying for a premium benefit with the prescription drug plan but never reaching the deductible. I have switched to a lower cost plan with fewer benefits but I actually pay less for the prescriptions, saving on both.

Be careful who you deal with. These insurance companies are looking out for themselves and there are a lot of advertisements for Advantage plans. Check with a local senior service program for advice.

Not everyone pays the same for part B. It's based on your MAGI. Medicare MIGHT pay if you are out of the country. It MIGHT not. If it does, everything will need to be in english and coded properly. So that is, all hospital/dr records etc must be in english etc. The payment will be in the form of a reimbursement, not at point of service. So you will pay upfront and then try to get Medicare to reimburse you. That sometimes works. Some Advantage plans may be very localized. As in cross a state line and no supplemental coverage. Some plans my cover internationally. They tend to be cafeteria plans. every plan is different.

According to the Medicare site, it is unlikely that you will receive coverage outside the US. When I travel outside the US I get a separate, temporary policy because I don't want any nightmare bills that would ruin me financially. Temporary insurance is relatively cheap (even in your 70s) and you can bundle it with travel insurance.

I stand corrected on the cost of part B. It is income based. However, most people pay $164.90. You will pay more if you earn more than $97,000 (single) or $194,000 (joint) per year as reported to the IRS. Above that the rate varies and is available at the Medicare site. https://www.medicare.gov/Pubs/pdf/11...care-costs.pdf

I also stand corrected on the Advantage plans. They can be HMO or PPO. I had investigated them at retirement and didn't like the HMO plan, didn't know there was another option. I've been on Medicare since 2013 and have not had any problems but it's nice that you can change your coverage at re-enrollment.

Thanks for your input

I certainly would not rely on getting reimbursed for international medical costs. And I think it smart to carry some other type of international medical insurance.
I am very familiar with 2 incidences where people got reimbursed. Both were injuries in Europe. But again, i would not count on it, better to be proactive with that. We sold a long time rental property. wE got hit very hard with MAGI and IRMA.