The difference between skilled care and custodial care and why the second is excluded by statute, the four conditions on a covered nursing facility stay and the daily skilled requirement that usually ends one, observation status and how it quietly disqualifies a hospital stay, the dental, vision and hearing exclusions with the narrow carve-outs inside each, why care abroad is not covered, and the missing annual out-of-pocket maximum that sits underneath all of it.
What Original Medicare and a Medicare Advantage plan each cost in 2026, what a plan's yearly limit of up to $9,250 does not count, the six month Medigap window that does not reopen, and the two trial rights that are the only clean way back.
The three phases of a 2026 drug year and the point at which cost sharing stops entirely, why the ceiling counts only covered drugs and what that means for choosing a plan, the option to spread costs across the year rather than pay them at the counter, how the late enrollment penalty is calculated and why it grows without the percentage changing, the 63 day gap that triggers it and the creditable coverage that prevents it, and the two routes out of a penalty once one has been applied.
How to tell within a minute which appeal system applies, the fast route when home health or nursing care is ending and the noon deadline that governs it, the hospital discharge appeal and the financial protection a timely request buys, the five levels and the deadlines that run from receipt rather than from the date on the letter, the Advantage process that forwards a losing denial to an independent reviewer automatically, reopenings for clerical errors, and the evidence rule that binds fewer people than it appears to.