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Understanding Medicare

Medicare can feel complicated, but it doesn't have to be. This guide breaks down the basics so you can understand your options.

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The Basics

The Parts of Medicare

Medicare is divided into different parts, each covering specific services.

A

Hospital Insurance

Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Most people don't pay a premium for Part A.

  • Inpatient hospital care
  • Skilled nursing facility care
  • Hospice care
B

Medical Insurance

Part B covers doctor visits, outpatient care, preventive services, medical equipment, and some home health care. Most people pay a standard monthly premium.

  • Doctor and outpatient visits
  • Preventive care and screenings
  • Durable medical equipment
C

Medicare Advantage

Part C plans are offered by private companies and include all Part A and B coverage, often with Part D drug coverage plus extras like dental, vision, and hearing.

  • Bundles Parts A, B, and often D
  • Extra benefits (dental, vision, hearing)
  • Out-of-pocket maximum for protection
D

Prescription Drug Coverage

Part D covers prescription medications through plans offered by private companies approved by Medicare. Each plan has its own formulary and costs.

  • Prescription medication coverage
  • Standalone or within Part C
  • Review formulary for your medications

Visual Guides

Medicare at a Glance

Quick visual references to help you understand key Medicare concepts.

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Important Dates

Enrollment Periods

Understanding when you can enroll or make changes is critical.

IEP

Initial Enrollment Period

A 7-month window around your 65th birthday: 3 months before, the month of, and 3 months after. Your first opportunity to sign up for Medicare.

AEP

Annual Enrollment Period

October 15 to December 7 each year. Switch plans, change from Original Medicare to Advantage (or vice versa), and join or drop Part D. Changes take effect January 1.

SEP

Special Enrollment Period

Available under specific circumstances: moving, losing employer coverage, qualifying for Medicaid, or entering a nursing facility. Lets you make changes outside standard windows.

OEP

Open Enrollment Period

January 1 to March 31. If you have a Medicare Advantage plan, you can switch to a different MA plan or return to Original Medicare and join a standalone Part D plan.

Visual Guides: Enrollment Periods

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Compare Options

Which Plan Type Is Right for You?

Every situation is different. Here's a general guide to help you think about your options.

Consider Medicare Advantage if you...

  • Want one plan that covers most of your needs
  • Value extra benefits like dental, vision, and hearing
  • Are comfortable using a network of doctors
  • Prefer lower monthly premiums with copays per visit

Consider Medicare Supplement if you...

  • Want the freedom to see any doctor who accepts Medicare
  • Prefer predictable out-of-pocket costs
  • Travel frequently or split time between locations
  • Don't mind a higher monthly premium for peace of mind

Visual Guides: Plan Comparison

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Want to learn more?

Visit our Learning Center for videos, infographics, and presentations that explain Medicare in plain language.

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Common Questions

Frequently Asked Questions

Most people become eligible for Medicare when they turn 65. Your Initial Enrollment Period (IEP) begins 3 months before your 65th birthday month and ends 3 months after. Some people under 65 qualify due to a disability or End-Stage Renal Disease (ESRD).
Yes. If you don't sign up for Part B when you're first eligible and you don't have other qualifying coverage (like from an employer), you may pay a late enrollment penalty for as long as you have Part B. The same applies to Part D.
Medicare Advantage (Part C) replaces Original Medicare and typically bundles hospital, medical, and drug coverage into one plan with a provider network. Medigap (Medicare Supplement) works alongside Original Medicare to help cover out-of-pocket costs like copays and deductibles. You cannot have both at the same time.
Original Medicare (Parts A and B) generally does not cover routine dental, vision, or hearing services. However, many Medicare Advantage plans include these benefits. Standalone dental and vision plans are also available.
Costs vary depending on your coverage choices. Most people pay no premium for Part A. The standard Part B premium changes each year. Medicare Advantage and Part D plans have their own premiums, deductibles, and copays. We can help you compare costs based on your specific situation.
Yes. You can make changes during the Annual Enrollment Period (October 15 - December 7), the Medicare Advantage Open Enrollment Period (January 1 - March 31), or during a Special Enrollment Period if you qualify. Contact us to find out your options.
No. Our Medicare consultation and enrollment assistance services are provided at no cost to you. We are compensated by the insurance carriers, not by our clients.

Visual Guides: Eligibility, Costs & More

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