| CALL US NOW!

Medicare Insurance

Federal health coverage for seniors and certain individuals with disabilities

Medicare Insurance

What is Medicare Insurance?

Medicare is a federal health insurance program for people age 65 and older, as well as certain younger individuals with disabilities or serious health conditions. It was created to give affordable access to essential medical care, helping millions of Americans manage hospital stays, doctor visits, and other healthcare needs.

Medicare is divided into different parts. Part A covers hospital care, skilled nursing, hospice, and some home health care. Part B helps with outpatient care like doctor visits, preventive services, and durable medical equipment. Prescription drug coverage is offered separately under Part D, while Medicare Advantage (Part C) plans combine Parts A and B, often Part D, and may include extras like dental or vision.

Coverage comes with some costs. Beneficiaries pay premiums, deductibles, and coinsurance, and many choose a Medicare Supplement (Medigap) plan to help cover these expenses. While Medicare doesn’t cover everything, it provides a strong foundation for health coverage in retirement and can be tailored with additional options to fit individual needs and budgets.

What is a Medicare Supplement(Medigap) plan?

A Medicare Supplement plan, also known as Medigap, is private insurance that works alongside Original Medicare (Parts A and B). It helps pay for certain out-of-pocket costs that Medicare doesn’t fully cover, such as deductibles, copayments, and coinsurance. This added protection gives people more predictable healthcare expenses and less worry about surprise medical bills.

Medigap plans are standardized by the federal government, which means the benefits for each plan type (A, G, N, etc.) are the same no matter which insurance company offers it. For example, a Plan G from one company will cover the same services as a Plan G from another company, though premiums can differ by insurer and location. These plans do not include prescription drug coverage, so most people add a separate Part D plan if they want drug coverage.

The main benefit of a Medicare Supplement plan is peace of mind. With fewer gaps in coverage, members can visit any doctor or hospital that accepts Medicare nationwide without worrying about network restrictions. While Medigap requires a monthly premium, it can save money in the long run by reducing out-of-pocket costs and providing more financial security.

What is a Medicare Advantage Plan?

A Medicare Advantage plan, also called Part C, is an alternative way to receive your Medicare benefits. These plans are offered by private insurance companies approved by Medicare and include all the services covered under Original Medicare (Parts A and B). Many also bundle in additional benefits like prescription drug coverage (Part D), dental, vision, hearing, fitness programs, and even over-the-counter allowances.

Medicare Advantage plans often use provider networks, similar to traditional insurance like HMOs or PPOs. This means you will need to use doctors, hospitals, and pharmacies within the plan’s network to keep your costs low. While you still have to pay your Part B Medicare premium, Advantage plans often have low—or even $0—monthly premiums, though you may have copays or coinsurance when you receive care. Each plan also has an annual out-of-pocket maximum for Part A and B services, providing financial protection.

The biggest advantage of Part C is convenience and added benefits. Instead of managing multiple plans (Original Medicare, Medigap, and a Part D drug plan), everything is combined into one plan with one card. This makes Medicare Advantage attractive to many people who want an “all-in-one” approach, especially if they value extra benefits not offered by Original Medicare. However, it’s important to compare plans carefully since costs, networks, and benefits vary by county and insurance carrier.

When can you enroll in Medicare?

Initial Enrollment Period (IEP)

This is your first chance to sign up for Medicare.
- It’s a 7-month window:
- 3 months before your 65th birthday month
- Your birthday month
- 3 months after your birthday month
If your birthday is on the 1st of the month, Medicare starts the month before your birthday.

General Enrollment Period (GEP)

If you miss your Initial Enrollment, you can sign up between January 1 and March 31 each year.
Coverage begins the first day of the month after you apply.
You may face a late enrollment penalty if you didn’t have other qualifying coverage

Special Enrollment Period (SEP)

If you delayed Part B because you had employer-sponsored coverage, you can sign up later without penalty.
SEP lasts for 8 months after employment or coverage ends (whichever comes first).

Annual Enrollment Period (AEP)

Runs every year from October 15 to December 7.
During this time, you can join, drop, or switch Medicare Advantage (Part C) or Prescription Drug (Part D) plans.
Changes take effect on January 1 of the following year.