What do I need to know about Medicare?
Medicare is the federal health insurance program primarily for people age 65 and older, though certain younger individuals with disabilities or specific conditions such as ESRD, end-stage-renal disease, or ALS (Lou Gehrig’s disease) also qualify. Medicare is operated by the Centers for Medicare and Medicaid Services (CMS) and consists of four different parts.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact medicare.gov or 1-800-MEDICARE to get information on all of your options.
Part AHospital Insurance
Part A helps cover inpatient hospital stays, skilled nursing facilities, hospice care, and some home health care. Most people don’t pay a premium for Part A because they (or their spouse) paid Medicare taxes while working. However, if you do not qualify for premium-free Part A, you may need to pay a monthly premium.
Part BMedical Insurance
Part B covers a broad range of outpatient services such as doctor visits, outpatient hospital services, preventative services, lab and diagnostic testing, durable medical equipment and medical supplies and ambulance. Part B typically has a monthly premium that is deducted automatically from your social security benefit or billed every three months. a bill every three months.
Part CMedicare Advantage
Medicare Advantage Part C plans are offered by private insurance companies that contract with the government to provide and administer Medicare benefits. These plans bundle Part A and Part B (and often Part D) together.
Part DPrescription Coverage
Part D covers prescription drugs, including both brand name and generics prescribed by your doctor. Offered by private insurers approved by Medicare, you can get Part D as a stand-alone plan that works alongside Original Medicare (Part A + Part B) or through a Medicare Advantage plan that includes drug coverage.
Medicare Supplement InsuranceWhat is Medicare Supplement Insurance?
Many people have a hard time budgeting their healthcare expenses due to out-of-pocket costs that can add up, depending on the services they use.
Original Medicare doesn’t cover everything — you’re still responsible for deductibles, coinsurance, and copayments. Medicare Supplement Insurance plans (Medicare Supplement Insurance) can help fill those “gaps,” so you have fewer out-of-pocket surprises.
When you receive medical care, Medicare pays its share of the approved amount and your Medicare Supplement Insurance plan pays its share automatically, giving you stronger financial protection and flexibility with your healthcare choices.
How Does Enrollment Work?
Understanding enrollment requirements is essential for maximizing your Medicare benefits, avoiding potential penalties, and ensuring timely access to necessary healthcare services that you are eligible for.
Our team can help you navigate the complexities of the Medicare enrollment process with confidence, allowing you to focus on your health and well-being.
There are specific enrollment periods for Medicare that are essential to your coverage. Sometimes just a small mistake can result in a larger expense. We’ll work with you to make sure your enrollment process is seamless, accurate and on-time to prevent any penalties or gaps in coverage.
If you have any questions regarding enrollment periods, please contact Jessica by clicking here.
Initial Enrollment Period:Your 7-month window to sign up for Medicare, starting 3 months before your 65th birthday month, the month of, and 3 months after.
Annual Election Period (Oct 15 – Dec 7):The time each year when you can review and change your Medicare Advantage or Part D plan. The one you chose takes effect on Jan.1 of the following year.
Open Enrollment Period (Jan 1 – March 31):During this time you can make a one-time change to your Medicare health plan. It will be effective the beginning of the next month after you have made a change. Individuals must have a valid SEP such as turning 65, new to medicare, moving or losing coverage, Medicare and Medicaid beneficiaries, etc.
Special Enrollment Periods:Certain life events (like losing employer coverage, moving, or changes to your income) allow you to make changes outside the usual windows.
Why Understanding Medicare MattersChoosing the wrong plan, or missing an enrollment window, can mean higher costs or even lifelong penalties.
That’s why working with an insurance agent is valuable: you get clear answers, unbiased comparisons, and peace of mind knowing you’re in the right plan for your needs.