Medicare Coverage Essentials
Whether you're turning 65 soon or helping a loved one explore coverage options, understanding Medicare is an important step toward protecting your health and financial well-being. Here’s a clear, easy-to-understand guide to help you get started.
What is Medicare?
Medicare is a government-run health insurance program for:
- People age 65 or older
- Individuals under 65 with certain disabilities
- People with End-Stage Renal Disease (ESRD)
There are different “parts” of Medicare, and each covers specific health care services.
When Can I Enroll?
Timing matters! Here are the key enrollment periods:
- Initial Enrollment Period (IEP): A 7-month window around your 65th birthday
- Annual Enrollment Period (AEP): October 15 – December 7 each year — make changes or switch plans
- General Enrollment Period: January 1 – March 31 (if you missed your IEP)
- Special Enrollment Periods (SEPs): Triggered by life events like moving, retiring, or losing employer coverage
Missing a deadline can result in late penalties, so don’t wait too long!
The Four Parts of Medicare
Part A - Hospital Insurance
Covers inpatient hospital stays, skilled nursing facilities, hospice care, and some home health care. Most people don’t pay a monthly premium for Part A.
Part B - Medical Insurance
Helps pay for doctor visits, outpatient services, preventive care, durable medical equipment, and more. There is a monthly premium.
Part C - Medicare Advantage
Offered by private insurance companies, Medicare Advantage bundles Parts A and B (and usually Part D). These plans may also include extra benefits like dental, vision, hearing, or fitness memberships.
Part D - Prescription Drug Coverage
Helps pay for the cost of prescription medications. Offered through private insurance companies.
Medigap - Medicare Supplement Insurance
Optional coverage that helps pay for “gaps” in Original Medicare — like deductibles and coinsurance
How to Choose the Right Plan
Here are some tips to guide your Medicare decisions:
- Check your doctors – Are they in-network or do they accept Medicare?
- Review your prescriptions – Does the plan cover your medications?
- Compare total costs – Look beyond monthly premiums. Consider deductibles, copays, and coinsurance.
- Think about extras – Do you want dental, vision, or hearing benefits?
- Review annually – Your needs and available plans may change every year.
Need Help?
Medicare isn’t one-size-fits-all. Taking the time to understand your options can make a big difference.
Whether you’re enrolling for the first time or reviewing your coverage, we’re here to help guide you through the process.
Call us to get personalized, no-cost support from a licensed agent in your area.
Or visit Medicare.gov to explore official resources.