Your Medicare Guide
Medicare is a lifelong journey, and every journey is easier with a guide who knows the terrain. Here is the plain-English version of how Medicare is built, when you have to act, and what we do in an appointment to build your roadmap.
Part A
Hospital
Covers "room and board" for inpatient hospital stays, skilled nursing, and hospice. For most, there is no monthly premium if you’ve worked 10+ years and paid payroll taxes.
Part B
Medical
Covers doctor visits, outpatient care, and durable medical equipment. There is a monthly premium set by the government (often deducted from Social Security), and it goes up if your income is above a certain threshold.
Part C
Medicare Advantage
A private plan that bundles A and B, usually adds drug coverage, and often adds dental, vision or hearing. In exchange, you stay inside a network and the insurance company determines your medical copays. Your monthly premium is generally lower than Medigap but it's important to understand trade-offs.
Part D
Prescription
Drug coverage, sold separately or built into an Advantage plan. Every plan has its own formulary, so the right one is specific to your prescriptions and your changes.
Medigap
Supplement
Sits alongside Original Medicare and covers most of what A and B leave behind. Any doctor who takes Medicare will accept your Medigap plan. Higher monthly premiums that don't adjust based on the medical care used. The window to buy one without underwriting is narrower than people realize.
DEADLINES
Timing Is Everything
Medicare doesn’t happen automatically. Don’t wait for the mail to tell you what to do—knowing when to act is the first step in avoiding lifelong penalties.
Annual Election Period
Oct 15 - Dec 7
You can add or change a Medicare Advantage Plan, Part D Prescription Drug Plan or switch to Original Medicare. Your last change before Dec 7 will be effective Jan 1.
Open Enrollment Period
Jan 1 - Mar 31
If you are on a Medicare Advantage Plan, you can make one change to your Medicare Advantage Plan or return to Original Medicare and the change will be effective the first of the next month.
Initial Coverage Election Period
A 7-month window starting 3 months before you turn 65 and extending 3 months after you turn 65 to first enroll into Medicare. You may be able to delay Medicare enrollment with active employer coverage.
Special Election Period
You may have special enrollment periods available throughout the year to enroll in Medicare or change your Medicare Advantage Plan, based on certain events. Specific rules apply to these additional life situations.
Everything You Need To Know
Find quick answers to common questions about navigating your Medicare options.
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