How does Medicare work?
All Medicare eligible individuals begin with Original Medicare, which consists of Part A and Part B.
Most individuals who are approaching age 65 must enroll in some form of Medicare coverage in order to avoid incurring significant out-of-pocket expenses.
Individuals who are receiving Social Security Disability (SSDI) benefits will be automatically enrolled in Original Medicare.
When considering which Medicare plan will meet your unique needs, it’s important to understand the different Parts of Medicare and how each Part works together.
Original Medicare options
Medicare Part A
known as “hospital insurance”
- Inpatient care in a hospital
- Skilled nursing facility care
- Hospice care
- Home healthcare
Medicare Part B
known as “medical insurance”
- Doctor visits
- Medically necessary services
- Outpatient services
- Preventive care
It is important to note that Original Medicare – Parts A and B – has no limits on out-of-pocket expenses, however, by enrolling in a Medicare Advantage Plan (Part C) you may be able to limit your maximum out-of-pocket expenses.
Additional plans offered through private insurers
known as “Part C” or “MA Plans”
known as “Medicare drug coverage”
known as “Medigap”
Get a free consultation with an experienced licensed agent to discuss
which Medicare plan meets your individual needs.
Get a free consultation with an experienced licensed agent to discuss which Medicare plan meets your individual needs.
How do I enroll?
Contact us to discuss your options and enroll
in additional plans beyond Original Medicare.
Contact us to discuss your options and enroll in additional plans beyond Original Medicare.
Frequently asked questions
When do I enroll in Medicare?
Upon approaching eligibility for Medicare at age 65, you can enroll in a Medicare Plan three months before, the month of, or three months after your Medicare entitlement date. For Supplement Plans, the enrollment period lasts five months after your entitlement date.
Upon becoming eligible for Medicare because you have received 24 months of SSDI benefits, you will be automatically enrolled in Part A and Part B.
What happens if I miss my enrollment period?
I already have health insurance. Do I have to sign up for Medicare?
I am on a fixed monthly income. Can I get help paying for Medicare?
What is the difference between Medicare and Medicaid?
Can my spouse and family also receive Medicare coverage?
What is the difference between Medicare Advantage and Medigap?
While there are several types of Medicare coverage, two of the most common are Medicare Advantage and Medicare Supplement – also known as Medigap – plans. While both pay for expenses not covered by Original (“Governmental”) Medicare, you cannot be enrolled in both Medicare Advantage and Medigap coverage simultaneously, as they each serve different functions. There are also several important distinctions between Medicare Advantage and Medigap that you should know if you are looking to enroll in Medicare.
Is Medicare expensive?
While Medicare costs can add up fast depending on an individual’s needs and coverage selections, it is a myth that Medicare is unaffordable or that it is always more expensive than other forms of healthcare coverage. In fact, many people are surprised to discover that Medicare can lower their medical expenses. There are customizable options available for individuals considering Medicare, and these are worth exploring with the guidance of an experienced Licensed Insurance Agent to better understand all the Medicare available options and their associated costs.
Learn more: Is Medicare expensive?