Medicare Solutions
Medicare can feel confusing at first, but it doesn’t have to be. Here’s a simple breakdown of how it works and what your options are when it’s time to enroll.
What is Medicare?
Medicare is a federal health insurance program for:
People 65 and older
Certain younger people with disabilities
People with End-Stage Renal Disease(ESRD)
It’s designed to help cover many of your health care costs as you age, but understanding the different parts of Medicare is the key to choosing the right coverage.
The Four Parts of Medicare
Part A – Hospital Insurance
Covers inpatient hospital stays, skilled nursing facilities, hospice, and some home health care.
Most people don’t pay a premium for Part A.
Part B – Medical Insurance
Covers doctor visits, outpatient care, preventive services, and durable medical equipment.
There is a monthly premium for Part B.
Part C – Medicare Advantage
An “all-in-one” alternative to Original Medicare (Parts A & B).
Offered by private insurance companies approved by Medicare.
Usually includes prescription drug coverage, dental, vision, and wellness benefits.
Helps cover the cost of prescription medications.
Plans are offered by private insurance companies.
Part D – Prescription Drug Coverage
Original Medicare vs. Medicare Advantage
When you’re eligible, you can choose between:
Nationwide coverage.
Doesn’t include prescription drugs unless you add Part D.
You can also add a Medicare Supplement (Medigap) plan to help pay costs like copays, coinsurance, and deductibles.
Original Medicare (Parts A & B)
Medicare Advantage (Part C)
Combines Part A and B (and usually Part D).
May include extras like dental, vision, hearing, and fitness programs.
Plans often use networks of doctors and hospitals.
When to Enroll
Initial Enrollment Period (IEP):
A 7-month window around your 65th birthday.
General Enrollment Period:
January 1 – March 31 each year if you missed your IEP.
Special Enrollment Periods (SEPs):
Certain life events (like losing other coverage or moving) may allow you to enroll outside the normal times.
Why Medicare Decisions Matter
Choosing the right Medicare plan can impact:
Your monthly costs
Which doctors and hospitals you can see
What prescription drugs are covered
Extra benefits you may want
Need Help Deciding?
You don’t have to figure it out alone. I’ll walk you through your options step by step, answer your questions, and help you make the best choice for your health and budget.