Medicare Insurance Plans
Eliminate gaps in insurance
coverage over age 65
As you approach your retirement years and turn 65, you become eligible for Medicare coverage. It's crucial to understand the extent of your Medicare coverage and whether you may need additional insurance. I can guide you in selecting the appropriate coverage, whether it's a Medicare Supplement Plan (Medigap Policy) or a Medicare Advantage Plan. I'm here to provide you with the information and support you need to make an informed decision about your healthcare coverage during retirement.
What does Medicare cover?
Medicare Part A
This part covers hospital expenses such as inpatient hospital stays, nursing care, hospice care, and home health services. Beneficiaries typically qualify for Part A by paying Medicare taxes during their working years. However, there may be deductibles, coinsurance, and copayments.
Medicare Part B
Part B covers outpatient services, including doctor's office visits, lab work, x-rays, and outpatient surgeries. It also includes preventive services like cancer screenings and flu shots, as well as medical equipment such as wheelchairs and walkers if needed.
Medicare Part C
Part C, or Medicare Advantage Plans, is offered by private, Medicare-approved companies. These plans provide additional benefits beyond what Parts A and B cover. Many Medicare Advantage Plans have lower or no monthly premiums compared to alternative options.
Medicare Part D
This part is the prescription drug plan. You can obtain Part D coverage through an independent Prescription Drug Plan (PDP) or as part of a Medicare Advantage Plan. It's essential to sign up for this coverage when it's available to avoid potential financial penalties for late enrollment.
What is a Medicare Supplement Plan?
A Medicare Supplement Plan, often referred to as Medigap, is additional coverage that can be added to your original Medicare. After enrolling in both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), Medicare typically covers about 80% of your healthcare expenses. The remaining 20% can be covered by a Medigap plan.
It's important to note that a Medicare Supplement Plan does not include coverage for prescription drugs. If you require prescription drug coverage, you may need to consider enrolling in a separate Medicare Part D prescription drug plan.
What is a Medicare Advantage Plan?
Medicare Advantage Plans, also known as Part C, are comprehensive, all-in-one plans offered by private Medicare-approved insurance companies such as Aetna, Humana, and Kaiser Family Foundation. These plans are typically managed like HMO (Health Maintenance Organization) or PPO (Preferred Provider Organization) insurance plans.
If you choose to enroll in a Medicare Advantage Plan, you don't lose your Medicare coverage. Part C plans are bundled insurance options that include coverage for Medicare Part A (hospital insurance), Medicare Part B (medical insurance), and often Medicare drug coverage (Part D).
What are Medicare Prescription Drug Plans?
Medicare Prescription Drug Plans (Part D) provide coverage for prescription medications in addition to your original Medicare coverage. Each Medicare Prescription Drug Plan maintains its own list of covered drugs, known as a formulary. These drug plans often categorize drugs into different tiers on their formularies, and each tier may have a different cost associated with it.

It's essential to be aware that if you don't enroll in Part D coverage when you first choose your Medicare coverage and later decide to enroll, you may be subject to a financial penalty.
I do not offer every plan available in your area. Any information I provide is limited to those plans I do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Which Medicare plan do I need?
When selecting your Medicare coverage, it's essential to start by enrolling in traditional Medicare, which includes Part A (hospital insurance) and Part B (medical insurance). However, traditional Medicare still leaves you responsible for about 20% of your medical expenses, and it doesn't cover prescription drugs.
To complement your traditional Medicare coverage, you can consider various options, including Medicare Advantage Plans and Medicare Supplement Plans. Several factors to keep in mind when choosing the right coverage for your needs include:
- The cost of premiums, copays, and other out-of-pocket expenses.
- Any limitations in coverage.
- Whether prescription drug coverage is included or needs to be purchased separately.
- If you need access to doctors outside of Medicare Advantage networks.
- The availability of local covered providers.
- Your travel habits, such as frequent travel or having a secondary residence in a different coverage area.
- Any specific healthcare needs related to chronic conditions or serious illnesses.
Comparing costs and evaluating your unique needs is essential to ensure you select the Medicare coverage that best suits you. As your insurance broker, I can assist you in price comparing options to make an informed decision.
Stay up-to-date on Medicare changes
Government programs like Medicare are always changing with new legislation. You can always refer to official sources like www.medicare.gov for the most up-to-date information.
Does Medicare
cover dental?
Original Medicare coverage does not extend to routine dental services. Without supplemental coverage from a Medicare Supplement Plan or Medicare Advantage Plan, you would be required to cover all your dental expenses.
If you need to verify whether a specific medical test, item, or service is covered by original Medicare, you can use the "Medicare Coverage" search tool at www.medicare.gov/coverage. This tool allows you to check whether Medicare covers a particular service or treatment.
When can I get Medicare?
As you near the age of 65, it's essential to determine your eligibility for Medicare, and you can use an eligibility tool to help with this. For most individuals, it's advisable to enroll in both Part A and Part B coverage within the seven-month period that begins three months before your birthday month.
During this enrollment period, it's also a good idea to consider additional coverage to supplement your Medicare benefits. I can assist you in identifying your specific Medicare needs and help you explore additional coverage options.
What is the difference between
Medicare and
Medicaid?
Medicare is a federal insurance program primarily designed for individuals aged 65 and older or those with qualifying disabilities. It operates consistently across all states and is managed at the federal level.
Medicaid, on the other hand, is a medical assistance program that serves low-income individuals, irrespective of their age. It operates at the state level, following federal guidelines, and its specific details can vary from one state to another.
Do I have the option to change my Medicare coverage?
Medicare offers an annual enrollment period that usually runs from mid-October through early December. During this period, you can make changes to your Medicare coverage. However, it's essential to be aware that certain changes made outside this enrollment period can result in penalties. For example, delaying enrollment in a Prescription Drug Coverage plan may lead to penalties.
When you initially sign up for Medicare Part A and Part B, Medicare supplement plans are generally required to offer you a policy without considering pre-existing conditions. However, this guarantee may not apply if you've previously enrolled, changed plans, and are attempting to switch back to the original Medicare and a supplement plan at a later date.
Understanding all the details of your Medicare coverage is crucial, and I'm here to assist you with that. Feel free to get started by requesting a quote today.
Do you have a question
about Medicare?
I'm ready to answer any of your questions. Contact us today!