Helping Simplify Medicare Plans

What is Medicare?

Medicare is a federal health insurance program primarily designed for individuals age 65 and older, as well as certain younger individuals who qualify due to a disability or end-stage renal disease (ESRD). The program is divided into several parts, with Original Medicare consisting of Part A (hospital insurance) and Part B (medical insurance).

While Original Medicare provides essential coverage, it doesn’t pay for all healthcare costs—beneficiaries are still responsible for deductibles, coinsurance, and other out-of-pocket expenses. To help manage these costs, you have two main options: you can either enroll in a Medicare Advantage (Part C) plan, which replaces Original Medicare and may offer additional benefits, or you can stay with Original Medicare and add a Medicare Supplement (Medigap) policy to help cover the gaps. While Medicare Part D (prescription drugs) is available to you after meeting certain requirements covered below.We can help you better understand your options and help you save on out-of-pocket costs.

Original Medicare & It's Parts

Original Medicare is a federal health insurance program available to most Americans when they turn 65. It includes Part A, which covers hospital care, and Part B, which covers doctor visits and other outpatient services.

While Original Medicare helps with many medical costs, it doesn’t cover everything—services like routine dental, vision, and hearing care are not included.

Medicare Part A

Medicare Part A is hospital insurance that helps cover the cost of inpatient stays in hospitals and skilled nursing facilities. However, it does not cover long-term care or the medical treatments you receive while in the hospital—those services are typically covered under Part B. Each part of Medicare is designed to cover different types of care, so it’s important to understand how they work together.

Medicare Part B

Medicare Part B is medical insurance that helps pay for doctor visits & other outpatient care. It covers two main types of services: medically necessary care & preventive care. Medically necessary services include things like tests, medical equipment, or treatments your doctor needs to diagnose or treat a health condition. Preventive services help catch health issues early and may include screenings, shots, and yearly check-ups.

Medicare Part C

Medicare Part C, aka Medicare Advantage, is a type of health plan offered by private insurance companies. Enrolling in a Medicare Advantage plan is optional. Plans are approved & contracted by the federal government, and must include all the benefits of Medicare Part A & Part B. Many plans also offer extra benefits—like dental, vision, hearing, or prescription drug coverage—but the specific features and costs can vary by plan and provider.

Medicare Part D

Medicare Part D helps cover the cost of prescription drugs and is offered by private insurance companies. If you choose to enroll, you'll pay a monthly premium for your coverage. Part D helps pay for medications you get at your local pharmacy or through mail-order services. In most states, there are dozens of plans available, giving you a variety of options to choose from based on your specific medication needs and budget.

Our services

Provide a general summary of the services you provide, highlighting key features and benefits for potential clients.

Medicare Supplement Plans

Medicare Advantage Plans

Medicare and Medicaid Plans

Stand-Alone Part D
Prescription Plans

Dental & Vision Plans

Individual Health Plans

Long Term Care Plans

Final Expense

Things You Should Know...

Original Medicare (Parts A and B) is a federal health insurance program that becomes available to most people when they turn 65. While it provides coverage for many hospital and medical services, it doesn’t cover everything. Important benefits such as routine prescription drugs, dental care, vision exams, and hearing services are typically not included, which may leave gaps in coverage for many beneficiaries.

In most cases, you’ll need to pay a deductible before Medicare begins to cover your healthcare costs. After meeting the deductible, Medicare pays its share, and you’re responsible for any coinsurance or copayments for covered services and supplies.

In addition to Original Medicare, there are optional plans you can enroll in during specific enrollment periods to help cover costs that Medicare doesn’t pay for. These plans, which vary by state, include Medicare Advantage (Part C) plans, Medicare Supplement Insurance (Medigap), and Part D prescription drug coverage helping to cover the cost of medications. Each option is designed to help reduce out-of-pocket expenses and offer more comprehensive healthcare protection.

To join Part D prescription drug coverage, an individual must:

• Have Medicare Part A (Hospital Insurance) or Part B (Medical Insurance).

• Live in the service area of the plan you want to join.

• Be a U.S. citizen or lawfully present in the U.S.

• Complete an enrollment request during a valid election period.

There are six types of election periods:

1. Initial Enrollment Period for Part D (Part D IEP)

2. Initial Coverage Election Period (ICEP)

3. Annual Coordinated Election Period (AEP)

4. Medicare Advantage Open Enrollment Period (MA OEP)

5. Open Enrollment Period for Institutionalized Individuals (OEPI)

6. Special Election Periods (SEPs)

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