How Does Medicare Work?

Eligibility for Medicare

To sign up for Medicare Parts A, B, and supplemental coverage (known as Supplement, Advantage, or Prescription Drug Plans), most people will have an Initial Enrollment Period which is a 7 month period around the time they turn age 65. This period begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.

Once your Initial Enrollment Period is over, if you wish to change or purchase Advantage and Supplement Plans, you must act during the open enrollment period.

MISS THE DEADLINE? To enroll for Medicare outside of the open enrollment period, you will need a qualifying event to be eligible.

Click below to learn more about Medicare.

Medicare is the federal health insurance program for people who are 65 or older. The different parts of Medicare help cover specific services:

Medicare Part A (Hospital Insurance)
Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B (Medical Insurance)
Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. Most people will pay a standard Part B premium which varies depending on income.

Medicare Advantage Plans are offered by private carriers and replace your original Medicare Parts A and B, as they are rolled into one plan.

Much like regular insurance, you can select different plan types, such as a Health Maintenance Organization (HMO), or a Preferred Provider Organization (PPO), or a Medicare Medical Savings Account Plan. Premiums will vary, based on coverage, carrier and geographical location.

Advantage Plans include may include prescription drug coverage, and sometimes offer other supplemental coverage, like dental or vision.

Medicare Part D adds prescription drug coverage to Original Medicare and is offered through private insurance companies that are contracted and approved by Medicare – premiums vary between carriers. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

Medicare Supplement Insurance policies are offered through private carriers and work in conjunction to complement your original Medicare Parts A and B. They cover some, if not all, of the expenses that Part A and B do not cover, like co-pays, deductibles and other excess charges.

There are many different types of Medicare Supplement policies available, yet they are regulated so the benefits for these various policies (known as Plan A through N), are all the same regardless of the carrier. However, premiums can vary greatly among carriers.

Ultimately, the best supplement plan is one that is purchased from a quality carrier, has a low premium and leaves you with the least or no out of pocket expenses.