What Is Medicare?
Medicare is a federal health insurance program for people age 65+ and certain younger individuals with disabilities.
- Covers hospital, medical, and prescription needs
- Does not cover everything — gaps exist
- Understanding your options helps you choose the right plan
The Four Parts of Medicare
Part A — Hospital
- Inpatient hospital stays
- Skilled nursing & hospice
- Some home health care
- Usually $0 premium
Part B — Medical
- Doctor visits & outpatient care
- Preventive services
- Medical equipment
- Monthly premium + ~20% cost share
Part C — Medicare Advantage
- All-in-one alternative to A + B
- Often includes dental, vision, drugs
- Uses provider networks
- Has annual out-of-pocket limit
Part D — Prescription Drugs
- Covers medications
- Each plan has its own drug list
- Costs vary by plan
Three Ways to Get Coverage
Option 1: Original Medicare (A + B)
- Go to any doctor that accepts Medicare
- No network restrictions
- No out-of-pocket cap
- Does NOT include drugs or dental
Often paired with:
- Part D (drugs)
- Medigap (extra coverage)
Option 2: Medicare Advantage (Part C)
- All benefits in one plan
- May include extra benefits
- Uses network (HMO/PPO)
- Has max out-of-pocket protection
Simpler, bundled option
Option 3: Medigap (Supplement)
- Works with Original Medicare
- Helps pay deductibles & coinsurance
- More predictable costs
- Does NOT include drugs
Best for flexibility + lower surprise costs
Enrollment Periods
Initial Enrollment (IEP)
- Around your 65th birthday
- 7-month window
- Best time to enroll
Annual Enrollment (AEP)
- Oct 15 – Dec 7
- Change plans every year
Medicare Advantage OEP
- Jan 1 – Mar 31
- Switch Advantage plans or go back to Original
Medigap Open Enrollment
- 6 months after Part B starts
- No health questions (very important)
Special Enrollment (SEP)
- Life events (move, lose coverage, etc.)
- May qualify outside normal periods
Not sure which option is right for you?
Speak with a licensed agent to compare plans based on your needs, budget, and healthcare preferences, and get clear, personalized guidance every step of the way.
Schedule A ConsultationCall me at (626) 555-1288
(TTY: 711) for any inquiries.
TPMO Disclaimer (required on website, print, and email — use verbatim):
We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Get in Touch disclaimer:
By filling out this form, you agree that a licensed sales agent/broker [Insert Agent Name or Agency Name] may contact you by email, text, or phone to discuss Medicare Advantage, Medicare Supplement, and Prescription Drug plans.