Plan Types & Coverages

There are three primary types of Medicare coverage. Each of them has unique features, benefits and costs. Medicare Advantage has recently become the most common choice for people new to Medicare because of the unique extra benefits but it may not always be the best choice for everyone - particularly for people who don’t use any of the extra benefits.

Original Medicare

Part A

Medicare Part A, often referred to as "Hospital Insurance," is one of the four components of the Medicare program in the United States. It includes: inpatient hospital care, skilled nursing facility care, hospice care, home health care and blood transfusions.

Part B

Medicare Part B, often referred to as "Medical Insurance," is one of the four components of the Medicare program in the United States. It includes: outpatient medical services, durable medical equipment, ambulance services, mental health services, preventative services, home health care, limited outpatient prescription drug coverage, and physician services.

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Medicare Advantage or “Part C”

Medicare Part C, also known as Medicare Advantage, is one of the four components of the Medicare program in the United States. It offers an alternative way for beneficiaries to receive their Medicare benefits through private health insurance plans approved by Medicare.

To be eligible for Part C, individuals must first be enrolled in both Medicare Part A (hospital insurance) and Part B (medical insurance). Generally, individuals become eligible for Medicare when they turn 65, but eligibility can also occur due to certain disabilities or specific medical conditions.

Enrollment in Medicare Part C typically occurs during specific enrollment periods, such as the Initial Enrollment Period (IEP) around one's 65th birthday, the Annual Enrollment Period (AEP) which takes place from October 15th to December 7th each year, or Special Enrollment Periods (SEPs) triggered by qualifying life events like moving, losing other coverage, or becoming eligible for Medicaid.

During these periods, eligible individuals can choose a Medicare Advantage plan that suits their healthcare needs, and coverage generally begins on the first day of the month after enrollment. It's important for individuals to review available plans and consult with insurance agents or Medicare counselors to make informed choices about their Part C coverage.

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Medicare
Supplement Plans

Medicare Supplement Insurance, often referred to as "Medigap," is a type of private health insurance policy that helps cover certain out-of-pocket costs associated with Original Medicare (Part A and Part B).

Eligibility for Medicare Supplement plans requires being enrolled in both Medicare Part A and Part B. The best time to enroll in a Medicare Supplement plan is during the Initial Enrollment Period (IEP), which begins when you're 65 or older and already enrolled in Medicare Part B. During this period, you have guaranteed issue rights, meaning insurance companies cannot deny coverage or charge higher premiums based on your health status.

After your IEP, you can still apply for a Medicare Supplement plan, but you may be subject to medical underwriting, which can result in higher premiums or potential coverage denials based on your health history. Therefore, it's crucial to carefully consider your Medicare Supplement options and enroll at the most advantageous time to secure the coverage that best meets your needs.

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Comparing your current Medicare plan is a smart step to ensure it aligns with your evolving healthcare needs and budget.

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