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New To Medicare

Medicare is a health insurance program for:

- people age 65 or older,

- people under age 65 with certain disabilities, and

- people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).

Medicare has:

Part A Hospital Insurance- Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

Part B Medical Insurance - Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.

Part D Prescription Drug Coverage - Most people will pay a monthly premium for this coverage. In January 1, 2006, Medicare prescription drug coverage became available to everyone with Medicare. This coverage is to help you lower prescription drug costs and help protect against higher costs in the future. Medicare Prescription Drug Coverage is insurance. Private companies provide the coverage. Beneficiaries choose the drug plan and pay a monthly premium. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.

Medicare Supplement (Medigap) Plans

A Medicare Supplement plan, also know as Medigap, is private health insurance designed to help cover some of the out-of-pocket costs that original Medicare (parts A and B) doesn't pay. These costs can include copayments, coinsurance, and deductibles, which can add up quickly, especially if you need frequent medical care. Medigap policies work alongside your original Medicare coverage, not as a replacement, giving you more predictable healthcare cost.

One of the key benefits of a Medicare Supplement plan is that it gives you more freedom and flexibility when it comes to choosing doctors and hospitals. Because these plans work with Medicare, you can see any provider nationwide who accept Medicare – no networks or referrals required. This is especially helpful for those who travel frequently or split time between states.

Medigap plans are standardized, meaning the benefits of each plan (labeled A through N) are the same no matter which insurance company you buy from. However, premiums may vary based on the insurance company, your location, and other factors. It’s important to compare plans carefully to find one that fits your budget and healthcare needs. Keep in mind, Medigap doesn’t cover things like dental, vision, or prescription drugs, so you may want to consider adding separate coverage for those services.

Medicare Advantage Plans

When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your health care. In most of these plans, there generally are extra benefits and lower co-payments than in the Original Medicare Plan. Most Medicare Advantage Plans are managed care plans, usually a preferred provider organization (PPO) or a health maintenance organization (HMO) and you may have to see doctors that belong to the plan or go to certain hospitals to get services.

To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you may have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer. In 2025, the standard Part B premium amount is $185.00 (or higher depending on your income). However, some people who get Social Security benefits pay less than this amount.

Medicare Advantage Plans include the following:

Preferred Provider Organization (PPO)

A Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. In a PPO Plan, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan's network. You pay more if you use doctors, hospitals, and providers outside of the network.

Health Maintenance Organization (HMO)

In most HMO Plans, you can only go to doctors, other health care providers, or hospitals on the plan's list except in an emergency. You may also need to get a referral from your primary care doctor to see other doctors or specialists.

Will I have to Pay A Late Enrollment Penalty?

The Medicare late enrollment penalty is a financial penalty imposed on individuals who delay enrolling in certain parts of Medicare when they are first eligible. For Medicare Part B (medical insurance) and Part D (prescription drug coverage), there is a penalty if someone doesn't enroll during their initial enrollment period and doesn't have creditable coverage from another source, such as employer-sponsored insurance. The late enrollment penalty is a percentage of the standard premium and is added to the individual's premium for each full 12-month period they were eligible for but did not enroll. This penalty remains for as long as the individual has Medicare Part B or Part D coverage. It's important to note that the penalty is avoidable by enrolling in Medicare during the initial enrollment period or during special enrollment periods triggered by qualifying events. Individuals who may be subject to a late enrollment penalty should carefully consider their enrollment timing and understand the potential long-term financial consequences of delaying enrollment in Medicare.

NEW TO MEDICARE

Medicare is a health insurance program for:

- people age 65 or older,

- people under age 65 with certain disabilities, and

- people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).

Medicare has:

Part A Hospital Insurance- Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

Part B Medical Insurance - Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.

Prescription Drug Coverage - Most people will pay a monthly premium for this coverage. In January 1, 2006, Medicare prescription drug coverage became available to everyone with Medicare. This coverage is to help you lower prescription drug costs and help protect against higher costs in the future. Medicare Prescription Drug Coverage is insurance. Private companies provide the coverage. Beneficiaries choose the drug plan and pay a monthly premium. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.

Medicare Supplement (Medigap) Plans

A Medicare Supplement plan, also know as Medigap, is private health insurance designed to help cover some of the out-of-pocket costs that original Medicare (parts A and B) doesn't pay. These costs can include copayments, coinsurance, and deductibles, which can add up quickly, especially if you need frequent medical care. Medigap policies work alongside your original Medicare coverage, not as a replacement, giving you more predictable healthcare cost.

One of the key benefits of a Medicare Supplement plan is that it gives you more freedom and flexibility when it comes to choosing doctors and hospitals. Because these plans work with Medicare, you can see any provider nationwide who accept Medicare – no networks or referrals required. This is especially helpful for those who travel frequently or split time between states.

Medigap plans are standardized, meaning the benefits of each plan (labeled A through N) are the same no matter which insurance company you buy from. However, premiums may vary based on the insurance company, your location, and other factors. It’s important to compare plans carefully to find one that fits your budget and healthcare needs. Keep in mind, Medigap doesn’t cover things like dental, vision, or prescription drugs, so you may want to consider adding separate coverage for those services.

Medicare Advantage Plans

When you join a Medicare Advantage Plan, you use the health insurance card that you get from the plan for your health care. In most of these plans, there generally are extra benefits and lower co-payments than in the Original Medicare Plan. Most Medicare Advantage Plans are managed care plans, usually a preferred provider organization (PPO) or a health maintenance organization (HMO) and you may have to see doctors that belong to the plan or go to certain hospitals to get services.

To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you may have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer. In 2025, the standard Part B premium amount is $185.00(or higher depending on your income). However, some people who get Social Security benefits pay less than this amount.

Medicare Advantage Plans include the following:

Preferred Provider Organization (PPO)

A Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. In a PPO Plan, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan's network. You pay more if you use doctors, hospitals, and providers outside of the network.

Health Maintenance Organization (HMO)

In most HMO Plans, you can only go to doctors, other health care providers, or hospitals on the plan's list except in an emergency. You may also need to get a referral from your primary care doctor to see other doctors or specialists.

Will I have to Pay A Late Enrollment Penalty?

The Medicare late enrollment penalty is a financial penalty imposed on individuals who delay enrolling in certain parts of Medicare when they are first eligible. For Medicare Part B (medical insurance) and Part D (prescription drug coverage), there is a penalty if someone doesn't enroll during their initial enrollment period and doesn't have creditable coverage from another source, such as employer-sponsored insurance. The late enrollment penalty is a percentage of the standard premium and is added to the individual's premium for each full 12-month period they were eligible for but did not enroll. This penalty remains for as long as the individual has Medicare Part B or Part D coverage. It's important to note that the penalty is avoidable by enrolling in Medicare during the initial enrollment period or during special enrollment periods triggered by qualifying events. Individuals who may be subject to a late enrollment penalty should carefully consider their enrollment timing and understand the potential long-term financial consequences of delaying enrollment in Medicare.