Medicare, explained in plain language
Understand your choices and compare plans from the carriers we represent in your area.
Medicare is the federal health insurance program for people age 65 and older and for some younger people with disabilities. It has several parts, and you can add coverage to fill gaps. Bridgemont Life is an independent insurance agency. We help you understand your options and compare plans.
Your Medicare choices
You can keep Original Medicare and add other coverage, or you can join a Medicare Advantage plan. Here is how each piece works.
Original Medicare (Part A and Part B)
Original Medicare is run by the federal government. Part A helps cover hospital stays. Part B helps cover doctor visits, outpatient care and preventive services.
- You can see any doctor or hospital in the country that accepts Medicare.
- You pay deductibles, copayments or coinsurance, and a monthly Part B premium.
- There is no yearly limit on what you pay out of pocket.
- It does not cover most prescription drugs or routine dental, vision and hearing care.
Medicare Advantage (Part C)
Medicare Advantage plans are offered by private insurance companies that contract with Medicare. They provide your Part A and Part B coverage. Most also include prescription drug coverage, and many add benefits such as dental, vision and hearing.
- Most plans use a network of doctors and hospitals. Costs can be higher outside the network, and some plans do not cover out-of-network care.
- Plans have a yearly limit on what you pay out of pocket for covered services.
- You still pay your Part B premium, and some plans charge a monthly premium too.
- Plans, costs and benefits vary by county and can change each year.
Medicare Supplement (Medigap)
Medicare Supplement plans are sold by private insurance companies. They help pay costs that Original Medicare leaves, such as deductibles, copayments and coinsurance.
- They work only with Original Medicare. You cannot use a Medigap plan with a Medicare Advantage plan.
- Plans are standardized and labeled with letters, such as Plan G or Plan N. In most states, the same letter means the same basic benefits no matter which company sells it. Prices differ by company.
- You pay a monthly Medigap premium on top of your Part B premium.
- Medigap does not include prescription drug coverage. You add a separate Part D plan.
- The key time to buy is the Medigap Open Enrollment Period. It lasts six months, starting the month you are 65 or older and have Part B. During this time, companies cannot turn you down or charge you more because of your health. After it ends, they may.
Prescription drug plans (Part D)
Part D plans are sold by private insurance companies. You can add one to Original Medicare or to a Medigap plan. Many Medicare Advantage plans already include drug coverage.
- Each plan has a list of covered drugs and a network of pharmacies. Check your medicines before you join.
- Plans differ in premiums, deductibles and copays.
- If you go 63 days or more in a row without drug coverage that counts as creditable after you first qualify, you may pay a late penalty.
At a glance
| Original Medicare | Medicare Advantage | Medicare Supplement | Part D | |
|---|---|---|---|---|
| Offered by | The federal government | Private insurance companies that contract with Medicare | Private insurance companies | Private insurance companies |
| Helps with | Hospital and medical costs | Hospital and medical costs, usually drugs, often extra benefits | Costs Original Medicare leaves | Prescription drugs |
| Works with | Medigap and Part D | Cannot be used with Medigap | Original Medicare only | Original Medicare, Medigap and some other plans |
When you can sign up or make changes
Medicare has set windows for joining and changing coverage. Missing one can mean waiting or paying more. Here are the main ones.
| Period | When | What you can do |
|---|---|---|
| Initial Enrollment Period | A seven-month window around your 65th birthday. It starts three months before the month you turn 65 and ends three months after that month. | Sign up for Part A and Part B. Join a Medicare Advantage plan or a Part D plan. If you sign up before the month you turn 65, your Part B coverage can start the month you turn 65. |
| Annual Enrollment Period | Every year from October 15 to December 7 | Join, switch or drop a Medicare Advantage plan. Join, switch or drop a Part D plan. Changes start January 1. |
| Medicare Advantage Open Enrollment Period | Every year from January 1 to March 31 | For people already in a Medicare Advantage plan. Switch to another Medicare Advantage plan, or go back to Original Medicare. You cannot use it to move from Original Medicare to Medicare Advantage. |
| Medigap Open Enrollment Period | Six months, starting the month you are 65 or older and have Part B | Buy any Medigap plan sold in your state. This window happens one time. |
| General Enrollment Period | Every year from January 1 to March 31 | Sign up for Part A and Part B if you missed your Initial Enrollment Period. Coverage starts the month after you sign up, and a late penalty may apply. |
| Special Enrollment Periods | Varies | Some life events open a window outside these dates, such as moving to a new area or losing other coverage. |
Source note: Dates come from Medicare.gov and can change. Confirm them at Medicare.gov or by calling 1-800-MEDICARE.
Turning 65 checklist
Start about three months before your birthday month. Use this list to stay on track.
- Mark your dates. Your Initial Enrollment Period starts three months before the month you turn 65.
- Check Social Security. If you already get Social Security benefits, you are usually signed up for Part A and Part B automatically. If you do not, you sign up through Social Security.
- Review coverage from work. If you or your spouse still work, ask your benefits office how your plan works with Medicare before you delay Part B.
- Gather your information. List your doctors, your medicines and the pharmacies you use.
- Pick a path. Decide between Original Medicare with a Medigap plan and a Part D plan, or a Medicare Advantage plan. We can talk it through with you.
- Compare and enroll. Compare premiums, deductibles, copays, yearly out-of-pocket limits, networks and drug lists. Then sign up during your window.
- Review every fall. Plans change each year. Read your plan's yearly notice and review your options during the Annual Enrollment Period.
How we help
Medicare plans change every year, and your choices depend on where you live. A licensed agent can help you:
- Understand how the parts of Medicare fit together
- Check that your doctors and medicines are covered by the plans you are considering
- Compare costs and benefits for the carriers we represent in your area
- Enroll in the plan you choose
- Review your options each year
There is no fee to work with us. Insurance companies pay us when you enroll in a plan.
We do not offer every plan available 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. Bridgemont Life is not connected with or endorsed by the U.S. government or the federal Medicare program.