🩺 Medicare 101: A Basic Guide to Understanding Medicare

If you are turning 65 soon or are already eligible for Medicare, it’s normal to feel confused. Medicare has different parts, plans, and rules that can seem complicated at first. In this Medicare 101 guide, we explain the essentials in a clear and simple way.

What Is Medicare?

Medicare is a federal health insurance program for people who:

• Are 65 years old or older

• Are under 65 with certain disabilities

• Have End-Stage Renal Disease (ESRD)

Medicare is administered by the federal government, but many plans are offered by private insurance companies approved by Medicare.

The Parts of Medicare (A, B, C, and D)

🅰️ Medicare Part A – Hospital Coverage

Covers:

• Hospital stays

• Skilled nursing facility care

• Hospice care

• Some home health services

👉 Most people do not pay a premium for Part A if they worked and paid Medicare taxes.

🅱️ Medicare Part B – Medical Services

Covers:

• Doctor visits

• Outpatient services

• Preventive screenings

• Durable medical equipment

👉 Part B does require a monthly premium, which may vary based on income.

🅲 Medicare Part C – Medicare Advantage

Medicare Advantage plans:

• Are offered by private insurance companies approved by Medicare

• Include Part A and Part B

• Usually include prescription drug coverage (Part D)

• May offer additional benefits such as:

  • Dental

  • Vision

  • Hearing

  • Gym memberships

👉 You must typically use providers within the plan’s network.

🅳 Medicare Part D – Prescription Drugs

Helps cover the cost of prescription medications. Each plan has its own formulary (list of covered drugs) and costs.

What Does Medicare NOT Cover?

Original Medicare generally does not cover:

• Routine dental care

• Vision exams or eyeglasses

• Hearing aids

• Long-term care

• Cosmetic surgeries

Because of this, many people consider Medicare Advantage plans or Medicare Supplements.

What Is a Medicare Supplement (Medigap)?

Medigap helps cover:

• Deductibles

• Copayments

• Coinsurance

👉 Works alongside Original Medicare (Parts A and B)👉 Does not include prescription drugs (a separate Part D plan is required)

Important Enrollment Periods

🗓️ Initial Enrollment Period

• Begins 3 months before you turn 65

• Includes your birthday month

• Ends 3 months after

🔁 Annual Enrollment Period (AEP)

October 15 – December 7

You can:

• Change plans

• Enroll in Medicare Advantage

• Change Part D plans

🔄 Medicare Advantage Open Enrollment

January 1 – March 31

• Only for individuals already enrolled in a Medicare Advantage plan

Do I Need Help Choosing a Plan?

Everyone’s situation is different. The best plan depends on:

• Your doctors

• Your medications

• Your budget

• Your health needs

Speaking with a licensed insurance agent can help you understand your options at no additional cost.

⚠️ Important Medicare Notice (CMS)

We do not offer every plan available in your area. Any information provided is limited to the plans we represent. To learn about all of your options, visit Medicare.gov or call 1-800-MEDICARE.

📞 Ready to Learn More?

If you have questions about Medicare or want a personalized explanation:

New Age Insurance Brokers📞 (562) 276-0580📧 info@newageinsurancebrokers.com

A licensed agent can help you review your options with no obligation.