Medicare insurance is not a one-size fits all program. There are many options available to you, meant to meet your specific medical needs and budget.

First let's look at the basic parts offered in Medicare insurance coverage: 

Part A covers hospital, hospice and some home care.

Part B covers doctor visits, diagnostic tests and other outpatient services.

Parts A and B are referred to as Original Medicare and is administered by the federal government.

Part C, also known as Medicare Advantage, is an alternative to Original Medicare and is administered by private insurance companies, regulated by the Centers for Medicare and Medicaid Services or CMS.

Part D covers prescription drugs and is offered by private insurance companies. 

Finally, a Medicare Supplement plan, offered by private insurance companies, helps fill the gaps in Original Medicare Part A and B. A Medicare Supplement plan, also known as Medigap, is a type of health insurance that helps pay for out-of-pocket costs that Original Medicare doesn't cover such as copayments, coinsurance, and deductibles. For instance, Part B covers 80% of outpatient medical treatments. A Medicare Supplement Plan will pay all or some of the 20% coinsurance you pay. The amount the supplement plan pays, depends on the Medicare Supplement plan you purchase.

When enrolling in Medicare, you will need to choose between original Medicare (Part A and B), a Medicare Advantage plan (Part C), or a Medicare Supplement Plan.

If you choose original Medicare or a Medicare Supplement Plan, you’ll need to enroll in a Part D prescription drug plan to get your medications covered.

Medicare Advantage (MA), or Part C plans include additional benefits that Original Medicare does not offer including vision, dental and hearing benefits. Most MA plans also include prescription drug coverage, so you do not need to enroll in a separate prescription drug plan.

Click the Medicare link at the bottom of this page to learn more about your Medicare insurance options.

Medicare has an initial enrollment period (IEP) for people turning 65. It runs for three months before your 65th birthday month, the month of your 65th birthday and three months after.

You’ll need to sign up for Medicare Part B during that enrollment window or you’ll be subject to a late enrollment penalty, which means you’ll have to pay a higher monthly premium for as long as you are on Medicare. The same rule applies to Part D coverage.

Because most people don’t have to pay a premium for Part A after they retire, it likely won’t cost you anything to sign up for Part A coverage, and doing so will put you into the system and make it easier when it’s time to enroll in Part B.

While the Medicare eligibility age is 65, if you have comprehensive health insurance through your employer or are covered under a spouse’s health benefit, you may be able to defer enrolling in Medicare until you no longer have that coverage.

However, even if you have job-based insurance, an employer may require that you enroll in Medicare and use its insurance to fill any gaps in Medicare. So, check with the employer you get your coverage through.

If you receive health insurance through an Affordable Care Act (ACA) marketplace, you’ll have to switch over to Medicare when you turn 65. The same rule applies if you are covered under COBRA, which extends a former employer’s coverage; if you have the military’s Tricare insurance; or if you have a retiree health plan. None of these plans is a substitute for Medicare and is not considered credible coverage, making you vulnerable to paying late enrollment penalties.

The Social Security Administration (SSA) handles Medicare enrollment. You can sign up online at www.ssa.gov. You can also go to your nearest Social Security office, or call SSA at 800-772-1213. 

You will need to have a Medicare account and number in order to enroll in a Medicare Advantage or Medigap plan. It is best to sign up for Part A and B at least a month before you plan to enroll so you are assured to have your Medicare account number and your Part A and B effective dates. Be sure to make Part B coverage effective the month that you lose your current coverage. Your Part B premium will be due the first month that it is in effect.

Once you're ready to sign up for a Medicare Advantage plan or Medigap plan, reach out to Mark to help you select the plan that best fits your medical needs and financial budget. Fill out the contact form to the right and Mark will reach out to you to talk about all of your options. Mark's advisory services are always free.

While Medicare pays the lion’s share of enrollees’ medical costs, there is, as they say, no free lunch.

In addition to monthly premiums required for various Medicare coverage options, there are copays and coinsurance costs for services like doctor visits, diagnostic tests, hospital stays and prescription drugs.

How much you’ll have to pay will depend on which Medicare option you sign up for (original Medicare or Medicare Advantage) and which specific plan you pick. Mark can help you navigate through all of our options and costs.

Medicare coverage does not pay for everything. Here is a list of medical needs not covered by Medicare.

- Medical care in foreign countries. Emergency care is covered under certain circumstances.

- Cosmetic surgery. Medicare will cover plastic surgery in the event of an accidental injury or if needed after another treatment, such as breast reconstruction following a mastectomy.

- Original Medicare (Parts A and B) and Medigap plans do not cover dental, vision or hearing needs. Many Medicare Advantage plans cover these needs including chiropractic and massage therapy, also not covered by Medicare.

Make an appointment with Mark to find out more about all of your options.

You do not need an insurance agent to sign up for Medicare. You can always see your options and sign up for coverage at Medicare.gov.

An insurance agent like Mark will assist you navigate through the options available to you, help you make the choice that's best for you and your pocketbook and sign you up for the plan of your choice.

Mark is here as your agent to answer any questions you have about your Medicare coverage and advocate for you when you need help solving a problem with your Medicare insurance company. Mark often has resources available to him as an agent that you as a Medicare client don't have.

Mark does not charge you for his services since he is paid by the insurance company that you choose, similar to your auto or home insurance agent. Call Mark or make an appointment here on this website to talk more about your Medicare options.