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Medicare Part A
Who Qualifies?
Medicare Part A is part of the Original Medicare plan provided by the federal government. It helps cover hospital stays, skilled nursing care, hospice, and some home health services. Most people become eligible once they turn 65.
You can usually start your Initial Enrollment Period (IEP) three months before your 65th birthday, and coverage typically begins within the three months after.
People under 65 with certain disabilities may also qualify for Medicare Part A. After being approved through the disability process, there’s a 25-month waiting period before Medicare kicks in. At month 22, the IEP begins, and just like turning 65, coverage usually starts a few months later. In some urgent or severe cases, the process may be fast-tracked.
Getting close to 65 or have questions about qualifying with a disability? Let’s chat—we’re here to help!
What is Covered
Medicare Part A helps with big medical costs—like inpatient hospital stays, skilled nursing facility care, hospice services, and even some home health care. It can also cover care in religious non-medical facilities under certain circumstances.
But it’s important to know that Medicare doesn’t cover everything. If your expenses go beyond what’s allowed, you may be responsible for the difference. And if a service or procedure isn’t covered at all, you’ll need to pay the full cost out of pocket—sometimes even for things that are truly necessary.
That’s why many people look into extra coverage for things Medicare Part A doesn’t include—like dentures, hearing aids, eye exams, most dental work, and even blood transfusions.
Have questions or want to explore your options? Reach out—we’re here to help!
Medicare Part B
What’s Medicare Part B All About?
Medicare Part B is part of the Original Medicare health insurance provided by the federal government. It’s available to U.S. citizens—and legal residents who’ve lived here for at least five straight years—once they turn 65.
Most people can start signing up during their Initial Enrollment Period (IEP), which begins three months before their 65th birthday and runs for three months after. In most cases, your coverage will kick in within that same time frame.
Some people under 65 may also qualify for Medicare Part B if they have a disability. Once someone is officially approved as disabled, there’s usually a 25-month waiting period before Medicare begins. But the IEP opens at month 22, so they can get a head start. In certain serious cases, the process can move faster.
Getting close to 65? Or wondering if you qualify through a disability? Reach out—we’re happy to help!
What Does Medicare Part B Cover?
Medicare Part B helps cover things like doctor’s visits, outpatient care, home health services, and durable medical equipment (like walkers or wheelchairs). It can also include certain preventive services to help you stay healthy. Want to know exactly what’s available to you? Get in touch—we’re happy to walk you through it!
Just like Medicare Part A, Part B does have its limits. It doesn’t cover everything. You may still be responsible for some costs, especially for things like routine eye exams and glasses, hearing tests and hearing aids, or certain prescription drugs. It’s good to know what’s included—and what’s not—so there are no surprises.
Medicare Part C - Medicare Advantage Plans & Medigap
Why You Might Need Extra Coverage
Unfortunately, Medicare Parts A and B don’t cover everything—and when that happens, you could be left with a pretty big bill. In some cases, people may have to pay more than 25% of the total cost out of pocket. That’s a financial hit most folks aren’t ready for.
That’s why many people who qualify for Medicare look into Supplemental Insurance, like Medigap or a Medicare Advantage Plan. These plans help cover the gaps—like copays, coinsurance, and services that Medicare doesn’t fully pay for.
To make sure you’re protected, all companies offering Medicare Advantage or Medigap plans must be approved by Medicare, so you can feel confident you're getting quality coverage.
Have questions about what plan is right for you? We’re here to help you figure it out!
How to Qualify for a Medicare Advantage Plan or Medigap
To sign up for a Medicare Advantage Plan or Medigap, you’ll first need to be enrolled in both Medicare Part A and Part B—and you’ll need to keep paying your Part B premium.
In most cases, qualifying isn’t a problem. But there are situations where someone may not be eligible for a Medicare Advantage Plan, so it’s a good idea to reach out and talk through your specific circumstances with us.
The Medicare Advantage Open Enrollment Period runs from October 15 to December 7, with coverage starting January 1st of the following year. Certain life events—like moving or losing other coverage—may make you eligible for Special Enrollment outside of that window.
Not sure if you qualify? Contact us today—we’re happy to help you sort it out!
Medicare Part D Prescription Drug Plans
Medicaid doesn’t cover prescription drugs, which is why a lot of people choose to sign up for a Medicare Part D plan to help with those costs.
Just like Medicare Part C, all Part D plans have to be approved by Medicare. Keep in mind—these plans don’t cover over-the-counter meds.
To get a Part D plan, you’ll need to be enrolled in either a Medicare Supplement Plan (also called Medigap) or a Medicare Advantage Plan. So you’ll need to qualify for one of those first.
Not all Medicare Part D plans cover the same medications, and even when a drug is covered, it might only be available in limited quantities. Most plans use a tiered system to organize prescription coverage, which looks something like this:
- Tier 1 – Preferred Generic Medications
- Tier 2 – Generic Medications
- Tier 3 – Preferred Brand-Name Medications
- Tier 4 – Non-Preferred Medications
- Tier 5 – Specialty Medications
If you're not sure which plan works best with your current prescriptions, we’re here to help! We’ll help you find a plan that fits your needs—and if things change down the road and you need a medication that’s not covered, we’ll help you explore better options.