Q: What is the difference between Original Medicare and Medicare Advantage?

Original Medicare is the government program, Part A (hospital) and Part B (medical). You can see any provider in the U.S. who accepts Medicare and there are no networks. It does not include prescription drug coverage or limits on out-of-pocket costs by itself, so most people add a Part D drug plan and a Medicare Supplement (Medigap) to round it out. Medicare Advantage (Part C) is an all-in-one alternative offered by private insurance companies. It bundles Parts A, B, and usually Part D, and often adds extras like dental, vision, hearing, and fitness benefits. Plans typically have provider networks (HMO/PPO) and an annual out-of-pocket maximum.

Q: When can I enroll in or change my Medicare plan?

There are several enrollment windows. The Initial Enrollment Period (IEP) is the 7-month window around your 65th birthday. The Annual Enrollment Period (AEP) runs October 15 through December 7 each year, this is when most people on Medicare can switch plans for the following calendar year. The Medicare Advantage Open Enrollment Period runs January 1 through March 31 and lets people already in a Medicare Advantage plan switch once. A Special Enrollment Period (SEP) may be available if you lose other coverage, move to a new area, or experience other qualifying events.

Q: How much does Medicare cost?

Most people pay no premium for Part A if they (or a spouse) paid Medicare taxes for at least 10 years of work. Part B has a standard monthly premium set by CMS each year (higher-income beneficiaries pay more under IRMAA rules). Medicare Advantage plans have their own monthly premium, many are $0 in addition to your Part B premium. Medigap premiums vary by plan letter, age, ZIP code, and tobacco use. Part D drug plans have their own monthly premium plus copays. Check the most current numbers at Medicare.gov , or get a personalized estimate from one of our licensed agents.

Q: Can I keep my doctor with a Medicare plan?

With Original Medicare (Parts A & B) plus a Medigap policy, you can see any provider in the country who accepts Medicare, most do. With a Medicare Advantage plan, your access depends on the plan's network: HMO plans usually require you to stay in network except for emergencies, while PPO plans let you go out of network at a higher cost. Before recommending a plan, our agents check that your current doctors and pharmacies are in the network and that your prescriptions are on the plan's formulary.

Question 1

When am I eligible for Medicare?

Accepted Answer

Most people become eligible for Medicare when they turn 65. Your Initial Enrollment Period (IEP) is a 7-month window: it starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. Some people qualify earlier, typically after 24 months of receiving Social Security Disability Insurance, or with certain conditions like End-Stage Renal Disease or ALS. If you are already collecting Social Security at 65, you are usually enrolled in Parts A and B automatically.

Question 2

What is the difference between Original Medicare and Medicare Advantage?

Accepted Answer

Original Medicare is the government program, Part A (hospital) and Part B (medical). You can see any provider in the U.S. who accepts Medicare and there are no networks. It does not include prescription drug coverage or limits on out-of-pocket costs by itself, so most people add a Part D drug plan and a Medicare Supplement (Medigap) to round it out.

Medicare Advantage (Part C) is an all-in-one alternative offered by private insurance companies. It bundles Parts A, B, and usually Part D, and often adds extras like dental, vision, hearing, and fitness benefits. Plans typically have provider networks (HMO/PPO) and an annual out-of-pocket maximum.

Question 3

What is a Medicare Supplement (Medigap) plan?

Accepted Answer

A Medicare Supplement, also called Medigap, is a private insurance policy that helps pay the costs Original Medicare does not cover: coinsurance, copayments, and deductibles. Medigap plans are standardized by letter (Plan G and Plan N are the most popular today). You can see any provider nationwide that accepts Medicare, with no network restrictions. Medigap does not include prescription drug coverage, so most people pair it with a stand-alone Part D plan. The best time to buy Medigap is during your 6-month Medigap Open Enrollment Period, which starts when you are 65 or older and enrolled in Part B. During that window, insurers cannot deny you or charge more based on health history.

Question 4

Medicare Supplement vs. Medicare Advantage, which is better?

Accepted Answer

Neither is universally better, it depends on your priorities. Medicare Advantage typically has lower (or $0) monthly premiums and includes extras like dental and vision, but you usually need to stay in network and predict costs based on copays as you use care. Medigap has higher monthly premiums but very predictable costs at the point of service and lets you see any Medicare provider in the country. One critical difference: Medigap is only guaranteed-issue during your one-time 6-month Medigap Open Enrollment Period at 65. After that, in most states, insurers can use medical underwriting and may decline or charge more based on your health. Medicare Advantage has no medical questions, ever. A licensed agent can walk through your doctors, prescriptions, travel habits, budget, and health history to recommend the right fit.

Question 5

Can I switch from Medicare Advantage to a Medicare Supplement plan later?

Accepted Answer

Sometimes, but it's harder than people expect. You can drop Medicare Advantage and return to Original Medicare during the Annual Enrollment Period (October 15 to December 7) or the Medicare Advantage Open Enrollment Period (January 1 to March 31). But adding a Medigap policy after those windows usually requires you to pass medical underwriting in most states, which means the Medigap insurer can review your health history and decline you or charge a higher premium based on pre-existing conditions. A few specific situations grant guaranteed-issue rights outside your original 6-month window (such as your Medicare Advantage plan leaving your area, certain trial-right scenarios, or state-specific protections like California, Connecticut, Massachusetts, Maine, New York, Oregon, and Washington). This is why the choice you make at 65 matters: it's easy to switch into Medicare Advantage anytime, but switching back to Medigap may not be an option later. Get a free comparison from a licensed agent before deciding.

Question 6

When can I enroll in or change my Medicare plan?

Accepted Answer

There are several enrollment windows. The Initial Enrollment Period (IEP) is the 7-month window around your 65th birthday. The Annual Enrollment Period (AEP) runs October 15 through December 7 each year, this is when most people on Medicare can switch plans for the following calendar year. The Medicare Advantage Open Enrollment Period runs January 1 through March 31 and lets people already in a Medicare Advantage plan switch once. A Special Enrollment Period (SEP) may be available if you lose other coverage, move to a new area, or experience other qualifying events.

Question 7

How much does Medicare cost?

Accepted Answer

Most people pay no premium for Part A if they (or a spouse) paid Medicare taxes for at least 10 years of work. Part B has a standard monthly premium set by CMS each year (higher-income beneficiaries pay more under IRMAA rules). Medicare Advantage plans have their own monthly premium, many are $0 in addition to your Part B premium. Medigap premiums vary by plan letter, age, ZIP code, and tobacco use. Part D drug plans have their own monthly premium plus copays. Check the most current numbers at Medicare.gov, or get a personalized estimate from one of our licensed agents.

Question 8

Can I keep my doctor with a Medicare plan?

Accepted Answer

With Original Medicare (Parts A & B) plus a Medigap policy, you can see any provider in the country who accepts Medicare, most do. With a Medicare Advantage plan, your access depends on the plan's network: HMO plans usually require you to stay in network except for emergencies, while PPO plans let you go out of network at a higher cost. Before recommending a plan, our agents check that your current doctors and pharmacies are in the network and that your prescriptions are on the plan's formulary.

Question 9

Do I need Part D for prescription drugs?

Accepted Answer

If you take prescription medications, yes, Part D coverage is important. Original Medicare and Medigap do not cover most retail prescription drugs. You can get Part D coverage either through a stand-alone Prescription Drug Plan (if you have Original Medicare) or as part of a Medicare Advantage Prescription Drug (MAPD) plan. Even if you don't take any prescriptions today, signing up when first eligible avoids a permanent late-enrollment penalty added to your premium if you sign up later.

Question 10

Is there a fee to work with a licensed Medicare agent?

Accepted Answer

No. There is no cost to you. Our licensed agents are compensated directly by the insurance carriers when you enroll, so your premium is the same whether you sign up through us or directly with the carrier. The benefit of working with an independent agent: we represent multiple carriers, so we can compare plans across companies, verify your doctors and prescriptions are covered, and help you avoid common enrollment mistakes.

Question 11

What if I missed my Initial Enrollment Period?

Accepted Answer

If you missed your IEP, you may still be able to enroll during the General Enrollment Period (January 1 to March 31 each year, with coverage starting the month after sign-up) or during a Special Enrollment Period if you qualify. Be aware that late enrollment in Part B or Part D can result in a permanent monthly penalty, so it is best to act as soon as possible. Call us or request a quote to talk through your situation with a licensed agent.

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