Understanding Medicare

A visual guide to Medicare coverage options

Medicare is a federal health insurance program primarily for people who are 65 or older. It's divided into different parts that cover specific services. Understanding these parts can help you make informed decisions about your healthcare coverage

Medicare Part A

Medicare Part A, also called "hospital insurance," covers a range of inpatient care, including:

✅ Hospital stays (semi-private rooms, meals, and general nursing)

✅ Skilled nursing facility care (short-term care after a hospital stay)
✅ Hospice care for end-of-life support
✅ Home health care (limited services related to recovery or medical care)

It’s important to know that while many qualify for Medicare Part A without a monthly premium, certain deductibles and coinsurance costs apply especially for hospital stays over 60 days.

If you have specific questions about how Part A applies to you or want to explore strategies to maximize your Medicare benefits, feel free to reach out.

Medicare Part B

Medicare Part B, also known as "medical insurance," covers outpatient and preventive care. Here are some of the services it typically includes:

✅ Doctor visits and outpatient care
✅ Preventive services like screenings, vaccines, and wellness exams
✅ Diagnostic tests such as MRIs, X-rays, and blood work
✅ Durable medical equipment (like walkers and wheelchairs)
✅ Some home health services
It’s worth noting that Medicare Part B requires a monthly premium, and there may be deductibles and coinsurance associated with certain services. Enrollment timing can also impact costs—so it’s important to stay informed about deadlines and late enrollment penalties.

If you have specific questions about how Part B applies to you or want to explore strategies to maximize your Medicare benefits, feel free to reach out.

Medicare Advantage

Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare (Parts A and B) offered by private insurance companies approved by Medicare. These plans bundle hospital (Part A), medical (Part B), and often prescription drug coverage (Part D) into one comprehensive plan.

Key Features:

✅ All-in-One Coverage: Most plans include prescription drugs, dental, vision, hearing, and wellness programs.

✅Provider Networks: Many Medicare Advantage plans operate as HMOs or PPOs, meaning you may need to use doctors and hospitals in the plan’s network.

✅Costs: Monthly premiums can be as low as $0, but you still pay your Part B premium. Out-of-pocket costs vary by plan but are capped yearly, unlike Original Medicare.

✅Extra Benefits: May include transportation to medical appointments, over-the-counter allowances, and gym memberships.

Enrollment Windows:

✅ Initial Enrollment: When you first become eligible for Medicare.
✅ Annual Enrollment: October 15 – December 7, to join, switch, or drop plans.

✅ Open Enrollment: January 1 – March 31, allows switching between Medicare Advantage plans or returning to Original Medicare.

Medicare Advantage may be a good fit if you want coordinated care, potential savings, and extra benefits beyond what Original Medicare offers.

If you have specific questions about how Part C applies to you or want to explore strategies to maximize your Medicare benefits, feel free to reach out.

Medicare Part D

Medicare Part D helps cover the cost of prescription drugs and is offered through private insurance companies approved by Medicare. It can be added to Original Medicare (Parts A and B) or some Medicare Cost Plans, Medicare Private Fee-for-Service Plans, and Medical Savings Account Plans.

Key Features:

✅ Prescription Coverage: Helps pay for both brand-name and generic medications that are listed on your plan’s formulary (approved drug list).

✅ Standalone or Bundled: You can enroll in a standalone Part D plan or get drug coverage through a Medicare Advantage plan that includes Part D (MAPD).

✅ Costs: You’ll pay a monthly premium, and possibly an annual deductible, copayments, or coinsurance. Costs and covered drugs vary by plan.

✅ Coverage Stages: Plans typically include several stages—deductible, initial coverage, coverage gap (donut hole), and catastrophic coverage. Each stage affects how much you pay out of pocket.

Enrollment Windows:

✅ Initial Enrollment: When you first become eligible for Medicare.
✅ Annual Enrollment Period (AEP): October 15 – December 7, when you can enroll in, switch, or drop a Part D plan.
✅ Late Enrollment Penalty: If you don’t sign up when first eligible and go without other creditable drug coverage, you may pay a penalty if you enroll later.

Having the right Part D plan is important to ensure your prescriptions are covered affordably and conveniently.

If you have specific questions about how Part D applies to you or want to explore strategies to maximize your Medicare benefits, feel free to reach out.

Medigap

Medigap plans, also known as Medicare Supplement Insurance, help cover the out-of-pocket costs that Original Medicare (Parts A and B) doesn’t pay—like copayments, coinsurance, and deductibles. These plans are offered by private insurance companies and are designed to work alongside Original Medicare, not replace it.

Key Features:

✅ Fills the Gaps: Helps pay for costs such as Part A hospital coinsurance, Part B copays, and even foreign travel emergency care (depending on the plan).
✅ Standardized Plans: Plans are labeled by letters (A, B, D, G, K, L, M, and N) and standardized across most states—Plan G offers the most comprehensive coverage for new enrollees.
✅ Nationwide Use: You can visit any doctor or hospital that accepts Medicare—no networks or referrals required.
✅ No Drug Coverage: Medigap plans do not include prescription drug coverage. You'll need to enroll in a separate Part D plan for medications.
✅ Guaranteed Renewal: As long as you pay your premium, your Medigap plan can’t be canceled—even if your health changes.

Enrollment Tips:

✅ Best Time to Enroll: During your Medigap Open Enrollment Period—a six-month window starting the month you're 65 or older and enrolled in Part B. During this time, you can't be denied coverage or charged more due to health issues.
✅ Medical Underwriting: If you apply outside this window, you may have to answer health questions and could be denied or charged more.

Medigap plans are ideal for people who want predictable costs, freedom to choose providers, and strong coverage without the restrictions of a Medicare Advantage plan.

If you have specific questions about how Medigap applies to you or want to explore strategies to maximize your Medicare benefits, feel free to reach out.

Medicare Doesn’t Cover Everything — We Help Fill the Gaps

Original Medicare offers essential coverage, but it doesn’t cover everything. Hospital stays, prescriptions, and even routine doctor visits may leave you with out-of-pocket costs that can quickly add up. That’s where Medicare Advantage and Medicare Supplement (Medigap) plans come in.

At A to Z Retirement Planners, we help you understand and compare your options so you can choose the plan that best fits your health needs and budget.

Medicare Advantage vs. Medicare Supplement

We’ll guide you through the key differences:

Medicare Advantage offers a lower monthly premium but may include higher copays and a more limited provider network. It often includes additional benefits like dental, vision, and hearing coverage.

Medicare Supplement (Medigap) plans come with a higher monthly premium but offer lower out-of-pocket costs, broader provider access, and greater predictability.

Personalized Prescription Plan Assistance

Your prescriptions matter. We’ll search your preferred medications and compare available Part D prescription drug plans to help ensure you get the coverage you need—at the lowest possible cost.

Medicare can be confusing, but you don’t have to navigate it alone. Let us help you find the right plan and avoid costly surprises down the road.

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Medicare Blueprint™

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Understanding Medicare

A visual guide to Medicare coverage options

Medicare Part A

Medicare Part A, also called "hospital insurance," covers a range of inpatient care, including:

Medicare Part B

Medicare Part B, also known as "medical insurance," covers outpatient and preventive care. Here are some of the services it typically includes:

Medicare Advantage

Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare (Parts A and B) offered by private insurance companies approved by Medicare. These plans bundle hospital (Part A), medical (Part B), and often prescription drug coverage (Part D) into one comprehensive plan.

Key Features:

Enrollment Windows:

Medicare Part D

Medicare Part D helps cover the cost of prescription drugs and is offered through private insurance companies approved by Medicare. It can be added to Original Medicare (Parts A and B) or some Medicare Cost Plans, Medicare Private Fee-for-Service Plans, and Medical Savings Account Plans.

Key Features:

Enrollment Windows:

Medigap

Key Features:

Enrollment Tips:

Medicare Doesn’t Cover Everything — We Help Fill the Gaps

Medicare Advantage vs. Medicare Supplement

Personalized Prescription Plan Assistance

Ready to Secure Your Retirement?

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