Medicare has several parts, several ways to receive coverage and enrollment windows that matter. The descriptions below are starting points for a conversation, not recommendations. Benefits, costs, provider networks and plan availability vary by plan and by county.
Original Medicare (Parts A and B)
Original Medicare is the federal program. Part A generally covers inpatient hospital care, skilled nursing facility care, hospice and some home health care. Part B generally covers doctor visits, outpatient care, preventive services and some medical equipment.
Original Medicare does not include most prescription drug coverage, and it does not have an annual limit on out-of-pocket costs. Many people add other coverage for those reasons.
Medicare Advantage (Part C)
Medicare Advantage plans are offered by private companies approved by Medicare. They provide Part A and Part B coverage in one plan, and many include prescription drug coverage. Some include extra benefits, which vary by plan.
Most Medicare Advantage plans use a provider network, and some require referrals or prior authorization. It is worth checking whether your doctors, hospitals and prescriptions are covered before choosing a plan.
Prescription drug coverage (Part D)
Part D plans help cover prescription drugs. They can be a stand-alone plan alongside Original Medicare, or included in a Medicare Advantage plan. Each plan has its own list of covered drugs, pharmacy network and costs.
Delaying Part D coverage when first eligible, without other creditable drug coverage, can lead to a late enrollment penalty.
Medicare Supplement (Medigap)
Medicare Supplement insurance, also called Medigap, is sold by private companies and works alongside Original Medicare. It may help pay costs Original Medicare does not, such as some deductibles, copayments and coinsurance. It does not include prescription drug coverage.
There is a one-time Medigap open enrollment period of six months that starts the month you are 65 or older and enrolled in Part B. Outside that window, an insurer may be able to use medical underwriting, depending on state rules.
Key enrollment periods
- Initial Enrollment Period: seven months, starting three months before the month you turn 65 and ending three months after it.
- Medicare Open Enrollment: October 15 to December 7 each year. Changes generally take effect January 1.
- Medicare Advantage Open Enrollment: January 1 to March 31, for people already in a Medicare Advantage plan.
- Special Enrollment Periods: certain life events, such as moving or losing other coverage, may allow changes at other times.
Companies we currently represent
- Humana
- Devoted Health
- UnitedHealthcare
Plan options from each company depend on where you live. Not every company offers plans in every county.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Questions to bring to a conversation
- Which doctors, specialists and hospitals do you want to keep?
- Which prescriptions do you take, and which pharmacy do you use?
- Do you travel or spend part of the year in another state?
- Do you have coverage from an employer, union or other source?
- What would your total costs look like across a year, not only the monthly premium?
Educational information only. This page does not recommend a plan. Ascendra Solutions is not connected with or endorsed by the U.S. government or the federal Medicare program. Plan benefits, costs, networks and availability vary and are subject to change; plan documents control. Medicare conversations are currently available to residents of Georgia. Phone calls about Medicare plans may be recorded, as Medicare rules require.