EXPLORE YOUR
MEDICARE OPTIONS
Newly enrolling in Medicare can feel overwhelming, but at Insurance Pathways, we’re here to make it simple and stress-free. As your trusted health insurance partner, we guide you through every step, ensuring you find the right plan for your unique needs. From signing up through Social Security to exploring options like Medicare Advantage or Medigap, we’ll help you understand your choices. Once you're ready, we’ll assist you in making the best decision and submitting your enrollment with confidence. We're here to support you on your Medicare journey!
Are you eligible for a Special Enrollment Period?
You can make changes to your Medicare Advantage and Medicare drug coverage when certain events happen in your life, like if you move or you lose other coverage. These chances to make changes are called Special Enrollment Periods.
The types of changes you can make and the timing depend on your life event.
Contact us to learn more about your options.
UNDERSTANDING MEDICARE
What is Medicare?
Medicare is a federal health insurance program in the United States primarily for people who are 65 or older, but it also covers certain younger individuals with disabilities and those with End-Stage Renal Disease. Medicare is divided into several parts, each covering different aspects of health care. Expand each section below to learn more.
What are Medicare Savings Programs?
Medicare Savings Programs are specifically designed to help Medicare beneficiaries with out-of-pocket expenses. Get help from your state paying your Medicare Part A and Part B premiums through a Medicare Savings Program. If you qualify, Medicare Savings Programs might also pay your Part A and Part B deductibles, coinsurance, and copayments. In many cases, to qualify for one of four Medicare Savings Programs, you must have income and resources below a certain limit.
When should I enroll?
Medicare enrollment periods include the Initial Enrollment Period (IEP), which lasts seven months, starting three months before you turn 65. The General Enrollment Period (GEP) runs from January 1 to March 31 each year for those who missed their initial chance. The Annual Enrollment Period (AEP) occurs from October 15 to December 7, allowing beneficiaries to make changes to their existing Medicare plans. Additionally, there’s a Special Enrollment Period (SEP) for specific circumstances like losing employer coverage.
-
What is Medicare Part A? (Hospital Insurance)Medicare Part A is a key component of the U.S. federal health insurance program, primarily covering inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. It's often referred to as "hospital insurance" and is typically premium-free for those who have paid Medicare taxes for at least 10 years. Most people are automatically enrolled in Part A at age 65 if they're receiving Social Security benefits. While there's usually no premium, patients may still be responsible for deductibles, coinsurance, or copayments, and there are limits on coverage duration for certain services.
-
What is Medicare Part B? (Medical Insurance)Medicare Part B covers medical services and supplies needed for the diagnosis or treatment of health conditions. This includes outpatient care, preventive services, medical equipment, and some doctor services. Unlike Part A, Part B typically requires a monthly premium. Most beneficiaries enroll in Part B when they become eligible, though some may delay if they have other coverage. Part B also involves cost-sharing, with beneficiaries responsible for a deductible and usually 20% of the Medicare-approved amount for covered services.
-
What is Medicare Part C? (Medicare Advantage)Medicare Part C plans combine coverage for hospital care, medical services, and often prescription drugs into one plan. These plans must cover all services that Original Medicare covers, but may offer additional benefits like dental, vision, or hearing care. Part C plans often have network restrictions and different cost structures than Original Medicare. Beneficiaries who choose Part C still pay their Part B premium. These plans can provide more comprehensive coverage, but the specifics vary by plan and location.
-
What is Medicare Part D? (Prescription Drugs)Medicare Part D is an optional program that helps cover the cost of prescription medications. It's offered by private insurance companies approved by Medicare, either as a standalone plan or as part of a Medicare Advantage plan. Part D plans vary in terms of covered drugs, costs, and pharmacy networks. Beneficiaries typically pay a monthly premium, annual deductible, and copayments or coinsurance for their medications. Part D can significantly reduce out-of-pocket costs for prescription medications for many Medicare recipients.
MEDICARE ENROLLMENT: YOUR PREPARATION CHECKLIST
GETTING READY FOR MEDICARE? HERE'S HOW YOU CAN PREPARE
This checklist helps take the guesswork out of preparing for your Medicare enrollment. By giving yourself plenty of time to prepare for Medicare enrollment, you can choose the coverage that's right for you and learn how to make the most of your benefits.
12 MONTHS BEFORE
YOUR 65TH BIRTHDAY
Learn what each part of Medicare covers: Part A (Hospital Insurance), Part B (Medical Insurance), Part D (Prescription Drugs), Part C (All-in-one Coverage), and Medical Supplement Insurance (Medigap).
9 MONTHS BEFORE
YOUR 65TH BIRTHDAY
Learn all costs associated with each part of Medicare. Determine whether you qualify for premium-free Part A. Many people do. If you enroll in Part B, you will pay a monthly premium regardless of your work history.
6-9 MONTHS BEFORE
YOUR 65TH BIRTHDAY
Determine when it makes sense for you to transition from your existing coverage to Medicare. If you're planning to work after your 65th birthday and delay enrolling in Medicare, set a target retirement date and time your enrollment around it.
4-6 MONTHS BEFORE
YOUR 65TH BIRTHDAY
Meet with a Medicare agent who can help you fine-tune your choices. Check that your doctors, hospitals and pharmacies accept Medicare or are part of the Medicare Advantage network you’re considering.
1-3 MONTHS BEFORE
YOUR 65TH BIRTHDAY
Your Initial Enrollment Period (IEP) is underway. Your IEP runs the three months before, the month of, and three months after your 65th birthday. You can enroll in Medicare during this period. Once you're enrolled in Medicare, decide whether to sign up for a Medicare Advantage plan, a Part D plan, or Medicare Supplement Insurance.