Medicare is a federal health insurance program primarily available to people age 65 and older, as well as certain younger individuals with disabilities or qualifying medical conditions.

Medicare is divided into several parts:

• Part A (Hospital Insurance)
• Part B (Medical Insurance)
• Part C (Medicare Advantage)
• Part D (Prescription Drug Coverage)

Original Medicare consists of Part A and Part B and is administered directly by the federal government.

Medicare Advantage plans are offered by private insurance companies approved by Medicare. These plans provide all Part A and Part B benefits and often include additional benefits such as:

• Prescription drug coverage
• Dental coverage
• Vision coverage
• Hearing benefits
• Fitness programs

Most people do not pay a premium for Medicare Part A if they have sufficient work history.

However, beneficiaries typically pay:

• Part B monthly premiums
• Deductibles
• Copayments
• Coinsurance

Costs vary based on income and coverage selections.

A Medicare Advantage plan is an alternative way to receive Medicare benefits through a private insurance company contracted with Medicare.

Plans must provide at least the same level of coverage as Original Medicare and may offer additional benefits.

It depends on the plan’s provider network.

Many plans use:

• HMO networks
• PPO networks

Before enrolling, it’s important to verify whether your preferred doctors and specialists participate in the plan’s network.

You can use our provider search tools or contact a licensed agent for assistance verifying provider participation.

Provider networks may change throughout the year.

Many Medicare Advantage plans include Part D prescription drug coverage.

Coverage varies by plan, formulary, pharmacy network, and medication.

Part D helps cover the cost of prescription medications.

Plans are offered through private insurance companies approved by Medicare.

Coverage depends on:

• The specific drug
• Dosage
• Formulary placement
• Pharmacy used

You can use our prescription drug search tools to review available options.

Coverage depends on:

• The specific drug
• Dosage
• Formulary placement
• Pharmacy used

You can use our prescription drug search tools to review available options.

A formulary is a list of drugs covered by a prescription drug plan.

Each drug is assigned a tier that influences cost-sharing.

Yes.

Insurance companies may update:

• Formularies
• Pharmacy networks
• Drug tiers
• Cost-sharing requirements

Annual review is recommended.

Most people become eligible at age 65.

Your Initial Enrollment Period generally begins three months before your 65th birthday month and ends three months after.

The Annual Enrollment Period (AEP) runs from October 15 through December 7 each year.

During AEP, eligible beneficiaries can:

• Switch Medicare Advantage plans
• Join a Medicare Advantage plan
• Return to Original Medicare
• Change Part D plans

The Medicare Advantage Open Enrollment Period runs from January 1 through March 31.

During this period, individuals already enrolled in a Medicare Advantage plan may make certain plan changes.

Yes.

Many Medicare plans offer online enrollment options.

Availability depends on the carrier and plan.

The insurance company reviews the application and determines eligibility.

Applicants typically receive:

• Confirmation notices
• Enrollment materials
• Member ID cards

Processing times vary by carrier.

Medicare Advantage plans include an annual maximum out-of-pocket limit for covered Part A and Part B services.

Once this limit is reached, the plan pays covered costs for the remainder of the year.

A $0 premium plan means there is no additional monthly plan premium beyond any required Medicare Part B premium.

Members may still pay copayments, coinsurance, and other costs.

In most cases, yes.

Enrollment in a Medicare Advantage plan generally does not eliminate the Medicare Part B premium.

Medicare Supplement insurance helps pay certain out-of-pocket costs associated with Original Medicare.

These plans work alongside Original Medicare and are different from Medicare Advantage plans.

No.

You generally cannot use a Medicare Supplement policy and a Medicare Advantage plan at the same time.

Some Medicare Advantage plans include dental benefits.

Coverage levels vary by plan.

Many Medicare Advantage plans include vision benefits such as eye exams and eyewear allowances.

Many plans provide hearing exams and hearing aid allowances.

Benefits vary by carrier and plan.

SilverSneakers is a fitness program offered through certain Medicare plans that provides access to participating fitness centers and wellness resources.

Use your ZIP code to view Medicare plans available in your county and service area.

Yes.

Our comparison tools allow you to review plan benefits, costs, provider networks, and prescription drug coverage.