Understanding Medicare: Your Complete Guide

Medicare is the federal health insurance program for people 65 and older. This guide explains your options in plain language.

Medicare Disclaimer: We do not offer every plan available in your area. You can always contact 1-800-MEDICARE (1-800-633-4227) or visit medicare.gov for a complete list of available plans.

The Four Parts of Medicare

Medicare is divided into four parts, each covering different types of healthcare services.

Part A

Hospital Insurance

Inpatient hospital stays
Skilled nursing facility care
Hospice care
Some home health care

Part B

Medical Insurance

Doctor visits & outpatient care
Preventive services
Durable medical equipment
Mental health services

Part C

Medicare Advantage

Combines Parts A & B
Usually includes Part D
Extra benefits (dental, vision)
Offered by private insurers

Part D

Prescription Drugs

Prescription drug coverage
Offered by private insurers
Formulary varies by plan
Late enrollment penalty applies

Key Decision

Medicare Advantage vs. Medicare Supplement

Medicare Advantage (Part C)

Often $0 or low monthly premium
Includes dental, vision & hearing
Usually includes Part D drug coverage
Network-based (HMO or PPO)
Out-of-pocket maximum protects you
May require referrals for specialists

Best for: Healthy individuals who want extra benefits at a low premium cost.

Medicare Supplement (Medigap)

Covers Medicare cost-sharing gaps
Use any Medicare-accepting provider
No network restrictions nationwide
Predictable out-of-pocket costs
Requires separate Part D plan
Higher monthly premium

Best for: Those who travel, have chronic conditions, or want maximum provider flexibility.

Important Dates

Medicare Enrollment Periods

Initial Enrollment Period (IEP)

7-month window around your 65th birthday. 3 months before, birthday month, and 3 months after.

Annual Enrollment Period (AEP)

October 15 - December 7 each year. Switch plans or change coverage. Changes take effect January 1.

Special Enrollment Period (SEP)

Triggered by qualifying life events such as losing employer coverage or moving out of a plan's service area.

Medicare Advantage OEP

January 1 - March 31. Switch MA plans or return to Original Medicare.

General Enrollment Period (GEP)

January 1 - March 31 for those who missed their IEP. Coverage begins July 1. Late penalties may apply.

Medigap Open Enrollment

6-month period starting when you're 65+ and enrolled in Part B. Guaranteed issue rights apply.

Medicare FAQs

When can I first enroll in Medicare?

What is the difference between Medicare Advantage and Original Medicare?

Do I need a Medicare Supplement (Medigap) plan?

What is the Medicare Part D Late Enrollment Penalty?

Can I change my Medicare plan every year?

Medicare Marketing Compliance Notice

The information on this page is provided for educational purposes only and complies with CMS Medicare Marketing Guidelines (Chapter 3). IM65 is not affiliated with or endorsed by the U.S. government or the federal Medicare program. Medicare has neither reviewed nor endorsed the information on this page. For complete plan information, contact 1-800-MEDICARE (1-800-633-4227) or visit medicare.gov.

Ready to Compare Your Options?

An IM65 Approved Advisor can walk you through every option available in your area at no cost to you.