Medicare Explained – What is Medicare?

Table of Contents
    Add a header to begin generating the table of contents
    Scroll to Top

    Medicare explained!  Medicare Made Clear! Medicare simplified! Understanding Medicare!  Medicare explained simply.  No matter how we word it, understanding Medicare is not always as easy as it looks.   It’s not just Medicare Part A and Medicare Part B (Original Medicare).  We can explain Medicare parts so you are confident with your Medicare choice.

    What Is Medicare?

    What is Medicare? Medicare is federal government sponsored health care coverage. It’s health care coverage for people 65 and older as well as those under 65 who have been on Social Security disability insurance income for at least 24 months. Some medical conditions can lead to receiving Medicare coverage before they receive disability benefits for 24-months like Lou Gehrig’s disease and end stage renal disease.  That is the simple Medicare explanation.

    There are three categories of Medicare enrollment periods. There is the initial enrollment, when you turn 65, annual enrollments and special enrollment periods. Annual enrollment periods are for Advantage Plans and Part D prescription drug plans. Supplemental insurance does not have an annual enrollment.

    Medicare Parts Explained

    In this Medicare Explained  article I am going help you learn about the parts of Medicare, explained in an easy-to-understand format.  By the end of this article, you will understand how Medicare works.  You will understand both Medicare Part A & Medicare Part B, known as your Original Medicare plans.  Of course, you will also understand the choices you must make once you sign up for Medicare.

    I have recently published a new way of looking at Medicare and the choices you must make.   The new article and video is titled; Medicare Explained – Secrets of Who and Why.  It covers new studies on the demographics behind the choices.  Who decides Medicare Advantage is better for them?  Who prefers supplements, and so on.  It compliments this article very well.

    Medicare is a federal government health care program for those 65 and older, or under age 65 and disabled. Once you sign up for Medicare Parts A and B you must choose from one of three options.  There is coverage you can purchase that either replaces the parts of Medicare or adds coverage (supplements) to your parts of Medicare. We will go over each of those three options.  You will understand the pros and cons of your medical insurance that you should consider before making a decision.

    After you grasp the basics of the federal health insurance program; Medicare Part A hospital insurance and Medicare Part B outpatient services, you will be faced with choosing one of three paths to take with your government insurance program.  We want you to fully understand your Medicare coverage choices.  This will be the most important Medicare decision you will make.   It could set you on a course that will impact the quality and cost of your medical care.  It is critical because it can potentially be irreversible.  There are many mistakes that can be made.  Please check of my Medicare Mistakes blog post for details.

    I mentioned earlier that you will have one of three choices to make. Two of those three health care choices render moot the deductibles, copays and coinsurance described in your Medicare & You Guidebook.

    Next in this Medicare Explained article is a description of the parts of Medicareincluding Medicare Part A & Medicare Part B.

    Don’t Lose Site of the Big Picture

    I mentioned earlier that you will have one of three choices to make. We will get those shortly.  Two of those three choices render moot the deductibles, copays and coinsurance described in your Medicare & You Guidebook.

    Next in this Medicare Explained article is a description of the parts of Medicare, including Medicare Part A & Medicare Part B.

    Medicare Parts Explained

    What is Medicare Part A and Medicare Part B?

    Once you complete your Medicare enrollment through the U.S. Government Social Security Office or online at, you will receive a red, white and blue Medicare card.  The Medicare Card displays Medicare beneficiaries name, Medicare Beneficiary Number (MBN) plus the start dates of Medicare Part A hospital coverage and Medicare Part B outpatient services. Another term for “start date” is “effective date”.

    No matter what choices you intend to make with your Medicare, it all starts with this red, white, and blue card indicating you qualify for Medicare Part A hospital insurance & Part B outpatient coverage.  These two parts of Medicare are also referred to as Original Medicare. Once you have your card, you can decide on your other Medicare options.

    Medicare drug coverage falls under Part D.  Part D is offered as either a stand-alone plan or bundled with an Advantage Plan.  You can have either, but not both. I should had that there is also a penalty for going without prescription drug coverage.

    If you wish to know how to sign up for Medicare and when, please see my detailed article and video linked here:  How to Sign Up for Medicare & When.

    However, I suggest that you start with this article so that you better understand your enrollment and the choices you will need to make.  Of course, you can also reach out to us.  As  one of this country’s  top rated and award winning Independent Medicare Broker’s we add a lot of value helping consumers understand their Medicare choices.

    Confusing Descriptors

    One of the most confusing and least thought-out aspects of Medicare is the fact that all its Parts and Plans are designated by a letter, rather that a descriptive title.  Even more, the letters are repeated between Medicare Plans and Parts.  In other words, there is a Medicare Plan A and a Part A.  There is a  Plan B and Part B. The same with letters C and D.  Each Plan, Part and letter refer to a different part of your healthcare.  Parts A and B are supplement plans administered by private insurance companies.

    In general, a “Part” refers to a section of Medicare.  A “plan XYZ” refers to a Medigap that works with Medicare.

    We will go over what you need to know here.  But many prefer to reach out to an licensed Medicare expert.  We are just a phone call away: 800-847-9680.

    What is Medicare Part A?

    Medicare Part A hospital insurance is inpatient medical insurance coverage. It’s that portion of your health insurance that helps pay for your healthcare whenever you are an inpatient in a medical facility and skilled nursing facilities.   Please note, a skilled nursing facility is not long-term care. You can be discharged from inpatient status to a skilled nursing facility after three nights in a hospital. It’s short-term (up to 100-days) health care for rehabilitation.

    As soon as you become an inpatient in a hospital, your benefits are paid under Part A hospital insurance.  Part A covers Inpatient services in a skilled nursing facility or hospice and your inpatient hospital care.  The one exception is that if you are not able to physically get to a medical facility for healthcare, Part A hospital insurance also pays for home healthcare.

    Part A is your inpatient insurance that covers hospital costs.  Part A also covers hospice care

    How Much Does Medicare Part A Cost?

    Most of us have pre-paid  Medicare Part A by paying a Medicare payroll taxes. You paid for Part A when you or your spouse paid Medicare taxes.   

    If you are widowed or divorced you may be eligible for Medicare based on your former spouse’s work history. 

    The tax rate is 1.45% deducted each pay period from your paycheck, plus another 1.45% paid by your employer, for a total of 2.90% of your gross pay.  It is slightly more for annual incomes over $200,000.

    As long as you or your spouse has paid Medicare taxes for at least 40 quarters (10-years) during your lifetime, your Part A is fully paid for.  Those who have not paid that tax can still have Medicare Part A, but at a premium.  

    You do not pay a monthly premium for Part A unless you or your spouse did has not paid Medicare taxes for at least 10-years.

    What is Medicare Part B?

    Medicare Part B is your outpatient services coverage. It is the part of Medicare that pays for outpatient and physician services as well as durable medical equipment and home healthcare. This is the part that covers doctor visits.

    Your outpatient coverage helps pay your Medicare bills for doctor visits, have lab tests or physical therapy, ambulance services and so on.  In fact, any Medicare service or procedure not covered as an inpatient under Part A will be covered under Part B.   Part B also includes some wellness coverage or preventive services. In Medicare, preventive services are referred to as Wellness Visits.

    As you may have guessed, most of our medical care is via outpatient services.  Even many surgeries and hospital services are now done as an outpatient and are thus covered under Part B.

    Some doctors have a specific contract with Medicare that allows them to charge more than the Medicare assigned amount.  This is called an “excess charge” and is covered in detail in our Part B Excess Charges blog post.

    How Much Does Medicare Part B Cost?

    Unlike Part A, Part B has a premium requirement.  Everyone must pay for their Part B insurance.   No matter what choices you make with your Medicare, unless you are still covered under group health insurance you must have Part B and you will pay for it.

    The only exceptions are those who qualify for financial aid via their state government. Their state may pay the Part B premium for them.

    Your Premium requirement depends on your income.  Everyone with Part B will pay at least the base rate. 

    Late every year, Medicare announces new premium rates for the year to come.  Premiums usually, but not always, increase.  Thankfully, there is a “Medicare Hold Harmless” provision that prevent people on Social Security from seeing their Medicare premiums increase at a rate higher than their increase in Social Security income.  I provide detail on the hold harmless provision in the article linked above.

    Income Adjustments – IRMAA

    There are two parts to the Medicare Part B Premium, the base rate and the income adjusted rate.  How much you pay depends on your reported modified adjusted gross income as of two years ago.  For 2024 if your modified adjusted gross income as reported on your 2022 tax return was $103,000 or less for individuals or $206,000 or less joint, your Part B premium will be the base rate.

    The base rate for Part B as of January 2024 is $174.70 each month.

    If your income was higher, you will pay more. The extra amount you pay is called an “Income Related Monthly Adjustment Amount” or IRMAA.   There are currently five brackets of income, each bearing an additional increase in your Part B and Part D premium.

    For 2024 the highest IRMAA bracket is for those whose income was $500.000 or more as an individual or $750,000 joint.  At the highest bracket, your Part B monthly premium will be $594.00.

    Moving Target

    Keep in mind that the IRMAA amount and table will change every year on a calendar year basis.  Medicare typically releases the rates for the upcoming year around Thanksgiving.

    We display the latest Medicare benefits and rates here:

    Medicare Part B

    Medicare Coverage

    The intent of the Medicare program is to cover any medical procedure or service that is medically necessary.  Medicare relies on your doctor to help define medical necessity.

    In my opinion, the two greatest benefits of Original Medicare within the Medicare program are that

    • It is valid health care insurance anywhere in the U.S. or its territories. You can see any doctor or visit any medical facility as long as they accept Original Medicare.  You are not limited by a network and never need to ask permission to see a medical provider.
    • Your medical decisions are between you and your doctor. Your medical provider does not have seek prior approval for a recommended procedure and no insurance company can deny your coverage.

    With original Medicare health care you have both freedom and control.  You have the freedom to go where you need and control to see who you choose.  No other medical insurance in the United States offers these benefits.

    Both Part A & B have copays, co-insurance and deductibles.  In addition, Part B has a 20% coinsurance.  That means you pay 20% of all Part B charges.

    You will find a sheet detailing the benefits of Part A and Part B here:

    What Choices Do I Have with Medicare?

    As I mentioned earlier, please do not lose sight of the forest for the trees.  Knowing all the copays and deductibles of Original Medicare is not necessary.  In fact, our comparison plan calculator helps you compare Medicare to employer coverage easily, just assuming a $10,000 medical bill.

    Rather than go through the details of each co-pay or deductible it may be best for you to understand your options. You have three options or three choices.  Two of those three choices render moot the co-pays and deductibles printed in the Medicare & You Guidebook and on our tables.

    Once you enroll in Medicare your next step is to do one of three things:

    Choice # 1 – Do nothing

    Your first option is to simply keep your Original Medicare and do nothing else. Just keep Original Medicare (Your Medicare Part A & B).  This is the only choice that makes understanding those co-pays and deductibles important.  This is not an advisable choice because Original Medicare was never intended to be stand-alone health insurance.

    With just Original Medicare there is no limit on your potential expenses.  You are at substantial, unlimited financial risk for out of pocket costs that can be detrimental to your retirement.

    Still, this is a choice some people make.

    If you are to go this route, please add a prescriptions drug plan aka Part D.  Without Part D any serious illness has the potential to bankrupt you from prescription costs alone.

    Medicare Explained - What Is Medicare

    Choice #2

    Medicare Advantage Plans

    Your second option is to trade in your Part A and Part B for a Medicare Advantage Plan.  Medicare Advantage plans are also called Part C.

    What is Medicare Part C?

    Part C is more commonly referred to as Medicare Advantage Plans.  Many medical professionals also refer to them as Medicare Replacement Plans.

    Medicare Advantage Plans are private insurance that replaces both Medicare Part A & Part B with a privatized, for profit “actuarial equivalent” designed and managed by an insurance company. Some Medicare Advantage Plans will have a zero dollar premium.  With some, you will pay monthly premiums for the plan.  Either is in addition to your Medicare Part B monthly premium. 

    What does Actuarially Equivalent mean?   It means that of all the people on that specific plan; half the people will pay less for healthcare than those that just have Medicare A & B and half will pay more.  Your experience will be different than the next person. Whether you will pay more or less than average will depend on your healthcare needs.

    Please understand, Medicare Advantage Plans are not a Medicare supplement.  Medicare Advantage Plans do not supplement Original Medicare.  It is medical insurance that replaces your Original Medicare.

    With a Medicare Advantage Plan, you give up the Medicare you earned for a Medicare equivalent run by a private insurance company.  Keep in mind, you still must pay your Part B monthly premium and any IRMAA charges.

    Part C Replaces Original Medicare

    If you decide to get a Medicare Part C Advantage Plan, you throw out the door all the copays and deductibles for Part A & B that are in the guidebook and replace them with the copays and deductibles printed in your Medicare Advantage Plan Booklet.

    I have several videos on Medicare Advantage plans. But here, briefly, are some pros and cons.

    Most people know Medicare Advantage Plans as the HMOs (Health Maintenance Organizations) or PPOs (Preferred Provider Organizations). Most Medicare Advantage Plans are either an HMO or a PPO. There are other types of Medicare Advantage Plans but those are seldom used and goes beyond the scope of this video. All are considered Part C / Medicare Advantage Plans.

    Medicare Advantage Benefits

    Medicare Advantage plans are not enhanced Medicare coverage.  By design and regulation, Medicare Advantage plans offer health coverage that is Actuarially Equivalent to the benefits you receive from Part A & B.

    Many Medicare Advantage Plans will bundle a prescriptions drug plan with your medical coverage.  These are referred to as Medicare Advantage Prescription Drug Plans (MAPD).

    You cannot purchase a separate stand-alone Part D Plan if you have a Medicare Advantage HMO or PPO Plan, even if the plan does not include prescription coverage.


    With a Medicare Advantage plan, you have a select network of doctors or hospitals you available to you.  You must stay within that network in some plans, like HMOs.  With an HMO you have no insurance outside of your network, other than emergency. This means the private insurance company controls your Medicare coverage.

    With PPOs, you have insurance outside of your Network but it cost you more and your maximum out-of-pocket limit is much higher.  A PPO  allows you to ask a medical provider who is not in-network if they will accept your insurance.  However, they can and usually do say no.

    Many insurance agents who are inexperienced with Medicare  believe that a person with a Medicare Advantage PPO has the same right to see any doctor as you have with Original Medicare.  They believe this because the wording provided to them describes the benefit of a PPO as “You can see any doctor and pay the higher out-of-network rates.”    This is tricky wording.  Yes, you can see any medical provider.  But only with their permission and acceptance of your insurance terms and rates.  The medical provider is under no obligation to accept your insurance.  If they wanted to work with your insurance company they would have contracted with them.

    Medicare Part C Replaces Original Medicare

    The most important feature to understand is that with Medicare Part C you lose the two greatest benefits of Original Medicare as described above.  You are limited to a network of medical providers and no longer have freedom of choice with your doctors.  In addition, medical procedures will need preapproval from the insurance company, and they can deny services recommended by your doctor.

    I have several vides and articles detailing this issue.  See my Medicare Advantage Plans Explained video.

    Medicare Advantage Plans – Are They Free?

    On the Positive side, some of these Medicare HMOs and PPOs have no premium in some parts of the country. They are often sold as no-premium Medicare, especially in the southern half of the country.

    These plans are not free.    You will pay the same premium as you do with Original Medicare Parts A & B.  No less.  But you could pay an additional premium as well. In some states Medicare Advantage plans have an additional monthly premium even though they have more limited care.  Plus, there may be a separate premium and deductible for your bundled Part D plan that comes with your MAPD.

    Even more, the copays, coinsurance and deductibles you pay with Part C plans can be more than you would pay with Original Medicare.

    High Maximum Out-of-Pockets With Part C

    Fortunately, Medicare Part C plans will at least put a cap on your maximum annual out-of-pocket expense.  It limits your financial risk. Unlike having just Original Medicare where there is no cap on financial exposure, Part C plans have a maximum annual out-of-pocket you will pay during any calendar year.  The maximum out-of-pocket only applies to approved Medicare services.  To find the maximum out-of-pocket for any plan, you must check the Summary of Benefits for the plan you are considering. The maximum out of pocket levels allowed by Medicare are just over $7,000 annually for in-network services and just over $11,000 annually if you have approved out-of-network services.

    In addition, “approved” Medicare services is defined by the insurance company.  If you receive medical care not approved by the insurance company, you pay for that care out-of-pocket, and it does not apply to your maximum out-of-pocket.

    See my video on Maximum Out-of-Pocket limits for Medicare here:

    Medicare Part C is Local Coverage

    It is important to understand that Part C Plans are local coverage.  If you are a snowbird, an RVer or just like to travel the country, traveling should rule MAPD as an option.

    Medicare Part C is a Moving Target

    Lastly, Advantage plan benefits and costs change every year.  The doctors and hospitals can change.  The co-pays, coinsurance and deductibles can change.  Any feature of the plan can change.  As a result, you must re-shop your plan benefits and network every year to see if you want to keep the plan for the coming year, or change.  You must do this shopping during the Annual Election Period (AEP) from October 15 – December 07. There is no medical underwriting when changing plans.

    Medicare Cataract Exam

    Choice # 3

    Add a Medicare Supplement Plan

    So, your first choice is to do nothing, just keep your Original Medicare and add prescription drug coverage.  Your second choice is to trade in your Original Medicare for a privatized version called an Advantage plan and hope it’s a good experience.

    Your third choice is to keep your Original Medicare Parts A & B and add a Medicare supplement plan that pays the co-pays and deductibles of Original Medicare, so you don’t have to. Both the Advantage Plan and Supplement limit your out of pocket costs. Most Medicare supplement plans limit your maximum out-of-pocket costs to just a few hundred dollars per year.

    You don’t have to worry about learning all the copays and deductibles in Medicare when you have a supplement plan, because the supplement plan will pay them for you.

    Medicare Supplement Insurance

    Medicare supplement plans are insurance plans that pay the deductibles, coinsurance and copays of Original Medicare government health insurance program.  It is insurance in addition to Original Medicare. Original Medicare is your primary insurance with the supplement as secondary.  Medicare dictates to the supplement what to pay and by when to pay it.  The Medicare supplement insurance company has no say in your coverage.  If Medicare covers a service or procedure, your supplement will pay the deductible and coinsurance per its contract. That is completely different than with an Advantage plan.

    Both Advantage Plans and Supplements are operated by private insurers. But with the supplement plan private insurers have no say in your health care services.

    In my opinion, the most important feature of a Medicare supplement is that you get to keep the two best features of Original Medicare.  You can see any medical provider or go to any medical facility that accepts Original Medical. Plus, your healthcare is still between you and your doctor.  Plus, no insurance company can deny coverage or require pre-approval.

    Star Rankings

    There are no star rankings with a Medicare supplement, because there is no need for star rankings.  The supplement pays what Medicare tells them to pay.  Your experience in healthcare benefits and claims should be the exact same regardless of which insurance company you use for your Medicare supplement.

    Medicare supplement plan benefits are also standardized by the U.S. Government.  In fact, the benefits of each supplement plan are written into Social Security law.  Once you have a Medicare supplement plan, the benefits will never change.

    Medigap Plans

    Medicare supplement plans are also called Medigap Plans.  Medigap and Medicare supplement are the same thing.  We have found that Medicare publications typically use the term Medigap (because it fills in the gaps of Original Medicare) where insurance companies and agents often use the term Medicare supplement.

    The different Medigap plans are known by letter.  For example, there is a Medigap Plan F, a Plan G and Plan N and so forth.  Eleven in all.

    Yes, this includes a Medigap Plan A, Plan B, Plan C and Plan D just so we can all confuse them with the parts of Medicare.   Just remember, “Plans” are supplement plans.  “Parts” are part of Medicare.

    Every Medigap Plan G is identical in the benefits it offers.  Every Medigap Plan N is identical in the benefits it offers and so forth.

    The only difference from one insurance company to the other is the price of the plan.  It’s what you will pay in premiums today and what you will pay in the future.

    You can  learn more about Medicare Supplement Plan G by clicking here for other posts I wrote: Medicare Supplement Plan G or about Medicare supplement Plan N .   The most popular article I wrote on Medicare supplemental plans is one that walk you through how to choose between Plan G and Plan N.

    Monthly Premiums

    All Medicare supplement plans have a premium.   However, the premium rates vary widely by insurance company.  Rates are usually based on your region, age and gender.  Our role at Medigap Seminars Insurance Agency is to advise customers on the insurance company or companies that we expect to offer the lowest lifetime cost for their Medicare supplement. That is how we can save you money.

    With a Medicare supplement plan you improve your Medicare coverage, and you can still see any doctor, go to any medical facility in the entire country as long as they accept Medicare.

    Which Medigap Plan Does My Doctor Accept?

    A doctor or hospital does not need to accept insurance from the individual insurance company that provides your supplement. As long as the medical provider accepts Original Medicare (your red, white, and blue card), they will accept any Medicare supplement plan form any insurance company.

    The doctor only bills Medicare.  Medicare pays its’ portion and then instructs the Medicare supplement company to pay its portion.  It’s that simple.

    If your medical provider accepts Original Medicare, they will accept any Medicare supplement from any insurance company.

    A doctor or hospital does not need to accept insurance from the individual insurance company that provides your supplement. As long as the medical provider accepts Original Medicare (your red, white, and blue card), they will accept any Medicare supplement plan form any insurance company.

    How Much Does a Medicare Supplement

    Plan G Cost?

    Medicare Supplement plans have their own cost that depends on where you live, your age, gender, if you use tobacco products on so on.  In additions, some states have Medicare Override regulations or pricing structure regulations that impact your price.

    Even more, prices of the same plan but by different insurance companies can vary by 300% or more.

    In some states a Medicare supplement Plan G for a person turning 65 can be less than $100 / month.   In other states I have seen the same plan being offered for over $300 / month.

    Still, most people find that the cost of Medicare plus a supplement to be substantially less than the cost of employer or individual insurance when under 65.  If the cost of a Medicare supplement can fit into your budget, Medicare supplement plans offer the best health insurance coverage in the country.

    If you would like to know what your costs for a Medicare supplement will be, please complete a free quote request form linked here and at the end of this article.

    Can I Change a Medicare Supplement Plan?

    This is important!  You are only guaranteed to get the Medicare Plan of your choice when you are new to Medicare and within 6-months of starting your Part B.

    The first six-months after you started your Part B is called your Medicare supplement initial enrollment period.  Outside of that time period, in most states, you must qualify medically to get a new Medicare supplement plan.  If your health history includes serious events like cancer, heart attack, stroke, complications from diabetes, implanted medical devices and so on, you may not be able to change Medicare supplement plans or insurance companies.

    There are some states that have insurance laws that override Medicare to the benefit of the consumer, providing special enrollment periods.  Please contact us to see if your states has one of the these special rules.

    Of course, there are many people who move after retirement.  When you change where you live it is a great opportunity to shop for a new plan.  You will not always have the ability to save money.  For example, people moving to Florida often find their current plan to be better priced.  But it never hurts to shop.  We do it for you without cost or obligation. 

    Can I Change from a Medicare Advantage Plan To a Medicare Supplement?

    Can a person change from an Advantage Plan to a Medicare Supplement?   The short answer is “It depends.”

    In general, in most states you have six months from the start date (aka effective date) of Part B to apply for a Medicare supplement without medical underwriting.  The ability to apply without medical underwriting means you can get a Medicare supplement plan without regard to your health history and no insurance company can deny your application.  This six-month window is the National Medicare Rule.

    Because a consumer cannot have a Medicare supplement and a Part C Plan at the same time, the first step in switching to a supplement from Part C is to move back to Original Medicare.

    When Can I Move Back to Original Medicare

    In general, there are two annual periods when a person can move from a Medicare Advantage back to Original Medicare.  The first is the Annual election Period (AEP).  AEP is from October 15 through December 07 each year.  During AEP a person can request from Medicare that their Advantage Plan not renew for the coming year.  With this request, Medicare will transition the consumer back to Original Medicare as of January 01.   If you also desire a Medicare supplement, it would be wise to apply for the supplement plan first and only request your Advantage Plan not renew after you have received approval or acceptance from the supplement company.

    The second period for moving back to Original Medicare is the annual Open Enrollment Period (OEP).  This is from January 01 through March 31 of each year.  When an Advantage Plan is canceled during this period, the transition to Original Medicare takes effect as of the first day of the next calendar month.

    A Word of Caution

    I will add that every year we received many dozens of phone calls from people who wish to move from an Advantage Plan to a Medicare supplement but cannot do so due to their health.  These people are often in their 70s or 80s and are having or recently had meaningful health issues and experienced the limitations of a Medicare Advantage plan.

    We strongly encourage everyone new to Medicare to get today the health insurance they will want to have when they are sick or injured.

    Some of the exceptions and important rules to keep in mind are as follows:

    • Many insurance companies interpret the six-month Medicare Supplement Initial Enrollment Period to be 180 calendar days, not six calendar months. The interpretation is up to the insurance company.
    • Once you have an Advantage Plan you may only change to a Medicare supplement plan during two time-periods: AEP from October 15 through December 07 for a January 01 start date. Or OEP from January 01 through March 31.
    • If you lose your Medicare Advantage Plan coverage involuntarily, you will have a Guarantee Issue period where you can choose from a Medicare supplement Plan F or Plan C or a choose between Medicare supplement Plan G or Plan D. If you choose any other plan, you will be required to qualify through medical underwriting.
    • Some states have special rules where you never have to qualify medically for a Medigap Plan. The two most popular states with tis rule are New York and Connecticut.
    • Moving out of your Advantage Plan service area will trigger a Guarantee Issue Right.

    You can view other circumstances that trigger a Guarantee Issue right on the Medicare website:

    Cost of Cancer Treatment

    One subject this does not discuss is the increasing cost of cancer treatment.   No matter what choice you make with your Medicare, the cost of treating cancer is likely to be very expensive.  This linked article explains why and what you can do about it.  Medicare and the Cost of Cancer Treatment


    We have covered your three choices from which you must choose when you start Medicare, hopefully I have made understanding Medicare easy for you.

    Those choices are;

    • You can just keep Medicare Part A and Medicare B. Pay whatever deductibles and copays due out-of-pocket. You will have healthcare coverage with this choice, but unlimited financial exposure to medical bills.
    • You can trade in your Medicare Part A and Medicare B for a Medicare Advantage Plan (also known as Medicare Part C). There are advantages and disadvantages to this decision which must be weighed very carefully before making that decision.
    • Third, you can enhance your coverage with a Medicare supplement. You should consider the cost of the supplement and the fact that premiums will rise over time.  You may also live in a state with specific laws that improve the Medicare supplement choice.

    I have a several videos comparing the different Medicare supplement plans. They will be linked below and at the end of this video.  You can find more by clicking here: #MedigapSeminars

    Medicare Part D Prescription Drug Plan

    Lastly, why have we not talked about Medicare Part D prescription drug coverage plans in this article? Certainly, prescription drug coverage is an important part of your medical insurance. 

    Medicare Part D prescription drug coverage is regulated by the federal government, but not standardized.  Part D is your primary outpatient prescription drugs coverage, helping to reduce your prescription drug costs. Medicare Part D prescription drug plans do not offer the same insurance.   This is the part of Medicare that also covers most vaccines

    Medicare Part B offers coverage for some outpatient prescription drugs.  See our article on Medicare Part B drugs for details.  

    Rather than drag this article on too long, I strongly suggest you view my Video titled Medicare Part D Explained and find out why I strongly suggest that you never take a recommendation for a specific Part D prescription drug plan from an insurance agent or broker.

    I also have a video that takes you step by step on how to shop for your own Medicare Part D prescription drug plan using the site I have created to make shopping enrolling in Part B a breeze:

    Part D Shopper will show you the companies I recommend that offer prescription drug coverage.  The right plan can help you manage your prescription drug costs.

    The first step with Part D is How to Sign Up for Part D.   Once you have a clear understanding of these steps, I suggest visiting my website.  My Part D Shopper website has everything you need to know to both shop for drug coverage and enroll in the right Part D Plan for your needs and budget.

    Medicare is health insurance for U.S. citizens and legal U.S. residents who are at least 65-years of age or who are under 65, disabled and have received Social Security disability income for at least 24-months.  There are some exceptions to the under 65 and disabled category to include those with ALS or End-Stage Renal Disease who have not yet received disability income.

    Recapping what we have covered so far.  We know that Medicare Part A is inpatient health insurance.  If you are an inpatient in a hospital, nursing facility, hospice or at home for home healthcare; that all falls under your Part A insurance.

    Medicare Part B is outpatient and physician services, which includes wellness care, lab work, medical equipment and therapy.

    Together, Medicare Part A and Medicare Part B are called Original Medicare.

    That is an important term you will hear often.  Medicare Part A and Medicare Part B together are called Original Medicare.

    They are the pillars, the foundation of Medicare.

    The subject of how and when to apply for Medicare is lengthy and deserving of its own article and video.  You can read about how to sign up for Medicare or watch the accompanying video here:

    Medicare Explained - What Is Medicare?
    Article Name
    Medicare Explained - What Is Medicare?
    In this Medicare Explained article I am going help you learn about Medicare, explained in an easy-to-understand format. Of course, you will also understand the choices you must make once you sign up for Medicare. Medicare explained simply so you are fully informed.
    Publisher Name
    Medigap Seminars
    Publisher Logo

    Matthew Claassen, CMT and CEO of Medigap Seminars Insurance Agency. Medigap Seminars is an award winning premier national Medicare Insurance Brokerage, ranked among the top in the U.S.A. Matthew is considered a leading national expert on Medicare and Social Security. Mr. Claassen is a distinguished member of the Forbes Business council, an invitation only organization of business leaders and entrepreneurs. He and his team have received awards from many of the countries largest insurance companies including Mutual of Omaha, Aetna, Humana, Cigna, United American, United Healthcare and others. His videos have become the most popular Medicare educational videos on YouTube with millions of views. As a financial analyst Matthew lead a team of researchers to win the 2009 Best Equity Research & Strategy Award from The Technical analysis magazine.


    Talk to an Expert

    Contact Us

    MM slash DD slash YYYY
    This field is for validation purposes and should be left unchanged.

    Join our Free 6-Day Medicare Mini Course

    We’ll send you 6 email lessons with short videos that explain all the basics you need to know about Medicare. Plus BONUS New-to Medicare Checklist and Cost Worksheet to help you estimate your costs for Medicare.