Talk with a licensed Insurance Agent at 941-567-6000 (TTY 711)

Talk with a licensed Medicare Advisor
941-567-6000 TTY 711

Medicare At-A-Glance

The Big Picture on Medicare

Original Medicare

(medicare.gov)i

Original Medicare includes Hospital (Parts A and B) insurance. A separate drug plan (Part D) is optional. You can also add Medicare Supplement Insurance (Medigap) to help pay your out-of-pocket costs.

Part A Hospitalization i

Medicare Part A is for everyone. In general, part A covers:

  • Inpatient care in a hospital
  • Skilled nursing facility care
  • Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)
  • Hospice care
  • Home health care

Coinsurance of 20% applies and coverage has limits for hospitalization longer than 60 days at a time. If your work history qualifies, there are no monthly payments for Part A.

Part B Outpatient i

Enrolling in Medicare Part B right away prevents penalty costs later, unless you’re covered by other medical insurance when you turn 65. Part B covers:

  • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
  • Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.

You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.

Medicare Supplement Plans (Medigap) i

(view Medicare Supplement comparison chart)

Medigap is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. It’s preferred by people who want predictable healthcare costs, no matter how much healthcare they need. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay most of the remaining healthcare costs – depending on the plan you select. These remaining costs can consist of:

  • Copayments
  • Coinsurance
  • Deductibles

Part C Medicare Advantage Plans i

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are an “all-in-one” alternative to Original Medicare. They are often preferred by people who want the lowest price on Parts A, B, and D, but may carry substantial out of pocket costs if you need healthcare. They are offered by private companies approved by Medicare. These “bundled” plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare drug coverage (Part D).

Part D (Prescriptions) i

Part D may be included in a Medicare Advantage Plan, but not in a Medicare Supplement plan or Original Medicare. All Medicare Part D plans must cover a wide range of prescription drugs that people with Medicare take, including most drugs in certain protected classes, like drugs to treat cancer or HIV/AIDS. A plan’s list of covered drugs is called a “formulary,” and each plan has its own formulary. Many plans place drugs into different levels, called “tiers,” on their formularies. Drugs in each tier have a different cost. For example, a drug in a lower tier will generally cost you less than a drug in a higher tier.

Extra Coverage i

…and more” Extra coverage included in many Medicare Advantage plans, but additional options in Medicare Supplement (Medigap) plans.

Dental

Hearing

Vision

Long Term Care

If you’re receiving Social Security benefits, you’re likely already enrolled in Original Medicare, but may still have gaps in your coverage. If you’re a new ActivAger (turning 65 soon and planning an active retirement) you may need specific coverage options that cover your active retirement lifestyle.

Use our MediClear helper to zero in on the type of Medicare plan that provides the best coverage for your individual situation

At any time during your Medicare enrollment journey, call us at 941-567-6000 TTY 711 to ask questions and learn more. By contacting the phone number listed, you can expect to be in contact with a licensed insurance agent.

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WE WILL NOT SHARE YOUR INFORMATION WITH ANYONE ELSE. By providing your information – such as name, phone number, and email address – you agree to allow an ActivAge licensed Insurance Agent to contact you about various health plans, services, and/or educational information related to health care.

Medicare has neither reviewed nor endorsed this information. Not connected with or endorsed by the United States government or the federal Medicare program. Our National Producer Number is: 18595829

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Medical Terms and Definitions

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  • Excess charge
    If you have Original Medicare, and the amount a doctor or other health care provider is legally permitted to charge is higher than the Medicare-approved amount, the difference is called the excess charge.
  • Extra Help
    A Medicare program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance.
  • Formulary
    A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Also called a drug list.
  • Grievance
    A complaint about the way your Medicare health plan or Medicare drug plan is giving care. For example, you may file a grievance if you have a problem calling the plan or if you're unhappy with the way a staff person at the plan has behaved towards you. However, if you have a complaint about a plan's refusal to cover a service, supply, or prescription, you file an appeal.
  • Group health plan
    In general, a health plan offered by an employer or employee organization that provides health coverage to employees and their families.
  • Guaranteed issue rights (also called "Medigap protections")
    Rights you have in certain situations when insurance companies are required by law to sell or offer you a Medigap policy. In these situations, an insurance company can't deny you a Medigap policy, or place conditions on a Medigap policy, like exclusions for pre-existing conditions, and can't charge you more for a Medigap policy because of a past or present health problem.
  • Guaranteed renewable policy
    An insurance policy that can't be terminated by the insurance company unless you make untrue statements to the insurance company, commit fraud, or don't pay your premiums. All Medigap policies issued since 1992 are guaranteed renewable.
  • Health care provider
    A person or organization that's licensed to give health care. Doctors, nurses, and hospitals are examples of health care providers.
  • Health Insurance Marketplace
    A service that helps people shop for and enroll in affordable health insurance. The federal government operates the Marketplace, available at HealthCare.gov, for most states. Some states run their own Marketplaces. The Health Insurance Marketplace (also known as the “Marketplace” or “exchange”) provides health plan shopping and enrollment services through websites, call centers, and in-person help.
  • Home health agency
    An organization that provides home health care.