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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  • Medicare SELECT
    A type of Medigap policy that may require you to use hospitals and, in some cases, doctors within its network to be eligible for full benefits.
  • Medicare Special Needs Plan (SNP)
    A special type of Medicare Advantage Plan (Part C) that provides more focused and specialized health care for specific groups of people, like those who have both Medicare and Medicaid, who live in a nursing home, or have certain chronic medical conditions.
  • Medicare Summary Notice (MSN)
    A notice you get after the doctor, other health care provider, or supplier files a claim for Part A or Part B services in Original Medicare. It explains what the doctor, other health care provider, or supplier billed for, the Medicare-approved amount, how much Medicare paid, and what you must pay.
  • Medigap Open Enrollment Period
    A one-time only, 6-month period when federal law allows you to buy any Medigap policy you want that's sold in your state. It starts in the first month that you're covered under Part B and you're age 65 or older. During this period, you can't be denied a Medigap policy or charged more due to past or present health problems. Some states may have additional open enrollment rights under state law.
  • Medigap policy
    Medicare Supplement Insurance sold by private insurance companies to fill "gaps" in Original Medicare coverage.
  • Multi-employer plan
    In general, a group health plan that's sponsored jointly by 2 or more employers.
  • Original Medicare
    Original Medicare is a fee-for-service health plan that has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). After you pay a deductible, Medicare pays its share of the Medicare-approved amount, and you pay your share (coinsurance and deductibles).
  • out-of-pocket costs
    Health or prescription drug costs that you must pay on your own because they aren’t covered by Medicare or other insurance.
  • Pap test
    A test to check for cancer of the cervix, the opening to a woman's uterus. It's done by removing cells from the cervix. The cells are then prepared so they can be seen under a microscope.
  • Pelvic exam
    An exam to check if internal female organs are normal by feeling their shape and size.