Find the Right
Medicare Plan
for You

Choosing the right Medicare plan starts with understanding your priorities: your doctors, your medications, and your budget. First, decide between Original Medicare (Parts A & B) and Medicare Advantage (Part C). Original Medicare offers the broadest doctor access nationwide, while Medicare Advantage often bundles extra benefits like dental, vision, and hearing at a lower premium.

Next, consider whether you need a Medigap (Supplement) plan to cover out-of-pocket costs, and whether you need a standalone Part D plan for prescriptions. Make a list of your current doctors and medications, then use a plan comparison tool to find coverage that includes them.

Medicare Advantage (Part C) replaces Original Medicare entirely. It is sold by private insurers and typically bundles hospital, medical, and drug coverage into one plan — often with a $0 monthly premium. However, you must use a provider network, and out-of-pocket costs can add up if you need a lot of care.

Medigap (Medicare Supplement) works alongside Original Medicare. It does NOT replace it. Medigap pays the “gaps” — copays, deductibles, and coinsurance — that Original Medicare leaves behind. You can see any doctor nationwide who accepts Medicare, but you will typically pay a monthly Medigap premium.

Your Initial Enrollment Period (IEP) is a 7-month window: 3 months before your 65th birthday month, the month you turn 65, and 3 months after. The Annual Enrollment Period (AEP) runs October 15 – December 7 each year and lets you change Medicare Advantage or Part D plans.

Part A (hospital) is free for most people. Part B (medical) has a standard premium of $185/month in 2026. Many Medicare Advantage plans have a $0 additional premium. Medigap typically costs $80–$300/month. A Part D drug plan typically costs $10–$60/month.

Original Medicare does not cover most outpatient prescriptions. You need either a Part D standalone drug plan or a Medicare Advantage plan with drug coverage (MAPD). Starting in 2025, the maximum out-of-pocket for Part D drugs is capped at $2,000/year.

Medicare eligibility is primarily based on age and work history, not medical conditions. You qualify at age 65 if you or your spouse worked and paid Medicare taxes for at least 10 years. Younger people qualify with SSDI for 24 months, End-Stage Renal Disease, or ALS.

Using a licensed Medicare broker is free to you — brokers are paid by insurance companies, not beneficiaries. Plans cost the same whether you use a broker or enroll directly. A broker shops multiple carriers at once.Speak with a free licensed agent →

There is no single “best” company — the right carrier depends on your location, doctors, medications, and budget. The largest MA carriers include UnitedHealthcare, Humana, Aetna, Anthem/BCBS, and Cigna. Compare all available plans in your ZIP code side by side.

Switch during the Annual Enrollment Period (AEP): October 15 – December 7 each year. The Medicare Advantage OEP runs January 1 – March 31 for one additional switch.

(1) Are my doctors in-network? (2) Are my medications covered — check the formulary. (3) What are my total out-of-pocket costs including deductible, copays, coinsurance, and annual maximum?

Medicare Advantage suits you if you want bundled coverage at a low premium and your preferred doctors are in-network. Original Medicare + Medigap is better for complex health needs, frequent travel, or wanting any doctor nationwide.

Missing your IEP can result in permanent late-enrollment penalties. Part B: 10% added to your premium for every 12-month gap — paid for life. Part D: 1% of the national base premium for every month without creditable coverage.

Look at the plan’s Summary of Benefits for: deductible, copays, coinsurance, and annual out-of-pocket maximum. Part A: $1,676 hospital deductible per benefit period (2026). Part B: $257 annual deductible then 20% with no cap — which is why many add Medigap.

It depends on the plan. HMO plans require in-network doctors only; PPO plans allow out-of-network at higher cost. Always verify your doctors are in-network before enrolling.

Medigap plans are standardized by letters (A, B, C, D, F, G, K, L, M, N). Most popular: Plan G (covers almost everything except the Part B deductible) and Plan N (lower premium with small copays). Medigap does NOT cover dental, vision, hearing, or drugs.

Original Medicare does NOT cover routine dental, vision, or hearing. Medicare Advantage plans frequently include these benefits — ranging from basic cleanings and eye exams to dentures, glasses, and hearing aids.

Yes — Part B covers preventive services at no cost to you: Annual Wellness Visit, flu/pneumonia vaccines, mammograms, Pap tests, colorectal cancer screenings, bone density, cardiovascular/diabetes screenings, and depression screenings.

The three months before your 65th birthday month are the ideal time to enroll — coverage begins on the first of your birthday month with no gap. Aim to complete Social Security enrollment at least 3 months before you turn 65.

Five appeal levels: (1) Redetermination within 120 days; (2) Reconsideration by an independent entity; (3) OMHA administrative law judge; (4) Medicare Appeals Council; (5) Federal Court. Act quickly — deadlines are strict.

Yes — Part A covers inpatient hospital stays. $1,676 deductible per benefit period (2026); $0/day for days 1–60; $419/day for days 61–90. Note: “observation status” vs. “inpatient” status makes a significant difference for coverage.

Part A covers: inpatient hospital care; skilled nursing facility care after a qualifying 3-day hospital stay; hospice care; and limited home health care. It does NOT cover long-term custodial care or private-duty nursing.

Part B covers: doctor visits; outpatient care; preventive services; lab tests, X-rays, durable medical equipment; mental health; outpatient surgery. After the $257 deductible you typically pay 20% with no cap unless you have Medigap.

Enter your exact medications in our free comparison tool or at Medicare.gov’s Plan Finder. The tool shows which plans cover your drugs and at what cost tier.Find drug-friendly plans →

Part B: $185/month standard. Medicare Advantage: many plans $0 additional premium. Part D: avg $35–$45/month. Medigap Plan G: avg $100–$200/month depending on age, gender, tobacco, and state.

Yes — during the AEP (Oct 15 – Dec 7) or the MA OEP (Jan 1 – Mar 31). The challenge is adding Medigap afterward may require medical underwriting outside of a guaranteed-issue period.

Original Medicare generally does NOT cover care outside the U.S. Medigap Plans C, D, F, G, M, and N include foreign travel emergency coverage (80% after $250 deductible, up to $50,000 lifetime).

Medicare Savings Programs (MSPs) can pay your Part B premium and cost-sharing. Extra Help reduces Part D drug costs. Income limits ~$22,590/year (individual) or $30,660 (couple) in 2026. Apply at ssa.gov or your state Medicaid office.

Medicare is federal insurance for age 65+ (or disabled). Medicaid is a joint federal-state program for low-income people of any age. People eligible for both are “dual-eligible” and may use Special Needs Plans (D-SNPs).

Extra Help income limits ~$22,590 (individual) / $30,660 (couple) in 2026. QMB covers people with income up to 100% federal poverty level. Reapply each year — thresholds change.

All legitimate Medicare plans are listed on Medicare.gov. Medicare will never call you unsolicited to sell a plan. Report suspected fraud to 1-800-MEDICARE.

If you already receive Social Security, you will be automatically enrolled in Parts A and B. If not, you must actively enroll at SocialSecurity.gov. Once you have your Medicare number, compare plans — our agents can help you prepare before your birthday month.

Yes. If your employer has 20+ employees, employer plan pays first. If fewer than 20, Medicare pays first. Veterans may use VA benefits and Medicare together. Coordinate carefully to avoid claim denials.

Visit SocialSecurity.gov/medicare (takes ~30 minutes) or call 1-800-772-1213 Mon–Fri 8am–7pm. Enrollment for Part C and D is done with the insurer or through a broker.Enroll in a plan online →

Plan availability varies significantly by ZIP code. Urban areas have many more Advantage options than rural areas. Enter your ZIP in our free comparison tool to see exactly what is available.See plans in your ZIP →

Medicare Advantage and Part D cannot deny coverage or charge more for pre-existing conditions. Medigap is different — outside of guaranteed-issue periods, most states allow medical underwriting. Enroll in Medigap as soon as eligible.

Part D covers outpatient prescription drugs — brand-name and generic. Formularies are organized in tiers (Tier 1 = preferred generics, Tier 5 = specialty). Starting 2025: $2,000 annual out-of-pocket cap on Part D drugs.

Yes — our licensed agents specialize in personalized recommendations based on your health conditions, medications, preferred doctors, budget, and travel habits. People with chronic conditions may benefit from Special Needs Plans (SNPs).Get a personalized recommendation →

Medicare has no waiting periods for pre-existing conditions in Advantage or Part D — covered from day one. However, when you enroll affects your coverage start date. Enroll during your birthday month and coverage starts the following month.

Use Medicare.gov’s Plan Finder or our free comparison tool — both let you enter your ZIP and medications to compare all available plans.Compare all plans in your area →

Once during the AEP (Oct 15 – Dec 7) and once more during the MA OEP (Jan 1 – Mar 31). Review your plan annually before AEP — premiums, formularies, and benefits change every year.Review plans for next year →