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You can enroll in a Medicare Advantage plan if you recently turned 65 or qualify for a Special Enrollment Period, like moving or retiring.

Use our quoting tool below to compare plans, or schedule a free consultation with Tonia to get personalized guidance today.

What is Medicare Insurance?

A federal health insurance program that provides critical coverage for individuals age 65 and older, as well as those under 65 with qualifying disabilities or End-Stage Renal Disease (ESRD). It helps pay for hospital stays, doctor visits, preventive care, and prescription drugs—reducing out-of-pocket costs and ensuring access to essential medical services.

Whether you’re nearing retirement or navigating a disability, it acts as a vital safety net—protecting your health and your financial future.

How Medicare Can Help You

It offers broad coverage that can dramatically reduce your healthcare costs—especially as you age or manage chronic conditions. Depending on the plan you choose, it can help pay for hospital stays, doctor visits, preventive screenings, specialist care, and prescription drugs.

For those who qualify, it also provides reliable access to the care you need—without the overwhelming financial burden. Whether you’re retiring soon or already enrolled, the right Medicare plan can protect both your health and your savings.

Download our Medicare Playbook

Who is eligible for Medicare?

Eligibility is based on a few qualifying factors:

You are 65 or older
You are younger than 65 but have been classified as disabled for longer than two years, and have received Social Security disability checks.
You are eligible to receive benefits from Social Security
You are a United States Citizen OR you have legally resided in the Untied States for more than 5 years
You have Lou Gehrig Disease
You have End-Stage Renal Disease

Medicare Basics: What You Need to Know

Turning 65 & Medicare

You are eligible when you turn 65.
You can enroll during your Initial Enrollment Period (IEP), which starts 3 months before, includes your birthday month, and ends 3 months after.
If you’re already receiving Social Security, you’ll be automatically enrolled in Part A and Part B.
If you are not receiving Social Security, you will need to sign up for Part A and Part B.
If you’re still working and have employer coverage, you may be able to delay Part B without penalties.

New to Medicare? Start Here

Medicare has four parts:

- Part A (Hospital Insurance) – Covers hospital stays, skilled nursing care, hospice, and some home health care.
- Part B (Medical Insurance) – Covers doctor visits, outpatient care, preventive services, and medical equipment.
- Part C (Medicare Advantage) – Private insurance plans that bundle Parts A, B, and usually D.
- Part D (Prescription Drug Coverage) – Helps cover medication costs.
You can choose between Original Medicare (Parts A & B) with optional Medigap (supplement insurance) or a Medicare Advantage plan.
If you miss your Initial Enrollment Period, you may face late enrollment penalties.

Is Your Medicare Advantage Plan Changing? Here’s What to Do:

Medicare Advantage plans can change every year—premiums, drug coverage, and provider networks may shift.
The Annual Enrollment Period (AEP) runs from October 15 – December 7; this is your chance to switch, drop, or enroll in a new plan.
Open Enrollment runs January 1 – March 31, allowing you a one-time switch to another Medicare Advantage plan with or without drug coverage. or return to Original Medicare and join a separate Medicare drug plan.
Always review your Annual Notice of Change (ANOC) to understand how your plan is changing.

Losing Coverage? You Have Options:

If you lose employer or group health coverage, you may qualify for a Special Enrollment Period (SEP) to sign up without penalties.
If you lose Medicare Advantage or Part D coverage, you may be able to switch plans during a Special Enrollment Period.
Check if you qualify for Medicaid, Extra Help, or a Medicare Savings Program to lower costs.
You may be eligible for a Medigap (Medicare Supplement) plan to cover out-of-pocket costs from Original Medicare.

Benefits of Medicare

Coverage Options

It offers different parts to cover specific services:

• Part A: Hospital Insurance, covering inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
• Part B: Medical Insurance, covering certain doctors’ services, outpatient care, medical supplies, and preventive services.
• Part C (Medicare Advantage): An alternative to Original Medicare that bundles Part A, Part B, and usually Part D (prescription drug coverage). These plans are offered by private insurance companies and often include additional benefits like vision, dental, and wellness programs.
• Part D: Prescription Drug Coverage, helping to cover the cost of prescription drugs, including many recommended shots or vaccines.
Preventative Services
Financial Protection

Open Enrollment vs. Applying After Your Open Enrollment Period

Open Enrollment

Open Enrollment Period: This is the designated time each year when you can enroll in or make changes to your coverage without any penalties. For most people, the Open Enrollment Period runs from October 15 to December 7 each year. During this period, you can:

• Switch from Original Medicare to a Medicare Advantage Plan (Part C) or vice versa.
• Change from one Medicare Advantage Plan to another.
• Enroll in or change a Part D prescription drug plan.

Applying After the Open Enrollment Period

If you miss the Open Enrollment Period, you may still be able to make changes to your coverage, but there could be consequences:

• General Enrollment Period (January 1 – March 31): If you didn’t sign up for Part A or Part B when you were first eligible, you could sign up during this period. However, your coverage won’t start until July 1, and you may have to pay a late enrollment penalty for as long as you have Medicare.

• Special Enrollment Period (SEP): If you qualify for a SEP, you can make changes to your Medicare Advantage and Part D coverage outside the standard Open Enrollment Period. SEPs can be triggered by certain life events, such as moving out of your plan’s service area, losing other insurance coverage, or qualifying for extra help due to low income.

• Late Enrollment Penalties: If you don’t sign up for Medicare when you’re first eligible and don’t have a qualifying Special Enrollment Period, you may face late enrollment penalties. These penalties can increase your premium costs and will last as long as you have Medicare coverage.

Understanding the timing and rules around enrollment periods is crucial to maximizing your benefits and avoiding unnecessary costs.

Medicare FAQs

What is Medicare?

It is a federal health insurance program primarily for individuals 65 and older, as well as younger people with certain disabilities or End-Stage Renal Disease (ESRD). It helps cover hospital care, doctor visits, preventive services, and prescription drugs depending on the coverage selected.
What are the different types of Medicare?
Part A: Covers inpatient hospital care, hospice, and some skilled nursing facility care.

Part B: Covers outpatient services, preventive care, lab tests, and doctor visits.

Part C (Medicare Advantage): A private plan that bundles Part A and B—and often Part D—into one plan. May include extra benefits like dental and vision.

Part D: Provides prescription drug coverage through private insurance companies.

Medicare Supplement (Medigap): Helps pay the out-of-pocket costs not covered by Original Medicare.
Is Medicare free?
What is the difference between Original Medicare and Medicare Advantage?

Original Medicare (Parts A & B) is provided by the federal government and allows you to see any doctor that accepts it. Medicare Advantage (Part C) is offered by private insurance companies and often includes extra benefits, but it may have network restrictions.
When can I enroll in Medicare?

The Initial Enrollment Period (IEP) is a 7-month window starting 3 months before your 65th birthday, including your birth month, and ending 3 months after. There are also Special Enrollment Periods (SEPs) for certain situations, and the General Enrollment Period (GEP) from January 1 to March 31 each year.
What happens if I don't enroll in Medicare on time?
Does Medicare cover long-term care?
Do I need a Medicare Supplement (Medigap) plan?
Can I have Medicare and employer health insurance at the same time?
Does Medicare cover dental, vision, and hearing?
When should I enroll in Medicare?

Your Initial Enrollment Period starts 3 months before your 65th birthday, includes your birth month, and ends 3 months after. Missing this window could lead to late penalties.

👉 Schedule your free consultation with Tonia, our Certified Medicare Planner, to avoid penalties.
What is the difference between Medicare Advantage and Medicare Supplement plans?
Medicare Advantage plans (Part C) are all-in-one plans offered by private insurers. They often include Part D drug coverage and extra benefits, but may restrict you to a network of providers.

Medicare Supplement (Medigap) plans work with Original Medicare to cover deductibles, copays, and coinsurance. They offer broader provider access and fewer out-of-pocket surprises.

👉 Not sure which is right for you? Schedule a call with Tonia.
Does Medicare cover prescription drugs?
Can I keep my doctor with Medicare?
Will I lose my employer or retiree coverage when I enroll in Medicare?

That depends. If you’re still working or receiving retiree benefits, your employer plan may coordinate with Medicare. In some cases, Medicare becomes primary. It’s important to compare both options.

👉 Let Tonia review your current coverage and help you decide.
Can I change Medicare plans later?
What does Medicare not cover?
Can I qualify for Medicare under age 65?
Where can I get help choosing the right Medicare plan?

No-Obligation Medicare Consultation

Choosing the right plan can protect your health, lower your out-of-pocket costs, and help you avoid costly enrollment mistakes. Whether you’re new to it or considering a plan change, expert guidance can make all the difference.

Tonia, CMIP© has over 20 years of experience, and is here to help you navigate your options with clarity and confidence.

👉 Schedule your free consultation with Tonia today and take the first step toward the right coverage for your needs.

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