If you’ve recently turned 65, are approaching eligibility, or are simply looking to review your current coverage, you know Medicare can feel like a complex puzzle. With terms like Part A, Part B, Medigap, and Advantage Plans, it’s easy to feel overwhelmed.
At Medicare Insurance Techs (MIT), we believe your healthcare security shouldn’t be a source of stress. Our team has over 95 years of combined experience helping people just like you in Missouri, Illinois, Kansas, and Arkansas find personalized, cost-effective coverage.
To help you cut through the confusion, we’ve compiled the top 10 most frequent questions we hear from clients and provided clear, concise answers.
This is the most crucial starting point!
Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services.
Part B (Medical Insurance): Covers certain doctor services, outpatient care, medical supplies, and preventive services.
Part C (Medicare Advantage): A type of plan offered by private companies that contracts with Medicare. It includes all Part A and Part B benefits (and often Part D), plus extra benefits like dental, vision, or hearing.
Part D (Prescription Drug Coverage): Adds drug coverage to Original Medicare (A & B), some Medicare Cost Plans, and some Medicare Private Fee-for-Service Plans.
There are several times you can enroll or change your plan:
Initial Enrollment Period (IEP): A seven-month window that begins three months before you turn 65, includes your birth month, and ends three months after.
General Enrollment Period (GEP): If you missed your IEP and don’t qualify for a Special Enrollment Period (SEP), you can enroll in Part A and/or Part B between January 1 and March 31 each year, with coverage starting July 1.
Annual Enrollment Period (AEP): From October 15 to December 7, anyone with Medicare can join, drop, or switch their Medicare Advantage or Part D plan.
Special Enrollment Period (SEP): Available if you experience certain life changes (e.g., moving, losing employer coverage).
This is the biggest decision point for most beneficiaries:
Medicare Advantage (Part C): Replaces Original Medicare. You receive your A and B benefits through the private plan, often including extra benefits and drug coverage. These plans typically have lower premiums but use defined network rules (HMOs/PPOs) and require copays/coinsurance for services.
Medigap (Medicare Supplement): Works alongside Original Medicare (A and B). It helps cover the “gaps” in Original Medicare—like deductibles, copayments, and coinsurance. You pay a separate premium, but you get to see any doctor or hospital that accepts Medicare nationwide.
Yes, but costs vary:
Part A: Most people do not pay a premium for Part A if they or their spouse worked and paid Medicare taxes for at least 10 years (40 quarters).
Part B: Everyone pays a standard monthly premium for Part B, which is deducted from Social Security benefits. Higher earners pay a higher premium called the Income-Related Monthly Adjustment Amount (IRMAA).
Part C/D: Premiums vary widely based on the specific plan chosen.
If you don’t sign up for Part B or Part D when you’re first eligible and don’t have other credible coverage (like employer insurance), you could face a late enrollment penalty that increases your monthly premium for the rest of your life. Don’t risk it—contact us to ensure you enroll on time!
It depends entirely on the type of coverage you choose:
Original Medicare + Medigap: You can see any doctor or facility in the U.S. that accepts Medicare.
Medicare Advantage (Part C): These plans use specific networks (HMOs/PPOs). It is vital to check if your current doctors and hospitals are in-network before enrolling. We always help our clients confirm their providers.
Generally, Original Medicare (Parts A & B) does not cover routine dental care, eye exams, eyeglasses, or hearing aids. However, most Medicare Advantage (Part C) plans include benefits for routine dental, vision, and hearing services to cover these gaps.
The “Donut Hole” is a coverage gap in Medicare Part D (prescription drug coverage). After you and your plan spend a certain amount on covered drugs, you temporarily pay a higher percentage of your drug costs until you reach the “Catastrophic Coverage” phase. Navigating this gap is tricky, but we help you find plans that minimize your out-of-pocket costs.
Yes! While you are generally locked into your plan for the calendar year, you have opportunities to switch:
Annual Enrollment Period (AEP): (Oct 15 – Dec 7) to switch plans starting January 1.
Medicare Advantage Open Enrollment Period (OEP): (Jan 1 – Mar 31) allows you to switch from one Medicare Advantage plan to another, or drop an Advantage plan to return to Original Medicare + Part D.
Special Enrollment Period (SEP): If you qualify based on a change in life circumstances.
Our guidance, expertise, and personalized consultations are absolutely free to you! We are compensated directly by the insurance carriers when you enroll in a plan, meaning you get unbiased, personalized help at no extra cost. Our commitment is to find you the best solution.
Ready to solve the Medicare puzzle? Don’t get lost in the ABCDs, parts, and plans. Let the experienced, dedicated experts at Medicare Insurance Techs guide you through every step.
Call us today! We treat you like family, not a number.