Learn About Medicare

What Is Medicare, and Who Qualifies?

Medicare is a federal health insurance program designed for:

People age 65 and older

Individuals under 65 with certain disabilities

People diagnosed with ESRD (End-Stage Renal Disease) or ALS

Not sure if you qualify?

A PlanSeek advisor can check for you.

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The Building Blocks of Medicare: Parts A, B, C, D & Medigap

Part A – Hospital Coverage
(Original Medicare)

Helps pay for inpatient care:

Hospital stays

Skilled nursing facility care

Hospice care

Limited home health care

Part B – Medical Coverage
(Original Medicare)

Covers outpatient and preventive services:

Doctor visits, lab tests, and screenings

Mental health services and physical therapy

Durable medical equipment

Some medications (like injections or chemotherapy)

Part C – Medicare Advantage Plans

Offered by private insurers, these bundle Part A + B, and usually Part D, into one plan.
May include extras like:

Dental, vision, and hearing

Gym memberships

Transportation and over-the-counter benefits

Compare Medicare Advantage Plans
with PlanSeek

Part D – Prescription Drug Coverage

Helps cover:

Daily medications

Vaccines

Specialty and maintenance drugs
Available as a standalone plan or included in some Advantage plans

Medicare Supplement (Medigap)

Helps cover what Parts A & B don’t cover like:

Deductibles, copays, and coinsurance

Explore Medigap Options to reduce your out-of-pocket costs

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When to Enroll in Medicare (Parts A & B)

Enrolling at the right time helps avoid penalties and delays.

Initial Enrollment Period (IEP)

Your first chance to enroll in Medicare A & B.

Starts 3 months before your 65th birthday
Includes your birthday month
Ends 3 months after your birthday

💡 Enroll early to avoid gaps in coverage.

General Enrollment Period (GEP)

Missed your IEP?
You can enroll:

January 1 to March 31 each year
Coverage starts July 1

⚠️ Late penalties may apply.

Special Enrollment Period (SEP)

You may qualify for
a special window if:

You lose employer coverage
You move
You qualify for Medicaid
Have certain chronic conditions

👉 Ask a PlanSeek Advisor to see if you’re eligible

When to Enroll in Medicare Advantage(Part C)
or Drug Plans (Part D)

These plans have separate enrollment periods from Original Medicare.

Annual Enrollment Period (AEP) – October 15 to December 7

Switch or join a Medicare Advantage or Part D plan
Changes take effect January 1

Medicare Advantage Open Enrollment – January 1 to March 31

If you're already in a Medicare Advantage plan, you can:
- Switch to a different Advantage plan
- Go back to Original Medicare

Medigap (Supplement) Enrollment

Medigap has a one-time guaranteed window when you're first eligible.

Begins the month you’re 65 or older AND enrolled in Part B
Lasts for 6 months
You can enroll regardless of pre-existing conditions

👉 After this period, you may be denied coverage or charged more

Check Enrollment Timeline

Is Medicaid the Same as Medicare?

No. Medicaid and Medicare are different programs, but some people qualify for both.

What’s the difference?

Medicare

Federal health insurance for people 65+ and certain disabilities

Covers hospital, medical, and prescription services

Not based on income

Medicaid

State & federally funded program based on income

May help cover premiums, copays, and services Medicare doesn't

Based on financial need

You might qualify for both if:

Your income is limited

You receive Supplemental Security Income (SSI)

You have high medical needs and low savings

See If You’re Eligible

What Happens If You Don’t Enroll in Medicare on Time?

Missing your initial opportunity to enroll in Medicare can result in coverage delays and permanent penalties. Here’s what to expect for each part:

If You Don’t Enroll In Part A (Hospital Insurance)

Most people qualify for premium-free Part A, but if you don’t enroll when first eligible:

You may face a 10% premium penalty
The penalty lasts twice the number of years you delayed enrollment
You can only enroll during specific periods, which may delay your coverage

💡 If you have employer coverage, you may not need to enroll right away. Ask a PlanSeek Advisor to be sure.

If You Don’t Enroll In Part B (Medical Insurance)

Delaying enrollment in Part B without other qualifying coverage (like employer insurance) can lead to:

A 10% premium penalty for every 12-month period you delay
This penalty is added to your Part B premium for life
You’ll have to wait for the General Enrollment Period (Jan 1–Mar 31) and coverage won’t start until July 1

💡 The longer you wait, the more you’ll pay—forever. Even if you’re healthy now, delaying may hurt you later.

If You Don’t Enroll In Part D (Prescription Drug Coverage)

Even if you don’t take medications now, delaying Part D can cost you later.

You’ll pay a 1% monthly penalty for every month you were eligible but didn’t enroll
The penalty is based on the national base premium and lasts for life
The only way to avoid it is to have other creditable drug coverage (like through an employer or union plan)

💡 Many plans with drug coverage cost little or nothing. Don’t skip it unless you're sure you're covered elsewhere.

Bottom Line

If you miss your Medicare enrollment window and don’t have other qualifying coverage, you could end up with:

Higher monthly costs—for life

Gaps in your healthcare coverage

Delays in when your insurance starts

Don’t guess. Schedule a Free Consultation with PlanSeek to avoid mistakes and penalties.

Preparing for Your Consultation With PlanSeek

Before your call or meeting gather:

Medication list

Doctor and specialist names

Preferred pharmacy

Medicare card or eligibility letter

Your questions or concerns

Schedule Your Free Medicare Consultation