%20PNG.png)
Learn About Medicare
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
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
āš” 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
ā ļø 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
š 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
-
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
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
š” 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
š” 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)
š” 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
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
