Frequently Asked Questions

Medicare Advantage, also called Part C, is an alternative way to receive your Medicare benefits through a private insurance company approved by Medicare. These plans cover everything Parts A and B cover (except hospice, which Original Medicare still covers), and many include prescription drug coverage and extra benefits such as dental or vision. Plans usually use provider networks, and costs and benefits vary by plan and location.

A Medicare Supplement plan, also known as Medigap, is a private insurance policy that works alongside Original Medicare. It helps pay some of the costs Original Medicare does not, such as deductibles, coinsurance, and copayments. Medigap plans do not include prescription drug coverage, so many people pair them with a Part D plan.

Medicare Part D is prescription drug coverage offered by private insurers approved by Medicare. You can get it as a stand-alone plan that works with Original Medicare, or as part of a Medicare Advantage plan. Each plan has its own list of covered drugs, so it is important to check that your medications are included.

Most people first enroll during their Initial Enrollment Period, a 7-month window that includes the 3 months before, the month of, and the 3 months after the month they turn 65. After that, you can make changes during the Annual Enrollment Period from October 15 to December 7, or during a Special Enrollment Period if you have a qualifying life event. Enrolling late in some parts may result in penalties.

Yes, during certain times of the year. The Annual Enrollment Period (October 15 to December 7) lets you join, switch, or drop Medicare Advantage and Part D plans, and the Medicare Advantage Open Enrollment Period (January 1 to March 31) lets Advantage members make one change. You may also qualify for a Special Enrollment Period after events like moving or losing other coverage.

Original Medicare is the traditional program run by the federal government, made up of Part A (hospital insurance) and Part B (medical insurance). It lets you see any doctor or hospital in the U.S. that accepts Medicare, generally without referrals. It does not include most prescription drug coverage and has no yearly out-of-pocket limit, which is why many people add Part D and a Medigap policy.

Part A helps cover inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Part B helps cover doctor visits, outpatient care, preventive services, and medical equipment. Part D covers prescription drugs, and Medicare Advantage plans may add benefits such as dental, vision, and hearing. Coverage details and costs are set annually by CMS and vary by plan.

Original Medicare generally does not cover the medications you fill at a retail pharmacy, though Part B covers certain drugs given in a doctor’s office or hospital outpatient setting. To get coverage for most prescriptions, you can join a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage. Plans differ in which drugs they cover and how much they cost.

Start by listing your doctors, prescriptions, preferred pharmacies, and monthly budget. Then compare plans available in your area on premiums, deductibles, copays, out-of-pocket limits, provider networks, and drug coverage. A licensed agent can do this comparison with you at no cost and explain the differences in plain language.