Medicare
I make Medicare simple. With 17+ years of experience, I help you find the right Advantage, Supplement, or Drug Plan coverage.
Who Is Eligible for Medicare?
Medicare is a federal health insurance program for:
People age 65
or older
People under 65
with certain disabilities
People of any age with End-Stage Renal Disease (ESRD)
What Are the Types of Medicare?
1. Original Medicare (Parts A & B)
Original Medicare is the traditional health insurance program run by the federal government. It includes two parts (as shown below) and gives you the freedom to see any doctor or provider that accepts Medicare.
Part A – Hospital Insurance
Covers inpatient hospital stays
Includes skilled nursing facility care
Covers hospice care
May include limited home health care
Part B – Medical Insurance
Covers doctor visits and outpatient care
Includes preventive services (like screenings and vaccines)
Covers lab work, X-rays, and durable medical equipment
Requires a monthly premium
2. Medicare Advantage (Part C)
Medicare Advantage plans are offered by private insurance companies approved by Medicare. They bundle your hospital (Part A) and medical (Part B) coverage often include extra benefits like dental and vision care.
What Medicare Advantage Covers:
Includes everything Original Medicare (Parts A & B) covers
Most plans include prescription drug coverage (Part D)
May include dental, vision, hearing, and fitness benefits
Usually features one ID card for everything
Medicare Advantage Plans include:
HMO (Health Maintenance Organization)
PPO (Preferred Provider Organization)
PFFS (Private Fee-for-Service)
SNP (Special
Needs Plans)
Important Notes:
You must have Parts A & B to enroll in a Medicare Advantage plan
It includes Part D prescription drugs
Each plan has its own network and coverage rules
3. Medicare Supplement (Medigap)
Medicare Supplement plans, also called Medigap, help cover the costs that Original Medicare doesn't like copayments, coinsurance, and deductibles. These plans give you more financial predictability and peace of mind.
What Medigap Covers:
Helps pay for:
Hospital stay copayments
Doctor visit
copays
Skilled nursing facility costs
Part A and Part B deductibles
Lets you see any doctor nationwide who accepts Medicare
Plans are standardized, so Plan G or Plan N from one company is the same as from another
Important Notes:
You must have Parts A & B to to get a Medigap plan
These plans don’t include prescription drug coverage (You’ll need a separate Part D plan for medications)
You typically pay a monthly premium for Medigap in addition to your Part B premium
4. Prescription Drug Coverage (Part D)
Part D plans help cover the cost of prescription medications because Original Medicare doesn’t. These plans are offered by private insurance companies approved by Medicare.
What Prescription Drug (Part D) Covers:
Helps pay for prescription drugs, both brand-name and generic
Covers medications you get from a pharmacy or mail order
Each plan has a formulary (a list of covered drugs), so it’s important to choose one that fits your needs
Important Notes:
There may be a copay for each prescription, depending on your plan’s formulary and tier system
If you have Original Medicare (Parts A & B) or a Medigap plan, you’ll need a standalone Part D plan
If you’re in a Medicare Advantage plan, it may already include drug coverage
You may face a permanent late enrollment penalty if you go too long without creditable drug coverage
Even if you don’t take medications now, enrolling in a basic plan can protect you from future costs and penalties
General Requirements
Age-Based Eligibility (65 and older)
You may qualify for Medicare if:
You’re 65 or older
You’re a U.S. citizen or legal permanent resident (for at least 5 continuous years)
You or your spouse worked at least 40 quarters in Medicare-covered employment
You’ll get Part A if:
You already receive Social Security or Railroad Retirement benefits
You’re eligible for those benefits but haven’t started collecting them yet
You’ll get Part B if:
You enroll in Part B (medical insurance), which has a monthly premium
You get Social Security, your Part B premium is automatically deducted.
If you don't get Social Security, Medicare sends you a bill every 3 months if you don't get those payments
Disability-Based Eligibility (Under 65)
You may qualify for Medicare if:
You’ve received Social Security or Railroad Disability benefits for 24 months
You have ALS (Lou Gehrig’s Disease) — Medicare starts right away
You have End-Stage Renal Disease (ESRD) — requiring dialysis or transplant
What to Prepare for Enrollment
Medicare Number
Part A and Part B must already be active
A list of your prescriptions and doctors
When to Enroll
Enrolling in Medicare at the right time helps you avoid gaps in coverage and possible late penalties. Here’s what you need to know:
Initial Enrollment Period (IEP)
This is your first chance to enroll in Medicare.
It’s a 7-month window:
- Starts 3 months before the month you turn 65
- Includes your birthday month
- Ends 3 months after your birthday month
You can sign up for Parts A, B, and D during this time
Enroll early in this window to avoid coverage delays.
Annual Enrollment Period (AEP)
If you missed your IEP, you can enroll between:
- October 15 - December 7
Coverage begins on January 1 of the next year
Special Enrollment Period (SEP)
You may qualify for a SEP if you:
- Had employer coverage and are now retiring
- Lost other creditable coverage
- Move out of your current plan’s service area
- Have both Medicare and Medicaid (you may qualify for a D-SNP)
- Have a chronic health condition like diabetes, heart disease, or kidney failure (you may qualify for a C-SNP)
How to Get Started
Book A
Call
Have a 1:1 Consultation
& Evaluation
Feel Protected With
The Right Plan
Frequently Asked Questions
Q: When can I enroll?
You can sign up starting 3 months before you turn 65.
If you’re still working, you might be able to wait without a penalty.
Q: What does it cover?
That depends on the plan you choose. Refer to the information above.
Q: How much does it cost?
There’s no one-size-fits-all price, it depends on the plan you choose and your situation.
Q: Will I get to keep my doctors?
Yes, you can if you pick the right plan. I’ll help you find one that includes your current doctors.
Our firm is staffed by proven insurance professionals committed to providing our clients with highly personalized service.
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This is a solicitation for insurance. Submitting information or calling numbers listed on this website will direct you to a licensed Agent/Broker.
Important disclosures about Medicare Plans: Medicare has neither endorsed nor reviewed this information. Not connected or affiliated with any United States Government or State agency. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
© 2025 Stacy Gregory Insurance - All Rights Reserved.
Our firm is staffed by proven insurance professionals committed to providing our clients with highly personalized service.
Other Links
Privacy Policy
Receive My Newsletters
I Consent to Receive Newsletters and other Marketing Emails from Stacy Gregory Insurance. You can unsubscribe at any time.
This is a solicitation for insurance. Submitting information or calling numbers listed on this website will direct you to a licensed Agent/Broker.
Important disclosures about Medicare Plans: Medicare has neither endorsed nor reviewed this information. Not connected or affiliated with any United States Government or State agency. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.