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Line III — Medicare

Medicare, explained simply.

Medicare is the federal health program for people 65 and older (and some younger people with disabilities). Understanding its parts and enrollment windows is the foundation of the senior market.

Overview

What medicare coverage is

Original Medicare is made of Part A (hospital insurance) and Part B (medical insurance). It covers a lot, but not everything — there is no annual out-of-pocket cap, and it generally does not include prescription drugs, dental, or vision. Beneficiaries fill those gaps in one of two ways.

The first path adds a Medicare Supplement (Medigap) policy plus a standalone Part D drug plan to Original Medicare. The second path replaces the way benefits are delivered with a Medicare Advantage (Part C) plan from a private carrier, which bundles Part A, Part B, usually Part D, and often extra benefits. Which path fits depends on budget, doctors, prescriptions, and travel — and enrollment is governed by specific windows each year.

Coverage Types

The senior-market product shelf

Medicare Advantage (Part C)

Private plans that bundle Parts A, B, and usually D, often with dental, vision, and fitness extras — typically network-based with an out-of-pocket cap.

Medicare Supplement (Medigap)

Standardized plans that pay the gaps in Original Medicare (deductibles, coinsurance), letting members see any provider that accepts Medicare.

Part D drug plans

Standalone prescription coverage with a plan-specific formulary; pairs with Original Medicare or a Medigap plan.

Dental, vision & hearing

Ancillary coverage sold alongside Medicare for benefits Original Medicare excludes.

Hospital indemnity

Supplemental cash-benefit plans that help with Advantage-plan cost sharing.

Final expense pairing

Small whole-life often written alongside Medicare for funeral costs.

Who It's For

Common client profiles

Turning 65

New beneficiaries choosing between Advantage and Supplement for the first time.

Aging in

People approaching their Initial Enrollment Period.

Under-65 disabled

Beneficiaries who qualify through disability.

Plan switchers

Members reviewing options during the Annual Enrollment Period.

Snowbirds & travelers

Clients who value Medigap's nationwide provider freedom.

Dual-eligibles

People eligible for both Medicare and Medicaid.

Key Terms

Terms worth knowing

Original Medicare
Part A (hospital) and Part B (medical) administered by the federal government.
Part C (Advantage)
A private bundled alternative to Original Medicare, often including drug coverage.
Part D
Prescription drug coverage, standalone or built into an Advantage plan.
Medigap
Standardized supplement plans that cover Original Medicare's cost-sharing gaps.
IEP
Initial Enrollment Period — the seven-month window around a person's 65th birthday.
AEP
Annual Enrollment Period, Oct 15 – Dec 7, when anyone can change Medicare coverage.
OEP
Medicare Advantage Open Enrollment, Jan 1 – Mar 31, to switch Advantage plans.
Formulary
The list of drugs a Part D or Advantage plan covers, organized by tier.
Educational information only — not medical or enrollment advice. We do not offer every plan available in your area. Any information provided is limited to the plans we offer. To get information on all of your options, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048), 24 hours a day, 7 days a week. Not connected with or endorsed by the U.S. government or the federal Medicare program.
Common Questions

Medicare FAQ

When can someone enroll?
During the Initial Enrollment Period around age 65, the Annual Enrollment Period (Oct 15 – Dec 7), the Advantage Open Enrollment Period (Jan 1 – Mar 31), or a qualifying Special Enrollment Period.
Advantage or Supplement?
Advantage bundles benefits with lower premiums and networks plus an out-of-pocket cap; Supplement offers broad provider freedom and predictable costs at a higher premium. The right fit depends on doctors, drugs, budget, and travel.
Does Medicare cover drugs?
Original Medicare generally does not. Drug coverage comes from a standalone Part D plan or a Medicare Advantage plan that includes it.
Is there a premium?
Most people pay no Part A premium but do pay a Part B premium; Advantage and Supplement plans have their own premiums that vary by plan and area.

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