Understanding your Medicare options
Medicare coverage is not one-size-fits-all. Below is an overview of the main paths — we will help you find what fits your health needs and budget.
Original Medicare (Parts A & B)
Original Medicare is federal health insurance for people 65+ and certain younger people with disabilities. Part A covers hospital stays; Part B covers doctor visits and outpatient care.
Key points at a glance
- You can see any provider nationwide that accepts Medicare
- No referral needed for specialists in most cases
- Does not include prescription drug coverage (you need Part D) or an out-of-pocket maximum
- Many people add a Medigap policy to help with deductibles and coinsurance
Medicare Advantage (Part C)
Medicare Advantage plans are offered by private insurers approved by Medicare. They combine Part A and Part B — and often Part D — into one plan, sometimes with extra benefits like dental or vision.
Key points at a glance
- Usually uses provider networks (HMO or PPO)
- Often includes prescription drug coverage
- May have lower monthly premiums than Medigap + Part D combined
- Annual Open Enrollment (AEP) is a key time to review or switch plans
Medicare Supplement (Medigap)
Medigap policies help pay some of the costs Original Medicare does not cover — such as copayments, coinsurance, and deductibles. You must have Part A and Part B to buy a Medigap policy.
Key points at a glance
- Works alongside Original Medicare — not with Medicare Advantage
- Standardized plan letters (A, G, N, etc.) with consistent benefits by letter
- Guaranteed-issue rights apply in certain situations (e.g., turning 65, losing employer coverage)
- Does not include prescription drugs — pair with a standalone Part D plan
Medicaid & dual eligibility
Medicaid is a joint federal-state program for people with limited income and resources. Some beneficiaries qualify for both Medicare and Medicaid (dual eligible) and may access Special Needs Plans (SNPs).
Key points at a glance
- Eligibility rules vary by state — we help Florida residents understand options
- Dual-eligible individuals may have lower premiums and cost-sharing
- Medicare Savings Programs (MSPs) can help pay Medicare premiums
- We coordinate with your existing coverage when you qualify for both programs
Prescription Drug Plans (Part D)
Part D plans cover prescription medications. You can get Part D through a standalone plan (with Original Medicare + Medigap) or included in many Medicare Advantage plans.
Key points at a glance
- Compare formularies to ensure your medications are covered
- Late enrollment penalty may apply if you go without creditable drug coverage
- Annual plan review recommended — drug costs and formularies change each year
- Extra Help (LIS) may reduce Part D costs for qualifying beneficiaries
Not sure which path is right for you?
We will walk through your doctors, prescriptions, and budget — at no cost to you.