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Medicare Guidance You Can Count On

Turning 65 or already enrolled but unsure about your coverage?

You are not alone.

Medicare is one of the most important benefits you willll ever use, but it is also one of the most confusing.

From Parts A and Part B to Medicare Advantage plans, Medigap, and Part D drug coverage, it’s easy to feel overwhelmed by options, deadlines, and fine print. And making the wrong choice can mean higher out-of-pocket costs, limited doctor access, or even penalties that stick with you for life.

That’s where we can help you.

As independent, licensed Medicare Brokers, we will help you:

  • Understand the difference between Original Medicare, Advantage, and Medigap

  • Choose the right coverage based on your health, income, and lifestyle

  • Avoid late enrollment penalties and coverage gaps

  • Compare plans based on your preferred doctors, hospitals, and medications

When should you start planning for Medicare?

We recommend starting your Medicare preparations at least three years before you need coverage. This gives you time to:

  • Address income levels that may trigger IRMAA (higher Medicare premiums)

  • Coordinate with employer coverage or HSAs

  • Avoid rushed decisions that may limit your options or cause lifetime penalties

Whether you’re planning ahead, retiring soon, or reviewing your current plan, I’ll guide you every step of the way with clear answers, no pressure, and advice you can trust.

If you understand your benefits, you will maximize your care.

Medicare 101 - Video Series

Medicare 101 is a five-episode educational video series created to provide a clear and concise introduction to the basics of Medicare. In this series, Peter, the owner of the company and a licensed insurance broker, guides viewers through essential Medicare topics such as coverage options, and how to choose the right plan. Designed to simplify the complexities of Medicare, the series aims to empower individuals with the knowledge needed to make informed decisions about their Medicare coverage.

Episode 1: Medicare Part A & B

Medicare Part A FAQs

  • Medicare Part A covers inpatient hospital care, skilled nursing facilities, hospice, and limited home health care. You must be formally admitted to a hospital for coverage to apply.

  • • $0/month if you paid Medicare taxes for 40+ quarters

    • $285/month if you paid for 30–39 quarters

    • $518/month if fewer than 30 quarters

  • • Deductible: $1,676 per hospital admission

    • Days 1–60: $0 daily coinsurance

    • Days 61–90: $419/day

    • Days 91–150: $838/day using lifetime reserve days

    • Beyond 150 days: No coverage — you pay 100%

  • Original Medicare has no out-of-pocket maximum, so long hospital stays can result in tens of thousands in bills. For example, a 150-day stay could cost $64,526, and anything beyond that is entirely on you.

Medicare Part B FAQs

  • Part B covers outpatient care: doctor visits, ER, urgent care, lab work, chemotherapy, and more.

  • • Premium: $185/month (higher if income triggers IRMAA)

    • Deductible: $257/year

    • Coinsurance: 20% of all covered costs after deductible

  • No. Part B has no out-of-pocket maximum. You pay 20% indefinitely for:

    • Surgeries

    • Imaging

    • Treatments like chemotherapy or dialysis

    Real examples:

    • A $30,000 knee replacement = $6,000 out of pocket

    • $500,000 in chemo = $100,000 out of pocket

Episode 2: Medicare Part D

Medicare Part D FAQs

  • Part D adds prescription drug coverage to your Medicare benefits. It’s sold by private insurers and helps lower your pharmacy costs.

  • 1. Avoid future penalties

    • If you go without creditable drug coverage, you’ll pay a Late Enrollment Penalty (LEP) when you enroll later

    2. Protection against future drug costs

    • Expensive new prescriptions can cost thousands without Part D

  • • A formulary (list of drugs) with negotiated prices

    • Access to preferred pharmacies

    • A monthly premium (varies by plan)

    Even if you’re healthy now, Part D is a safety net for your future.

Episode 3: Medicare Supplement - Medigap

  • Medigap is private insurance that fills the “gaps” in Original Medicare — like deductibles, coinsurance, and excess charges.

    Think of Medicare as a bucket with holes. Medigap plugs those holes so your money doesn’t leak out with every hospital stay or doctor visit.

  • • Freedom to see any doctor in the U.S. who accepts Medicare

    • No networks or referrals required

    • Stable, predictable out-of-pocket costs

    • Nationwide coverage — great for snowbirds or travelers

  • • Hospital costs (Part A) — including the deductible and long stays

    • Outpatient costs (Part B) — 20% coinsurance and more

    • Foreign travel emergency care (for some plans)

  • Your best window is during your Medigap Open Enrollment Period (6 months after enrolling in Part B at age 65). After that, you may be denied or charged more based on health history.

Episode 4: Medicare Advantage - Part C

Medicare Advantage FAQs

  • Medicare Advantage plans bundle Part A, Part B, and usually Part D into one plan managed by a private insurance company. Think of it as outsourcing your Medicare.

  • • One card, one plan, and often extra benefits (vision, dental, hearing)

    • May have lower premiums, but you’ll follow plan rules and networks

  • Yes. You may have:

    • Limited provider networks (especially with HMOs)

    • Referrals required to see specialists

    • Rules on where and how you receive care

  • • HMO – Must stay in network, referrals needed

    • PPO – More flexibility, higher out-of-network costs

    • PFFS – See any provider who agrees to plan’s terms

    • SNP – For special needs, Medicaid/dual-eligible, or chronic conditions

  • • Initial Enrollment Period (around age 65)

    • Annual Enrollment Period (Oct 15 – Dec 7)

    • Special Enrollment Periods (if you move, lose coverage, etc.)

Episode 5: Medicare Summary

Thank You for watching Medicare 101!

Get Answers to Your Medicare Questions

Still have questions? Our Medicare Knowledge Base features detailed articles with videos covering the most common Medicare questions!

Browse Topics Like:

  • Medicare enrollment deadlines and penalties

  • Understanding Medicare Supplement (Medigap) plans

  • Medicare Advantage vs Original Medicare

  • Prescription drug coverage (Part D) explained

  • And 8 more essential Medicare topics

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