Medicare 101
A Simple Guide for You
Navigating Medicare doesn’t have to feel overwhelming. At United Insurance Experts, we believe that when you’re informed, you make the right choices. Whether you’re turning 65, reviewing your coverage during the Annual Enrollment Period, or simply want to understand your options — this guide is for you.
What Is Medicare?
Medicare is the federal health insurance program for people aged 65 and older, and for certain younger people with disabilities or specific conditions. It’s broken into “Parts” so you can better understand what you’re covered for — and what you may still need to address.
The Parts at a Glance
- Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice, and certain home health services.
- Part B (Medical Insurance): Covers outpatient doctor visits, preventive services, durable medical equipment.
- Part C (Medicare Advantage): Offered by private insurance companies, it bundles Part A & B and often includes extras like prescription drug coverage, dental, vision, hearing.
- Part D (Prescription Drug Plans): Helps cover the cost of medications; you choose based on your prescriptions and pharmacy preferences.
- Medigap (Supplement Plans): These fill the “gaps” of Original Medicare (Parts A & B) — covering things like deductibles, coinsurance, copayments.
Get A Free Review
Original Medicare vs. Medicare Advantage
Original Medicare (Parts A & B):
✅Flexibility: See any doctor/hospital that accepts Medicare.
✅No network restrictions, but doesn’t cover prescription drugs (unless you enrol in Part D) or extras like dental/vision/hearing.
✅No annual out-of-pocket maximum, so costs can add up.
Medicare Advantage (Part C):
✅One plan, one carrier: Combines A, B (and often D) into a single plan.
✅Often includes extra benefits: dental, vision, hearing, fitness/transportation.
✅Usually has a network and defined benefits; review carefully.
✅The plan may change each year (costs, networks, benefits).
Ready for a free Medicare review?
When & How to Enrol
✅ Initial Enrollment Period (IEP): Around your 65th birthday (3 months before, month of, and 3 months after).
✅ Annual Enrollment Period (AEP): October 15 to December 7 each year — you can make changes to your plan for the upcoming year.
✅ Special Enrollment Periods (SEP): For qualifying life events (moving, losing employer coverage, etc.).
✅ Late enrolment can lead to penalties and higher costs, so timely review is important.
Costs & Coverage — What You Pay
✅ Premiums – What you pay monthly for coverage.
✅Deductibles – How much you pay out-of-pocket before your plan starts paying.
✅Copays/Coinsurance – Your share of the costs once the plan pays.
✅Out-of-Pocket Max – In Advantage plans, you usually get a cap; Original Medicare doesn’t provide a set limit.
✅Extras – Some plans include dental, vision, hearing, wellness, transportation — these may tip the balance in your favour when comparing.
How to Choose the Right Plan
Here’s a simple step-by-step:
- List your providers & medications. Ensure your doctors and prescriptions are in the plan’s network and formulary.
- Set your budget. Consider premiums, deductibles, out-of-pocket max, and how that fits your financial comfort.
- Check additional benefits. Does dental, vision, hearing or fitness matter to you? Some Advantage plans include them.
- Network matters. If you travel or live part of the year in another state, check plan coverage accordingly.
- Review annually. Even if you’re happy, plan benefits, costs and your health needs may change — a yearly check-in is wise.
Common Mistakes & Myths
✅ Myth: “Medicare covers everything.” – Reality: Some services (long-term care, most dental/vision/hearing, overseas care) aren’t covered.
✅ Mistake: “I don’t need to review my plan each year.” – Reality: Premiums, networks, and drug formularies often change yearly.
✅ Myth: “All Advantage plans are the same everywhere.” – Reality: Benefits and cost vary greatly by ZIP code and carrier.
✅ Mistake: “I’ll enrol when I’m sick.” – Reality: Late enrolment can incur penalties and add cost.
Why Work with United Insurance Experts
✅ Independent, licensed advisors — we review multiple carriers, not just one.
✅Personalized reviews: We map your doctors, medications and budget to find the best fit.
✅Annual check-ins: It’s not just about enrolment; it’s about staying current.
✅Local, compassionate service: We’re headquartered in Boca Raton and serve seniors across multiple states.
✅No cost to you: Our consultation is free — our compensation comes from carriers.
Let’s simplify Medicare together.
Original Medicare FAQs
You still qualify for Medicare, but certain plan rules and timelines may differ. Contact us for special enrolment guidance.
Yes — if you qualify for both, you may be eligible for a Dual Special Needs Plan (DSNP) or other benefits. We can review your situation.
During AEP (Oct 15–Dec 7) you can change your plan for the upcoming year. If you’re in a Medicare Advantage plan, the Open Enrollment Period (Jan 1–Mar 31) allows some changes.
No — you’ll need to check if your providers participate in the plan’s network each year.
🌟 About United Insurance Experts
United Insurance Experts, Inc. is an independent, Boca Raton–based insurance agency helping seniors and retirees across multiple states find Medicare coverage that fits their life and budget.
At United Insurance Experts, we protect you like family.
Licensed in multiple states, with dedicated pages for FL, AZ, CA, GA, NJ, NY, TX, AR.
⚖️ Disclaimer
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 call 1-800-MEDICARE to get information on all your options.
This is a solicitation of insurance. Contact may be made by a licensed insurance agent.
Last updated: October 2025