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Medicare

Medicare is a federal health insurance program for individuals 65 and older or under 65 with a disability. Medicare can be confusing! We stay up to date on all federal changes and are here to help you understand and get enrolled successfully.

Original Medicare

Medicare Part A and B form Original Medicare, which is the foundation of the Medicare program run by the federal government.

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Part A

This primarily covers inpatient hospital care, skilled nursing facilities, hospice care and home health. Most people do not pay a monthly premium for Part A. If you or your spouse has paid Medicare taxes for at least ten years or 40 quarters, this coverage is free to you.

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Part B

Part B is optional and covers outpatient care, doctor visits, durable medical equipment and preventative services. There is a standard monthly premium for Part B, which is $202.90 for 2026. Medicare uses the Income Related Monthly Adjustment Amount (IRMAA) to raise your Part B premium if your income exceeds these thresholds.

For 2026 the threshold for an individual is $109,000 and $218,000 if filing jointly. If you are not taking Social Security at the age of 65 then your Part B will be billed to you Quarterly and will need to be paid promptly. If you are taking Social Security, then your Part B will be subtracted from you Social Security payments monthly.

Note: Even though this is optional coverage, if you enroll late and are not coming off credible medical coverage you will be subject to an added premium penalty for life.

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Part C

Medicare Advantage

One must be enrolled in Part A and B to be eligible for a MedAdvantage plan. These plans are offered by private insurance companies that have been approved by Medicare and typically provide coverage through a network of participating doctors and healthcare providers. You remain enrolled in Medicare and continue to pay your Medicare Part B premium, while the Medicare Advantage plan manages your healthcare benefits. Many plans also include prescription drug coverage and may provide additional benefits such as dental, vision, hearing, fitness programs, and other wellness services. These plans will have a deductible and max out of pocket limits.

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Part D

Prescription Drug Coverage

Once an individual is enrolled in Part A or Part B are eligible for part D. Part D is optional coverage that helps individuals on Medicare A or B afford prescription drug coverage. This is offered through private insurance companies and can vary in cost, covered medications, and pharmacy networks. In 2027, the max out of pocket for any plan is $2400 of covered prescriptions. We help make sure you are enrolled in the best plan for the drugs you are currently taking at your preferred pharmacy.

Please note: If an individual over 65 goes without credible drug coverage for 63 days, he or she will be charged a late penalty that stays with you indefinitely when enrolling in Part D coverage. The amount of the penalty is based on the number of months that you go without coverage after turning 65.

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Medicare Supplement (MediGap)

Medicare Supplement (MediGap) is an option for additional coverage if you are enrolled in Part A and Part B (original Medicare). It is designed to fill in the gaps of co-insurance and deductibles and make costs more predictable. With this plan you are also free to see any provider you would like without any referrals. This plan cannot be combined with a Med Advantage plan and does not include prescription drug coverage.

We do not offer every plan available in your area. Currently we represent five organizations which offer 30+ products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Let Us Help You Navigate Your Medicare Options.

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