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What Is Medicare?

Medicare is the federal health insurance program primarily for people age 65 and older, although it also covers certain younger individuals with disabilities. If you’re approaching Medicare eligibility or just starting your research, it’s completely normal to feel overwhelmed. That’s why this site exists — to help you understand how Medicare works, what your options are, and how to make confident decisions.

The Four Parts of Medicare: A Simple Overview

Part A – Hospital Insurance  Part A helps cover inpatient hospital stays, skilled nursing facility care, hospice care, and some home
health services. Most people get Part A premium-free if they or their spouse worked and paid Medicare
taxes long enough.

Part B – Medical Insurance

Part B helps cover doctor visits, outpatient care, preventive services, lab work, and durable medical equipment. Unlike Part A,
there is a monthly premium for Part B, and that amount is determined by your income.

For More Information on Premiums check out Medicare Costs At A Glance.

It’s what you use when you go to the doctor or need treatment outside of a hospital.

Together, Part A and Part B make up “Original Medicare.”

Part C – Medicare Advantage

These are private insurance plans that bundle together the benefits of Original Medicare (Parts A and
B), often include Part D (prescription drugs), and may offer additional services like dental, vision,
hearing, or gym memberships. These plans vary greatly by region and insurer.

Part D – Prescription Drug Coverage

Part D helps cover the cost of prescription medications. These plans are offered by private insurance
companies and can be added to Original Medicare or sometimes included in a Medicare Advantage
plan. Each plan has a list of covered medications (called a “formulary”), and your costs can vary
depending on what drugs you take.

Medicare Supplement (Medigap)

These are additional policies offered by private insurance companies to help cover costs that Original
Medicare doesn’t, like deductibles, copays, and coinsurance. Medigap plans don’t include prescription
drug coverage, so you may still need a separate Part D plan.

No matter where you are in your Medicare journey, understanding your choices is the first step toward
peace of mind and better healthcare. This website is here to walk you through it all — clearly, honestly,
and without the pressure.

How Do They Calculate The Part B IRMAA Adjustment?
They Look A Income From 2 Years Prior.
You Can File A Life Changing Event Form With Social Security And Get Your Part B premium Lowered.
No, because It Is an Annual Deductible It Is Only Paid Once.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.
Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.
Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.

Choosing the Right Medicare Coverage

Selecting the best Medicare coverage depends on factors like your healthcare needs, budget, and preferred providers. You can choose between:
  • Original Medicare (Parts A & B): Allows you to see any doctor or
    hospital that accepts Medicare but does not include prescription drug
    coverage (Part D) or additional benefits.
  • Medicare Advantage (Part C): Offers bundled coverage with
    potential extra benefits but may require using a network of providers.
  • Medigap (Medicare Supplement Insurance): Helps cover
    out-of-pocket costs not covered by Original Medicare, such as
    copayments and deductibles.

Key Medicare Enrollment Periods

It is crucial to enroll in Medicare at the right time to avoid penalties and ensure continuous coverage:
  • Initial Enrollment Period (IEP): A seven-month window starting
    three months before your 65th birthday month.
  • General Enrollment Period (GEP): From January 1 to March 31
    each year for those who missed their IEP.
  • Annual Election Period (AEP): From October 15 to December 7,
    allowing you to switch or enroll in Medicare Advantage and Part D
    plans.
  • Open Enrollment Period(OEP): From January 1 to March 31 for
    those who missed AEP and want to make certain changes.
  • Special Enrollment Period(SEP): Can be used anytime during the
    calendar year for those that meet certain criteria such as moving to a
    new service area.

Finding Help with Medicare

Understanding Medicare can be complex, but you don’t have to do it alone. Licensed Insurance Brokers, Medicare.gov, and state health assistance programs can provide guidance tailored to your specific needs.
By taking the time to explore your Medicare options, you can make informed decisions that ensure you receive the healthcare coverage that best suits your lifestyle and budget.
Do I have to sign up for Medicare?
It depends upon your current coverage. If you are employed and your employer has over 20 employees then you can delay signing up for Medicare and avoid penalties.
No, You will have to enroll in a stand alone Part D plan or a Medicare Advantage Plan(Part C) to get coverage.
There are no networks with Medicare and most doctors and hospitals accept it. However, Medicare does not cover 100% of services so a Medicare Supplement or Medicare Advantage plans is advisable.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.
Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.
Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.
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