Medicare 101 — Understanding the Basics
Medicare can seem complicated at first, but it doesn’t have to be. My goal is to help you understand how it works, who’s eligible, and what each part covers—so you can make confident, informed choices about your healthcare and retirement.
What Is Medicare?
Medicare is a federal health insurance program for people age 65 and older, and for certain younger individuals with disabilities. It helps cover hospital stays, doctor visits, and prescription drugs, depending on the parts you choose.
The Four Parts of Medicare
I like to break Medicare into four simple parts. Once you see what each one does, the system starts to make sense:
- Part A (Hospital Insurance): Covers inpatient hospital care, skilled nursing facility care, and some home health and hospice services. Most people pay no premium for Part A.
- Part B (Medical Insurance): Covers doctor visits, outpatient services, lab work, preventive care, and durable medical equipment. There’s a monthly premium and potential late-enrollment penalties if you delay without credible coverage.
- Part C (Medicare Advantage): Private plans that combine Parts A and B (and often Part D). They usually include extra benefits like dental, vision, or hearing, and have different provider networks and copays.
- Part D (Prescription Drug Coverage): Helps pay for prescription medications. You can get Part D as a standalone plan or as part of a Medicare Advantage plan.
Who Qualifies for Medicare?
Most people qualify when they turn 65 and are U.S. citizens or permanent residents who’ve worked at least 10 years (40 quarters). Some people under 65 also qualify if they’ve been receiving Social Security Disability benefits for 24 months or have certain conditions like ALS or End-Stage Renal Disease.
When to Enroll
For most, the best time to enroll is during the Initial Enrollment Period (IEP)—a seven-month window that starts three months before the month you turn 65, includes your birthday month, and ends three months after. Enrolling on time helps avoid penalties and gaps in coverage.
Your Options: Original Medicare vs. Medicare Advantage
You can choose how you receive your Medicare benefits. Here’s how I explain the two main paths:
- Original Medicare (Parts A and B): You can visit any doctor or hospital that accepts Medicare. Most people add a Part D drug plan and may also buy a Medicare Supplement (Medigap) policy for extra coverage.
- Medicare Advantage (Part C): An all-in-one alternative that includes hospital, medical, and usually drug coverage. Many plans also include dental, vision, hearing, or fitness benefits—but you’ll use a plan’s network of providers.
How I Help You Navigate Medicare
My role is to make this process as clear and comfortable as possible. I’ll help you understand your options, compare reputable carriers, and find a plan that fits your doctors, prescriptions, and budget. No pressure, no jargon—just straightforward guidance from someone who cares about getting it right.
Ready to Learn More?
Understanding Medicare is the first step toward choosing the right plan. Let’s schedule a free consultation and go over your coverage options together.
Licensed in 48 states and based in Pittsburgh, Pennsylvania.
