Frequently Asked Questions
Clear answers to the most common Medicare questions — organized by topic and backed by a licensed advocate. Pick a category, then tap any question to read the answer.
What is Medicare and how does it work?
Medicare is a federal health insurance program for people 65+ or under 65 with certain disabilities. It includes Parts A, B, C, and D, each covering different services.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What are the different parts of Medicare?
Medicare includes: Part A (hospital coverage), Part B (medical coverage), Part C (Medicare Advantage), and Part D (prescription drug coverage).
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
When am I eligible for Medicare?
Most people become eligible at age 65. Some qualify earlier due to disability, ALS, or ESRD.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Do I need to enroll in Medicare if I’m still working?
It depends on your employer size and whether your coverage is creditable. Many people delay Part B penalty-free if they have large employer coverage.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is Medicare Part A?
Medicare Part A covers inpatient hospital stays, skilled nursing, hospice care, and some home health care.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is Medicare Part B?
Part B covers outpatient care, doctor visits, tests, durable medical equipment, and preventive services.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is Medicare Part C (Medicare Advantage)?
Part C bundles Parts A & B and often Part D into one plan with extra benefits like dental and vision.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is Medicare Part D?
Part D provides prescription drug coverage through private insurance companies.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is Medigap (Medicare Supplement)?
Medigap helps pay deductibles, copays, and coinsurance not covered by Original Medicare.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Do I need a Part D drug plan?
If you take medications, yes — skipping Part D may result in a permanent penalty.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover dental, vision, or hearing?
Original Medicare does not cover routine dental, vision, or hearing. Many Advantage plans include these benefits.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Difference between Medicare Advantage & Medigap?
Advantage = lower premiums, network restrictions. Medigap = higher premiums, nationwide usage, fewer out-of-pocket costs.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How do Medicare Advantage plans work?
Advantage plans replace Original Medicare and often include prescription drug coverage, dental, vision, and more.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is the Initial Enrollment Period?
The Initial Enrollment Period is a 7-month window surrounding your 65th birthday when you can first enroll in Medicare.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is the Annual Enrollment Period?
The Annual Enrollment Period (AEP) runs from October 15 to December 7 each year. During AEP, you can change Medicare Advantage or Part D plans for the upcoming year.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is Medicare Advantage Open Enrollment?
This period runs from January 1 to March 31. You can switch Medicare Advantage plans or go back to Original Medicare (with or without Part D).
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is a Special Enrollment Period?
A Special Enrollment Period (SEP) allows you to make Medicare changes outside normal enrollment periods due to life events like moving, losing employer coverage, or qualifying for Medicaid.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare have penalties?
Yes — late enrollment penalties may apply for Part B and Part D if you delay without creditable coverage. These penalties can last for life.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How much does Medicare cost?
Medicare costs vary based on income, plan type, and medication needs. Many people pay $0 for Part A but must pay a premium for Part B and sometimes Part D.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What if I can’t afford Medicare?
Programs like Medicaid, Extra Help (LIS), and Medicare Savings Programs can lower or eliminate Medicare costs. Many seniors qualify without knowing it.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover my doctor or hospital?
Medicare covers most doctors and hospitals that accept Medicare assignment. Medicare Advantage plans may have network restrictions depending on your county and ZIP code.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is a Medicare network?
A network refers to doctors, hospitals, and healthcare providers contracted with your Medicare Advantage plan. PPO plans offer more flexibility than HMO plans.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is a formulary for Part D drug plans?
A formulary is the list of medications a Part D plan covers. Drugs are organized into tiers that determine cost.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Are Medicare Advantage plans free?
Some Medicare Advantage plans have a $0 premium, but all plans still have cost-sharing such as copays, deductibles, and a maximum out-of-pocket limit.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Why do Medicare Advantage plans have different copays?
Copays vary because Advantage plans are run by private companies. Different plan structures, networks, and benefits affect costs.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Do all pharmacies charge the same price for medications?
No — preferred pharmacies typically offer lower copays, and prices can differ significantly even within the same plan.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is the Medicare Part B late enrollment penalty?
If you delay Part B without creditable coverage, your premium may increase 10% for each full year you delay — for life.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is the Part D late enrollment penalty?
If you delay enrolling in drug coverage without creditable coverage, you may pay a permanent penalty based on the number of months you delayed.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How do I avoid Medicare penalties?
Enroll on time or ensure your employer coverage is creditable. Missing deadlines is the #1 cause of lifetime penalties.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover pre-existing conditions?
Yes — Medicare covers all pre-existing conditions. Medicare Supplement (Medigap) plans may require underwriting unless you enroll during your guaranteed issue period.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Can I change Medicare plans anytime?
Some changes require specific enrollment periods, but others can be made through Special Enrollment Periods depending on your situation.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Can I have Medicare and employer insurance at the same time?
Yes — Medicare can coordinate with employer coverage depending on employer size. This may allow penalty-free delays for Part B.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How do I know if my medications are covered?
Coverage varies by plan and formulary. You must check your exact medications each year.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is Extra Help (LIS) for prescription costs?
Extra Help reduces your Part D premiums, deductibles, and medication copays — sometimes to as low as $0.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is a Dual Eligible plan (Medicare + Medicaid)?
Dual Eligible Special Needs Plans (D-SNPs) provide enhanced benefits for those who qualify for both Medicare and Medicaid.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is the Medicare Savings Program?
This program helps pay Medicare premiums and sometimes deductibles and coinsurance. Many people qualify without knowing it.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is the “Donut Hole” in Part D?
The Donut Hole is a temporary limit on what a Part D plan will cover for medications. Once you reach the limit, your cost-sharing changes until you reach catastrophic coverage.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover cancer treatment?
Yes — Medicare covers chemotherapy, radiation, surgeries, medications, and diagnostic imaging. Medicare Advantage plans may require authorizations.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover emergency care outside the U.S.?
Original Medicare does not cover most foreign travel medical emergencies, but some Medigap plans provide limited international emergency coverage.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Can I use Medicare anywhere in the country?
Original Medicare can be used nationwide with any provider that accepts Medicare. Medicare Advantage plans may restrict you to local networks depending on the plan type.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How do I get Medicare if I’m disabled?
People who receive Social Security Disability (SSDI) benefits automatically qualify for Medicare after 24 months of disability payments. Those with ALS or ESRD may qualify sooner.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover home health care?
Yes — Medicare covers skilled nursing, physical therapy, occupational therapy, and certain home health services when medically necessary and ordered by a doctor.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover nursing homes or long-term care?
Medicare does NOT cover most long-term custodial care. It does cover medically necessary skilled nursing care for a limited time after a qualifying hospital stay.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover physical therapy?
Yes — Medicare Part B covers medically necessary outpatient physical therapy. Medicare Advantage plans may require preauthorization.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How do Medicare copays and deductibles work?
Medicare has standardized deductibles and cost-sharing that change yearly. Medicare Advantage plans set their own copays but must follow Medicare regulations.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is the Medicare Out-of-Pocket Maximum?
Original Medicare has no out-of-pocket maximum. Medicare Advantage plans include an annual cap on what you pay for covered services.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Are Medicare Advantage plans required to cover everything Original Medicare covers?
Yes — Medicare Advantage must cover all services that Original Medicare covers. They may add extras like dental, vision, hearing, and more.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What does Medicare NOT cover?
Medicare does not cover routine dental, vision, or hearing; long-term care; most cosmetic surgery; routine foot care; or hearing aids (Original Medicare). Some Advantage plans cover these extras.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover routine checkups?
Medicare covers an annual wellness visit and several preventive services. Routine physicals are not fully covered under Original Medicare.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover mental health services?
Yes — Medicare covers therapy, counseling, psychiatric evaluation, and inpatient mental health services. Copays vary depending on plan type.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover chiropractic care?
Medicare covers medically necessary chiropractic adjustments for spinal subluxation under Part B. Other chiropractic services are not covered.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover emergency ambulance services?
Yes — Medicare Part B covers medically necessary ambulance transportation. Some Medicare Advantage plans may have different copays or rules.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover telehealth?
Yes — Medicare expanded telehealth coverage for doctor visits, mental health services, and more. Medicare Advantage plans may offer additional telehealth benefits.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How do I enroll in Medicare for the first time?
You can enroll through Social Security, online, by phone, or in person. Enrollment timing depends on your employment status and eligibility.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Can I enroll online without speaking to an agent?
Absolutely — you can use May River Medicare’s secure online tools to compare plans and self-enroll anytime, 24/7.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How long does Medicare enrollment take?
It typically takes 2–4 weeks for your Medicare card to arrive after signing up. Some cases may take longer depending on Social Security processing.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What documents do I need for Medicare enrollment?
You may need your Social Security number, proof of age, citizenship or residency documents, and employer coverage forms (if delaying Part B).
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Can I switch from Medicare Advantage back to Original Medicare?
Yes — you can switch during AEP or Medicare Advantage Open Enrollment. You may also need a Part D plan and possibly Medigap underwriting.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Can I switch Medicare Supplement plans?
Yes — but some changes may require medical underwriting unless you’re in a guaranteed-issue window.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How often can I change my Part D drug plan?
You can change Part D plans during AEP each year (Oct 15–Dec 7). Special Enrollment Periods may allow changes outside AEP.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover durable medical equipment (DME)?
Yes — Medicare Part B covers durable medical equipment such as wheelchairs, walkers, CPAP machines, oxygen equipment, and more when medically necessary.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover diabetes supplies?
Medicare Part B covers diabetic testing supplies, insulin pumps, and screenings. Medicare Part D covers insulin and certain medications.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover kidney dialysis?
Yes — Medicare covers dialysis treatments, kidney-related medications, and transplant care for people with ESRD (End-Stage Renal Disease).
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover vaccines?
Yes — Medicare covers all ACIP-recommended vaccines including flu, COVID-19, pneumonia, shingles, and more under Part D or Part B depending on the vaccine.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover mammograms and cancer screenings?
Yes — Medicare covers mammograms, colonoscopies, lung cancer screening, prostate exams, and more as part of preventive care.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How do Medicare referrals work?
With Original Medicare, referrals are generally not required. Medicare Advantage HMO plans often require referrals for specialists.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What happens if my doctor doesn’t accept Medicare?
If your doctor doesn’t accept Medicare assignment, you may pay more out-of-pocket. Some Medicare Advantage plans require in-network doctors only.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What happens if my Medicare Advantage plan changes?
Plans may change premiums, copays, drug formularies, and provider networks each year. AEP (Oct 15–Dec 7) lets you switch if needed.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Are Medicare Advantage benefits guaranteed every year?
No — Advantage plans can change benefits, networks, and drug lists annually. Always review your Annual Notice of Change (ANOC).
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How do provider networks work with Medicare Advantage?
Networks determine which doctors and hospitals you can use. HMO = must use in-network; PPO = more flexibility.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What happens if my prescriptions change during the year?
Costs can change if the medication isn’t in your plan’s formulary or its tier differs. Some exceptions and appeals may apply.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Why do drug plans have different tiers and copays?
Medications are grouped into tiers — generics cost less, brand names cost more. Plans negotiate different prices with manufacturers.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What pharmacies are preferred in Part D plans?
Preferred pharmacies have lower copays and better pricing. Each plan has its own preferred pharmacy list.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How does May River Medicare help compare plans?
We provide unbiased comparisons of Medicare Advantage, Medigap, and Part D plans based on your county, ZIP code, doctors, medications, and budget.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How does the May River Medicare quote tool work?
Our technology delivers instant Medicare quotes from all major carriers in your county and ZIP code — from lowest to highest pricing.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Why do you need my ZIP code for accurate quotes?
Medicare plan pricing is based on location — county and ZIP code determine premiums, networks, and available plans.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How do I book an appointment with a licensed Medicare agent?
Booking is easy — use our online scheduling calendar to choose a time that works for you.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Do you have a mobile app for Medicare quotes?
Yes — the May River Medicare app delivers instant quotes, plan comparisons, and doctor/pharmacy lookup tools for all 50 states.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Can I enroll online through your website?
Yes — May River Medicare provides a secure online enrollment platform where you can compare and enroll in Medicare plans 24/7.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
How do I start the Preliminary E-Application?
You can start your Medicare enrollment online through our secure, guided E-Application process. It walks you through every step and submits your information safely.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What’s the difference between Medicare and Medicaid?
Medicare is a federal program based mainly on age or disability, while Medicaid is a state-run program based on income and resources. Some people qualify for both — called dual eligibility — and can receive extra help with their costs.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Can I keep my own doctor?
With Original Medicare plus a Medigap plan, you can see any provider nationwide that accepts Medicare — there are no networks. With a Medicare Advantage plan it depends on the plan’s network, so it’s worth checking that your doctors are included.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is IRMAA?
IRMAA stands for the Income-Related Monthly Adjustment Amount. Higher-income beneficiaries pay an extra amount on top of their Part B and Part D premiums, based on their tax return from two years prior.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does my income affect my Medicare costs?
It can. Higher earners may pay more for Part B and Part D through IRMAA, while people with limited income and resources may qualify for programs that lower or even eliminate their costs.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover hearing aids?
Original Medicare does not cover hearing aids or the exams to fit them. Many Medicare Advantage plans include a hearing benefit that helps with both.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover eyeglasses?
Original Medicare generally doesn’t cover routine eye exams or glasses, with a limited exception for corrective lenses after cataract surgery. Many Medicare Advantage plans add a vision benefit.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does Medicare cover routine foot care?
Routine foot care is generally not covered, but Medicare does cover medically necessary foot care — for example, for people with diabetes or certain conditions affecting the feet.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Can I have both a Medigap plan and a Medicare Advantage plan?
No. Medigap and Medicare Advantage can’t be used together — you choose one path or the other. A Medigap plan only works alongside Original Medicare.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What is a Special Needs Plan (SNP)?
A Special Needs Plan is a type of Medicare Advantage plan built for people with specific needs — such as certain chronic conditions, those living in an institution, or those who qualify for both Medicare and Medicaid.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
What happens if I miss my Initial Enrollment Period?
If you miss it, you may be able to sign up during the General Enrollment Period, but you could face a lasting late-enrollment penalty. Certain life situations may instead qualify you for a Special Enrollment Period.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Do I have to take Medicare at 65 if I have employer coverage?
If you have creditable coverage through a large employer, you may be able to delay Part B without penalty. With a smaller employer it’s usually best to enroll on time. It’s worth confirming your exact situation before deciding.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Does it cost anything to work with May River Medicare?
No. Our guidance, plan comparisons, and enrollment help are provided at no cost to you. We’re here to help you find the right coverage — not to add a fee.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Is May River Medicare licensed in my state?
May River Medicare is an independent agency licensed across many states nationwide. Reach out and we’ll confirm the plans and carriers available in your specific area.
Want guidance for your own situation? We’re here to help — free.
Prefer to talk now? Call (843) 227-6725
Medicare tools & quick guides
Interactive helpers for the questions people ask most — enrollment periods, Medicare Advantage vs. Supplement, Medigap plans, what Medicare covers, Part D drug rules, and savings programs. Tap through any tool, then talk with a licensed advocate when you’re ready.
Prefer to talk now? Call (843) 227-6725
Which enrollment window is mine?
Pick your situation to see the period that applies and its timing.
Initial Enrollment Period (IEP). A 7-month window — the 3 months before your birthday month, your birthday month, and the 3 months after. Signing up early helps your coverage start on time and avoids penalties.
Special Enrollment Period (SEP). When job-based coverage ends, you generally get an 8-month window to enroll in Part B with no late penalty. Part D has its own shorter window, so don’t wait to add drug coverage.
Special Enrollment Period (SEP). Moving out of your plan’s service area opens a window to pick a new Medicare Advantage or Part D plan. The exact timing depends on when you tell your plan about the move.
General Enrollment Period (GEP), Jan 1 – Mar 31. You can still enroll in Part A and Part B, and coverage starts the month after you sign up. A late-enrollment penalty may apply, so it’s worth reviewing your options.
Annual Enrollment Period (AEP), Oct 15 – Dec 7 to change Advantage or Part D for January 1. Medicare Advantage Open Enrollment, Jan 1 – Mar 31 lets current Advantage members switch once or return to Original Medicare.
Special Enrollment Period (SEP). Qualifying for Medicaid or Extra Help opens a window (often each quarter) to change plans. A Dual-Eligible plan (D-SNP) may combine both programs with added benefits.
Which Medicare path fits me?
Tell us what matters most and we’ll point you toward the likely fit.
Original Medicare + a Medigap (Supplement) plan + Part D. You can use any provider nationwide that accepts Medicare, with no networks and no referrals. Great for travelers and anyone who wants maximum freedom.
A Medicare Advantage plan often has a low or $0 monthly premium. The trade-off is a network of doctors and copays as you use care, up to a yearly out-of-pocket maximum.
A Medicare Advantage plan bundles hospital, medical, and usually drug coverage into one plan — often with extras like dental, vision, and hearing that Original Medicare doesn’t include.
Original Medicare + Medigap gives the steadiest costs: you pay a set premium and most gaps are covered, so surprise medical bills are rare. Pair it with a Part D plan for your prescriptions.
The right fit depends on your doctors, your medications, and your budget — we compare both approaches for you, free.
Advantage vs. Medigap guide →Medigap plans at a glance
Tap a plan to see what it covers. Lettered plans are standardized, so the same letter covers the same core benefits across carriers.
The most comprehensive plan for people new to Medicare. After you pay the annual Part B deductible, Plan G covers nearly every gap — hospital and Part B coinsurance, the Part A deductible, skilled-nursing coinsurance, Part B excess charges, and limited foreign-travel emergency care. Plan G details →
Lower premium than Plan G. Covers most gaps, but you pay small copays for some office and ER visits, and it does not cover Part B excess charges. A popular balance of savings and coverage. Plan N details →
Same broad coverage as Plan G, but you pay a set yearly deductible first. In exchange the monthly premium is much lower — a fit if you want strong coverage at the lowest premium. High-Deductible G details →
Cost-sharing plans. They cover a set percentage of the gaps (roughly 50% for K, 75% for L) with an annual out-of-pocket limit, which keeps premiums lower than full-coverage plans. Plan K → Plan L →
More basic coverage. Plan A covers the core benefits every Medigap plan must include; Plan B adds coverage of the Part A hospital deductible. Plan A → Plan B →
Fuller coverage that also pays the Part B deductible — but these are only available if you were eligible for Medicare before January 1, 2020. Plan C → Plan F →
Does Medicare cover it?
Tap a category for a quick covered / not-covered answer.
✓ Covered. Part A covers inpatient hospital care, short-term skilled-nursing care, and hospice.
✓ Covered. Part B covers doctor visits, outpatient care, lab tests, preventive services, and durable medical equipment.
✓ Covered through Part D (or a Medicare Advantage plan that includes drugs). Original Medicare alone does not cover most retail prescriptions.
✕ Not covered by Original Medicare. Many Medicare Advantage plans add routine dental, vision, and hearing benefits.
⚠ Mostly not covered. Medicare pays for short-term skilled care after a qualifying stay, but not ongoing custodial or nursing-home care.
⚠ Generally not covered by Original Medicare. Some Medigap plans add limited foreign-travel emergency coverage.
✓ Covered. An annual wellness visit plus many screenings and vaccines are covered, often at no cost to you.
✕ Not covered by Original Medicare. Some Medicare Advantage plans include a hearing-aid benefit.
Could I lower my Medicare costs?
Pick what best describes you to see which help may apply.
Medicaid + Medicare (dual eligible). You may qualify for both programs. A Dual-Eligible plan (D-SNP) can combine them and add extra benefits at little or no cost.
Medicare Savings Programs (QMB, SLMB, QI). Based on income and resources, these can pay some or all of your Part B premium and other Medicare costs.
Extra Help (Low-Income Subsidy). This lowers Part D premiums, deductibles, and drug copays — sometimes all the way to $0.
Many people qualify without realizing it. A quick look at your income and resources shows which savings programs you may be eligible for — we can walk through it with you.
How do Medicare penalties work?
Late penalties are avoidable. Here’s how each one works.
Part B late penalty. If you delay Part B without other creditable coverage, your premium can rise by 10% for each full 12-month period you could have had it — and it generally lasts the whole time you have Part B.
Part D late penalty. Go 63 days or more without creditable drug coverage and a permanent amount is added to your Part D premium, based on how many months you went uncovered.
Stay on time or stay covered. Enroll during your Initial Enrollment Period, or keep creditable coverage (like a large-employer plan) and enroll during a Special Enrollment Period when it ends. Keep proof of prior coverage.
Medicare Advantage vs. Supplement
Two ways to fill the gaps in Original Medicare. Here’s how they stack up.
What matters most to you?
Medicare Advantage usually wins on monthly premium — often $0 — with costs shared as you use care.
Original Medicare + Supplement lets you see any Medicare provider nationwide, with no networks.
Medicare Advantage commonly adds dental, vision, and hearing in one plan.
Original Medicare + Supplement gives the most predictable costs after your premium.
You can’t use both at once — a Supplement works only with Original Medicare. We’ll help you choose.
Full Advantage vs. Supplement guide →The four parts of Medicare
A quick reference to what each part does.
Hospital
Inpatient hospital stays, short-term skilled-nursing care, hospice, and some home health. Most people pay $0 premium because of prior work history.
Part A details →Part BMedical
Doctor visits, outpatient care, lab tests, preventive services, and durable medical equipment. Comes with a monthly premium.
Part B details →Part CAdvantage
A private all-in-one alternative to A and B — usually including Part D drug coverage plus extras like dental and vision.
Part C details →Part DDrugs
Prescription drug coverage through private plans. Going without creditable coverage can trigger a lasting late penalty.
Part D details →Estimate it in seconds
Fixed-by-law penalty math runs right here. For live dollar figures, each result links to the full calculator.
Part B late-penalty calculator
The penalty is set by law: +10% for each full year you could have had Part B but didn’t. Pick how long you delayed.
added to your Part B premium — and it keeps growing the longer you wait.
See the dollar impact →Part D late-penalty calculator
The penalty is about 1% of the national base drug premium for each month you went without creditable drug coverage. Pick roughly how long.
of the national base drug premium, added to your Part D premium each month.
Get today’s dollar amount →of the national base drug premium, added to your Part D premium each month.
Get today’s dollar amount →of the national base drug premium, added each month — for as long as you have Part D.
Get today’s dollar amount →of the national base drug premium, added each month — for as long as you have Part D.
Get today’s dollar amount →IRMAA: does a surcharge apply to me?
Higher incomes pay an extra amount (IRMAA) on top of Part B and Part D, set by income tier from your tax return two years back.
Most people pay the standard Part B and Part D premiums with no surcharge.
Check your exact surcharge →IRMAA is added to both your Part B and Part D premiums. The amount steps up by income tier.
Check your exact surcharge →IRMAA looks at your income from two years ago. If you’re a higher earner it may apply — the calculator shows your exact tier.
Check your exact surcharge →Cost & savings calculator
For a full estimate — monthly costs, Medigap vs. Advantage, and savings-program eligibility — open the complete calculator, updated for the current year.
Still have a question? Let’s answer it together.
Every situation is a little different. Talk with a licensed May River Medicare advocate and get straight, unbiased answers — free, with no pressure.
