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Medicare 101: Understanding the Basics

January 09, 20234 min read

Some people don’t realize that there may be penalties for not signing up for Medicare when they’re first eligible. Most people don’t pay a late-enrollment penalty for Medicare Part A. If you delay enrollment in Medicare Part B and/or Medicare Part D, you might face penalties. Don’t worry – if you have questions we have agents in all 50 states ready to answer your questions.” - Tyler Rees, CEO of Innovative Financial Group

Medicare is a national healthcare program in the United States that provides insurance coverage for people over 65 and some younger people with disabilities or certain medical conditions. It is administered by the Centers for Medicare and Medicaid Services (CMS), a federal agency within the Department of Health and Human Services (HHS).

Medicare has four parts: Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage Plans), and Part D (Prescription Drug Coverage). Each part covers different types of medical services and treatments.

1. Part A

Part A covers inpatient hospital stays, skilled nursing facilities, hospice, and home health care services. Most people do not have to pay a premium for Part A coverage, as it is usually paid for through payroll taxes while you are working.

2. Part B

Part B covers medically necessary outpatient medical care, such as doctor’s visits, preventive care, and durable medical equipment. Part B also covers some home health care services and some preventive services. Part B is optional, and most people have to pay a monthly premium for this coverage.

3. Part C

Part C, also known as Medicare Advantage Plans, are offered by private insurance companies that are approved by Medicare. These plans provide all of the benefits covered under Original Medicare (Parts A and B) and additional benefits such as prescription drug coverage and routine vision and dental services. As a result, Medicare Advantage Plans may have lower out-of-pocket costs than Original Medicare, but they may also have more limited provider networks.

4. Part D

Part D is the prescription drug coverage part of Medicare. It helps cover the cost of prescription medications not covered under Part A, or Part B. Part D plans are offered by private insurance companies that Medicare approves. You can enroll in a stand-alone Part D plan if you have Original Medicare (Parts A and B) or a Medicare Advantage Plan (Part C) that includes prescription drug coverage.

5. Who is eligible?

To be eligible for Medicare, you must be a U.S. citizen or permanent resident 65 years or older or under 65 and have a disability or specific medical condition (such as end-stage renal disease or Lou Gehrig’s disease). You may also be eligible for Medicare if you receive Social Security Disability Insurance (SSDI) benefits for at least 24 months.

If you are eligible for Medicare, you can enroll during your Initial Enrollment Period (IEP). Your IEP includes your 65th birthday month, the three months before, and the three months after. The Medicare Annual Enrollment Period – AEP for short – is a set time each year for changing your Medicare coverage choices if you choose to. AEP runs from October 15 to December 7. New coverage choices go into effect on January 1. In addition, you can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs).

Medicare is an important healthcare program that helps millions of American seniors get the necessary care they need to live healthy lives. If you are eligible for Medicare, it is essential to understand the different parts of the program and how they can help you get the coverage you need. Don’t hesitate to contact Medicare Planning of America for more information. Our well-trained, experienced agents are ready to answer questions about your Medicare or health insurance and put together a comprehensive plan to fit your needs.

6. Medicare Planning of America

Medicare Planning of America is powered by Innovative Financial Group. It utilizes industry-leading technology to ensure that we are confidently providing our clients access to what they need. The best part is our consultation services are at no cost. We work with dozens of top-rated carriers such as:

  • Humana

  • Cigna

  • Blue Cross Blue Shield

  • Aetna

  • And more

We work with your needs and compare the medical insurance plans are available to you. Ultimately, we provide you with tailored Medicare insurance plans to your specific wants and needs. Medicare coverage is updating year over year and people need to make sure they are shopping their health plan policies annually to make sure they have the best coverage, deductible, copays, and extra benefits available.

7. Need help deciding your coverage?

Our well-trained, experienced agents are ready to answer questions about your Medicare or health insurance and put together a comprehensive plan to fit your needs. We offer three ways to get the answers you need to make informed decisions:

blog author image

Tyler Rees

Tyler Rees is the Chief Executive Officer at Innovative Financial Group (IFG), one of the fastest-growing insurance platforms in the country. Tyler is the driving force behind IFG's successful business model, delivering end-to-end solutions to agents, clients, and carriers. Under his leadership, IFG has experienced unprecedented growth in the Medicare space with over 3,500 licensed Medicare agents, providing solutions to clients in all 50 states.

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We work with the following companies as an independent broker: Aetna Inc., Cigna Healthcare, Elevance Health, Inc., Humana Inc., UnitedHealthcare®, and Wellcare Health Plans, Inc.

Innovative Financial Group represents Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that have a Medicare contract. A non-government entity powered by Innovative Financial Partners, LLC, a health insurance agency. We do not offer every plan available in your area. Currently we represent 6 carrier organizations which offer 2,352 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Extra benefits require enrollment in an MA plan and depend on whether you are eligible to enroll in an MA plan in your area. Benefits are available only in select areas.

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Home Office:

3147 S 17th Street, Suite 300

Wilmington, NC 28412

Local: 910-834-6410

Toll Free: 888-200-1777 | TTY 711

Office Hours: Monday - Friday

9 am to 5 pm, ET

Visit our Facebook Community:

Innovative & Friends

We work with the following companies as an independent broker: Aetna Inc., Cigna Healthcare, Elevance Health, Inc., Humana Inc., UnitedHealthcare®, and Wellcare Health Plans, Inc.

A non-government entity powered by Innovative Financial Partners, LLC, a health insurance agency. We do not offer every plan available in your area. Currently we represent 6 carrier organizations which offer 2,352 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

© 2024 Innovative Financial Group | All Rights Reserved | Terms & Privacy |
Washington Consumer Health Privacy Policy