Medicare Resources and Information

Helpful tools, guides, and answers to your Medicare questions.

Frequently Asked Medicare Questions

What is Medicare?

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).

What are the different parts of Medicare?

• Medicare Part A (Hospital Insurance) helps cover inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

• Medicare Part B (Medical Insurance) helps cover doctor services, outpatient care, medical supplies, and preventive services.

• Medicare Part C (Medicare Advantage) is an alternative to Original Medicare offered by private insurance companies that contract with Medicare. These plans include Part A, Part B, and usually Part D coverage.

• Medicare Part D (Prescription Drug Coverage) helps cover the cost of prescription medications.

When can I enroll in Medicare?

Most people become eligible for Medicare when they turn 65. Your Initial Enrollment Period is a 7-month period that includes the 3 months before the month you turn 65, the month you turn 65, and the 3 months after the month you turn 65. If you're under 65 and have a disability, you automatically get Part A and Part B after you get Social Security disability benefits for 24 months.

What is the difference between Medicare Advantage and Original Medicare?

Original Medicare is provided directly through the federal government and includes Part A and Part B coverage. You can see any doctor that accepts Medicare.

Medicare Advantage plans are offered by private insurance companies approved by Medicare. These plans must cover all services that Original Medicare covers and often include additional benefits like prescription drug coverage, dental, vision, and hearing. Medicare Advantage plans typically have networks of doctors and hospitals.

What is Medigap, and do I need it?

Medigap, or Medicare Supplement Insurance, helps pay some of the healthcare costs that Original Medicare doesn't cover, such as copayments, coinsurance, and deductibles. Whether you need a Medigap policy depends on your healthcare needs, budget, and preference for predictable out-of-pocket costs.

How do I choose between Original Medicare with a Medigap policy and a Medicare Advantage plan?

This decision depends on your individual healthcare needs, preferences, and budget. Consider factors like:

•Whether your doctors accept Medicare or are in a plan's network

•Your need for prescription drug coverage

•Your desire for additional benefits like dental, vision, or hearing

•Your preference for predictable costs vs. potentially lower premiums

•Your travel habits and need for coverage away from home

Our licensed value-added consultants can help you compare these options based on your specific situation.

Medicare Terminology Glossary

Annual Enrollment Period (AEP)

The period from October 15 to December 7 each year when you can join, switch, or drop a Medicare Advantage or Medicare prescription drug plan. Coverage begins on January 1 of the following year.

Benefit Period

For Medicare Part A, a benefit period begins the day you're admitted to a hospital or skilled nursing facility and ends when you haven't received any inpatient care for 60 consecutive days.

Coinsurance

The percentage of costs you pay for a covered healthcare service after you've paid your deductible.

Copayment

A fixed amount you pay for a covered healthcare service, usually when you receive the service.

Creditable Coverage

Prescription drug coverage that's expected to pay, on average, at least as much as Medicare's standard prescription drug coverage.

Deductible

The amount you must pay for healthcare services or prescriptions before your insurance begins to pay.

Formulary

A list of prescription drugs covered by a Medicare Part D or Medicare Advantage plan that includes drug coverage.

Guaranteed Issue Rights

Rights you have in certain situations when insurance companies must offer you certain Medigap policies without charging more for pre-existing conditions.

Initial Enrollment Period (IEP)

The 7-month period when you can first sign up for Medicare, including the 3 months before, the month of, and the 3 months after your 65th birthday.

Late Enrollment Penalty

An amount added to your monthly premium if you don't join a Medicare plan when you're first eligible.

Medigap Open Enrollment Period

A 6-month period that begins the first month you have Medicare Part B and are 65 or older, during which you can buy any Medigap policy at the best available rate.

Network

The facilities, providers, and suppliers your health insurer has contracted with to provide healthcare services.

Out-of-Pocket Maximum

The most you'll have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits.

Premium

The periodic payment you make to Medicare, an insurance company, or a healthcare plan for health or prescription drug coverage.

Prior Authorization

Approval required from a health plan before you receive a service or fill a prescription for it to be covered.

Service Area

A geographic area where a health plan accepts members and where the plan provides services.

Special Enrollment Period (SEP)

A time outside the regular enrollment periods when you can sign up for Medicare or make changes to your coverage due to certain life events.

Step Therapy

A requirement that you try a certain, less expensive drug before the plan will cover another drug that may cost more.

Helpful Medicare Links

Official Medicare Resources

•Medicare.gov - The official U.S. government site for Medicare

•Social Security Administration - For Medicare enrollment and premium information

•Medicare & You Handbook - The official Medicare handbook

Additional Resources

•State Health Insurance Assistance Program (SHIP) - Free counseling and assistance for Medicare beneficiaries

•Medicare Rights Center - Consumer service organization that helps people with Medicare

•National Council on Aging - Resources for older adults, including Medicare information

•Benefits CheckUp - Find benefit programs that can help pay for medications and other healthcare costs

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Required Disclaimers

This is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, and/or copayments/co-insurance may change on January 1 of each year. Medicare has neither reviewed nor endorsed this information.

C & K Healthcare Advisors is not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

By contacting us, you may be speaking with a licensed insurance agent who may sell Medicare plans on behalf of contracted insurance companies. This Website serves as an educational invitation for you, the customer, to inquire about further information regarding your health insurance options, and submission of your contact information constitutes as permission for a Licensed Insurance Representative to contact you with further information, including complete details on cost and coverage of this insurance. Contact will be made by a licensed insurance agent/producer or insurance company. This is a solicitation for Insurance .C & K Healthcare Advisors, LLC and their agents are licensed and certified representatives of a Health and Life Insurance organization. Enrollment in any plan depends on contract renewal.

Nothing on this website should ever be used as a substitute for professional medical advice.