Speak with a Licensed Agent

904-878-0205 (TTY: 711)

What is Medicare?

Medicare is a Federal Health Insurance Program. There are several parts of Medicare coverage:

  • Part A covers inpatient hospital services, skilled nursing, hospice and home health care.

  • Part B covers outpatient medical services, home health care, durable medical equipment and preventive services.

  • Part C (Medicare Advantage) is offered by private companies and covers services under A, B, and D

  • Part D provides prescription drug coverage

  • Medicare Supplement (Medigap): Extra insurance offered by private companies that can help pay your share of costs in Original Medicare.

What is Original Medicare?

"Original Medicare" includes Medicare Part A and Part B.

Medicare Part A

Generally, Medicare Part A covers:

  • Inpatient care in a hospital

  • Skilled nursing facility care

  • Nursing home care (does not include custodial or long-term care)

  • Hospice care

  • Home health care

Medicare Part B

Medicare Part B covers medically necessary outpatient services and preventive care.

Generally, Medicare Part B covers:

  • Outpatient medical services

  • Preventive services

  • Ambulance services

  • Durable Medical Equipment (DME)

  • Mental healthcare including inpatient, outpatient and partial hospitalization

  • Limited outpatient prescription drugs

  • Clinical research

Medicare Part D

Medicare Part D covers prescription drugs.

Each Part D plan has its own "formulary" or list of drugs that they cover. These formularies place drugs into different levels or "tiers". Drugs in each tier have different costs. In general, a drug in a lower tier will cost less.

Medicare Part C & Medicare Supplement (Medigap)

Many beneficiaries choose to enroll in a Medicare Advantage (Part C) or Medicare Supplement (also called Medigap) plan to replace their benefits provided under Original Medicare. These plans can offer lower costs, more flexibility and additional benefits not provided under Original Medicare.

What is the difference between Medicare & Medicaid?

Medicare is a federal health insurance program that is available for eligible individuals age 65 and older (or those under 65 with certain disabilities or conditions).

Medicaid is coordinated at the State level and provides health insurance coverage and other benefits for those with limited income or resources.

When can I make changes to my plan?

You can make changes to a plan during your Initial Enrollment Period (IEP).

This is when you first become eligible to enroll in Medicare, which for most people is around the time of their 65th birthday.

You can make changes to a plan during Annual Enrollment Period (AEP).

Every year, during the Annual Enrollment Period you can switch, disenroll, or join a Medicare Advantage or Prescription Drug Plan of your choice. During AEP, you can also enroll in Original Medicare (Part A and Part B). Your new coverage will begin January 1 of the following year.

You can make changes to a plan during Open Enrollment Period (OEP).

If you are enrolled in a Medicare Advantage Plan, you can make a one-time change during the Open Enrollment Period.

You can make changes to a plan during a Special Enrollment Period (SEP).

Certain events allow you to make a change to your coverage during the year. For example, if you move outside your Plan's service area or lose your employer coverage, you may be eligible for a Special Enrollment Period.

Call: 904-878-0205 (TTY: 711)

Not affiliated with the U. S. government or 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 (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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