The Medicare Learning Center

Understanding Medicare is easy once you learn some basic concepts. When you’re informed, you can make smart decisions about your healthcare and what plan is best for you. Here is some basic information to help you better understand Medicare and how it works.

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Medicare Enrollment Periods

U.S. citizens and legal residents living in the U.S. for at least five years in a row are eligible for Medicare. One of the following must also be true:

  • You are age 65 or older.
  • You are younger than 65 with a qualifying disability.
  • You are any age and have End Stage Renal Disease (ESRD)



Verify your Medicare eligibility by clicking here.


Understanding the Different Parts of Medicare

Original Medicare, or Medicare Part A and Medicare Part B, is designed to cover the basics of your health care – things like hospitals, outpatient doctor visits, tests and preventive care.

With Original Medicare, you pay a set amount for your health care, called a deductible. Then, Medicare pays its share and you pay a percentage of the cost of the service, called coinsurance.

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Part C
Medicare Part C plans are a private insurance alternative to the government program. With this option, you get all your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage through the insurance company instead of directly through the government. Medicare Advantage plans that include drug coverage can give you all your Medicare benefits in one policy; these are known as Medicare Advantage Prescription plans.

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Prescription drug coverage is not included with Medicare. If you decide not to join a Medicare Prescription Drug Plan (Part D) when you’re first eligible, or if you decide not to join a Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage, you’ll likely pay a late enrollment penalty unless you have other creditable prescription drug coverage, or you get Extra Help.

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Medicare Supplement Plans
Medicare Supplement Plans, also known as Medigap, is designed to fill “gaps” in original Medicare Parts A and B. Medicare Supplements generally cover the remaining balance left after Medicare has paid its share, depending on the level of coverage you select. To ensure more complete coverage (medical and prescription drug), it is recommended that you also enroll in a standalone Prescription Drug Plan.

While there are many different levels of Medigap plans to choose from, the benefits are standardized by state. This means that within your state, the coverage of each plan offered by one insurance company will be the same as the coverage for the same plan offered by any other insurance provider. The difference among the Medigap plans within your state lies in the details of how much coverage is offered and which gaps will be filled.

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Confused? That’s why we are here.

All of the elements of Medicare can become overwhelming. Trying to navigate through it all by yourself is a risky proposition. Luckily, the licensed professionals at Comprehensive Benefits, LLC are here to help. If the time has come to explore your options for healthcare in the Medicare environment, contact us today.