Medicare Resources

Your guide to understanding Medicare—get the answers you need, when you need them.

Knowledge at Your Fingertips

At Heritage Health & Wealth, we know Medicare can be confusing. That’s why we’ve put together these frequently asked questions to help you make informed decisions—whether you’re just starting out or fine-tuning your coverage.

Frequently Asked Questions

Got questions? We’ve got answers. Here are some of the most common Medicare topics we hear about:

What is Medicare and what are its main parts?

Medicare is a federal health insurance program primarily for people aged 65 or older, as well as certain younger individuals with disabilities or specific medical conditions like End-Stage Renal Disease. It consists of several parts: Part A (hospital insurance) covers inpatient hospital stays, skilled nursing facility care, hospice, and some home
health care. Part B (medical insurance) covers outpatient care, doctor visits, preventive services, lab tests, and durable medical equipment. Part C, also known as Medicare Advantage, is an alternative offered by private insurers that bundles Parts A and B, often including additional benefits like prescription drugs. Part D provides prescription drug coverage through private plans.

Who is eligible for Medicare?

Most people become eligible at age 65 if they or their spouse worked and paid Medicare taxes for at least 10 years. Younger individuals may qualify if they have received Social Security disability benefits for 24 months, or if they have End-Stage Renal Disease requiring dialysis or a transplant. Eligibility also extends to those with certain conditions like ALS (Lou Gehrig’s disease), where coverage begins immediately upon receiving disability benefits.

When and how do I enroll in Medicare?

Your Initial Enrollment Period (IEP) is a seven-month window starting three months before your 65th birthday month, including the birthday month, and ending three months after. Many people are automatically enrolled if they’re already receiving Social Security benefits; otherwise, you can apply online through the Social Security Administration (SSA) website, by phone, or in person. The application typically takes 10-20 minutes, and you may receive your Medicare card within three weeks. If you’re still working with employer coverage, you may delay enrollment without penalty.

What does Medicare cover?

Original Medicare (Parts A and B) covers hospital inpatient care, skilled nursing, hospice, home health, doctor visits, outpatient services, preventive care like screenings and vaccines, lab tests, and durable medical equipment. Medicare Advantage plans cover all of Original Medicare plus often extras like prescription drugs. Part D specifically covers self-administered prescription drugs.

What's the difference between Original Medicare and Medicare Advantage?

Original Medicare (Parts A and B) is government-administered, allows you to see any provider accepting Medicare nationwide, but has no out-of-pocket maximum and requires separate Part D for drugs. Medicare Advantage (Part C) is through private insurers, often includes Part D and extras like dental/vision, has an annual out-of-pocket limit, but may restrict you to a network of providers (e.g., HMO vs. PPO). You can’t have both a Medicare Supplement (Medigap) and Advantage plan.

What is a Medicare Supplement (Medigap) plan?

Medigap policies, sold by private insurers, help cover Original Medicare’s out-of-pocket costs like deductibles, copays, and coinsurance. They are standardized (labeled A-N) and allow freedom to see any Medicare-accepting provider, but don’t include prescription drugs—you need separate Part D. Best to enroll during your six month Medigap open enrollment period after turning 65 and enrolling in Part B to avoid medical underwriting.

How do I get prescription drug coverage?

Enroll in a stand-alone Part D plan with Original Medicare, or choose a Medicare Advantage plan that includes drug coverage (MAPD). Plans vary in premiums, deductibles, and covered drugs—check the formulary. Delaying without creditable coverage incurs a permanent penalty.

Can I get financial help with Medicare costs?

Yes, programs like Extra Help (for Part D drugs), Medicare Savings Programs (to cover premiums/deductibles), and Medicaid assist low-income individuals. Eligibility varies by income and assets; dual-eligible individuals (Medicare and Medicaid) may qualify for special plans. Some Medicare Advantage plans offer a Part B premium giveback benefit, reducing your monthly cost.

Medicare Basics

New to Medicare? Start here with our simple guides:

Understanding Parts A, B, C, and D

What they cover and how they work together.

Key Deadlines You Can’t Miss

Stay on top of enrollment periods to avoid penalties.

Glossary of Medicare Terms

A handy reference for common Medicare language.

Latest Updates

5 Costly Medicare Mistakes & How to Avoid Them

Medicare is a critical part of your healthcare coverage, but making the wrong choice can lead to unnecessary costs. Here are five common Medicare mistakes and how you can avoid them. Avoid costly mistakes by speaking with a trusted Medicare expert.

Medicare Advantage vs. Medigap

When choosing Medicare coverage, many people face a common question: Should I go with Medicare Advantage or Medigap (Medicare Supplement)? Both options help cover healthcare costs, but they work differently. Let’s break it down to help you decide.

Ready to Find the Perfect Medicare Plan?

Don’t navigate Medicare alone—our licensed advisors are here to help at no cost to you. Get expert guidance, compare plans, and enroll with confidence.

Disclaimer: This is a solicitation for insurance. By submitting information or contacting us via this website or listed phone numbers, you will be connected with a licensed insurance Agent/Broker from Heritage Health & Wealth, LLC.

We do not offer every plan available 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.

This is a private website and is not affiliated with, endorsed by, or sponsored by the Centers for Medicare & Medicaid Services (CMS), the federal Medicare program, the U.S. Government, or any government agency. We are a privately owned and operated insurance agency/brokerage.

The information on this website is for educational purposes only and is not medical, financial, insurance, or legal advice. Benefits, costs, and availability vary. Always verify details with Medicare.gov or a licensed advisor.