Medicare Supplement (Medigap) plans are designed to help pay costs after Original Medicare (Parts A and B) pays its share. These plans are offered in standardized options labeled A through N. Each plan has a monthly premium, and prescription drug coverage must be purchased separately through a Part D plan. Because Medigap plans are standardized, each plan option (A-N) provides the same medical benefits regardless of the insurance company offering it.

Medicare Advantage plans (Part C) are “bundled” plans. These plans often have low or $0 monthly premiums. With an Advantage plan, Medicare is not billed directly; instead, the insurance company administers and pays the claims after required copayments or coinsurance. Many Medicare Advantage plans also include additional benefits not covered by Original Medicare, such as dental, vision, hearing, over-the-counter allowances, gym memberships, and more.

Neither option is inherently better than the other. The goal is to determine which plan structure best fits your healthcare needs, budget, and preferences.

Most people become eligible for Medicare when they turn 65. You can enroll during your Initial Enrollment Period (IEP), which lasts seven months:

• Three months before the month you turn 65
• The month you turn 65
• Three months after the month you turn 65

There are also Special Enrollment Periods (SEPs) that allow enrollment outside the IEP, such as when you are covered under employer-sponsored group insurance.

Individuals with certain disabilities may qualify for Medicare before age 65. Additionally, some people choose to delay Medicare enrollment past age 65 if they are still working and have creditable employer coverage. Late enrollment penalties may apply in certain situations, so it’s important to consult with a licensed professional to avoid unnecessary costs.

In most cases, yes. If you do not have other creditable prescription drug coverage (such as employer coverage), Medicare requires enrollment in a Part D prescription drug plan. Choosing not to enroll when first eligible can result in a Late Enrollment Penalty (LEP).

The penalty is calculated as 1% per month for each month you went without creditable drug coverage and continues for as long as you have a Part D plan. The penalty is assessed when you eventually enroll. Because this calculation can be confusing, we are happy to explain how it may apply to your specific situation.

It depends on the plan type.

Not all providers accept Medicare. Once enrolled in any Medicare plan, your provider must accept Medicare-approved rates. With Medicare Advantage plans, your doctor must typically be in the plan’s network. This is similar to employer or individual health insurance.

Some plan types, such as PPO or PFFS plans, may allow out-of-network visits, while others, such as HMOs, generally do not. We recommend verifying provider participation before enrolling in any plan.

Most individuals qualify for premium-free Part A by working at least 40 quarters (approximately 10 years) and paying Medicare taxes, or by being married to someone who has.

Medicare Part B has a monthly premium that can change each year. As of 2026, the standard Part B premium is $202.90 per month. Individuals with higher incomes may pay more due to IRMAA (Income-Related Monthly Adjustment Amount). IRMAA thresholds and amounts are adjusted annually.

We are happy to review your income level and explain how IRMAA may apply to you.

At Insurance Advisors, we work with all major Medicare insurance carriers, as well as many local and regional providers. Plan availability can vary by ZIP code, so we recommend contacting us to review the options available in your specific area.

Medicare does not offer a single “best” plan for everyone. Our role is to educate you so you can make an informed decision that aligns with your healthcare needs and financial goals.

Medicare can be complex, and understanding the differences between Original Medicare, Medicare Supplements, Medicare Advantage plans, and prescription drug coverage can feel overwhelming. With over 20 years of experience, we provide guidance at no cost to you. Your plan premium is never higher because you work with an agent.

Our goal is to simplify the process, answer your questions, and ensure you feel confident in your Medicare choices.