Understanding Medicare & Your Healthcare Options

Medicare is a federal health insurance program designed primarily for individuals 65 and older, as well as some younger individuals with disabilities or certain medical conditions. At

Kirby Senior Health Agency, we help you understand the different parts of Medicare so you can make the best choice for your healthcare needs.

Part A – Hospital

  • Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care

  • Usually premium-free if you or your spouse worked and paid Medicare taxes for at least 10 years

  • You may be responsible for a deductible and coinsurance for hospital stays

Part B – Medical

  • Covers doctor visits, outpatient care, preventive services, and medical supplies

  • Requires a monthly premium.

  • Has an annual deductible and covers 80% of approved medical services after it is met

Part C – Medicare Advantage

  • Offered by private insurance companies approved by Medicare

  • Combines Parts A & B coverage into one plan

  • Often includes extra benefits like dental, vision, hearing, and prescription drug coverage

Part D – Prescription Drug Plans

  • Helps cover the cost of prescription medications

  • Plans have formularies (lists of covered drugs) that vary by plan

  • Monthly premiums, copayments, and deductibles may apply

When can you enroll in Medicare?

Initial Enrollment Period (IEP)

  • Starts 3 months before you turn 65 and lasts 3 months after your 65th birthday month

  • Best time to sign up to avoid penalties

Special Enrollment Periods (SEPs)

  • Available if you experience a loss of coverage or other qualifying life event

Medicare Annual Election Period (AEP)

  • October 15 - December 7

  • Time to change your Medicare Advantage or Part D plan for the next year

  • You may swap from Original Medicare to Medicare Advantage or from Medicare Advantage to Original Medicare

Your Medicare enrollment period depends on your age, work history, and special circumstances.