YOUR LOCAL MEDICARE GUIDE
Medicare Guidance
Made Simple
Confused by Medicare choices and enrollment requirements? Benefits Connects provides personalized, local guidance to help you compare Medicare options, understand your benefits, and choose coverage that fits your health needs, prescriptions, doctors, and budget.
Medicare Supplement Plans (Medigap)
Help fill certain gaps in original Medicare.
Medicare Advantage Plans (Part C)
Comprehensive coverage with extra benefits.
Prescription Drug Plans
(Part D)
Coverage for your
medications.
Dental, Vision & Hearing Coverage
Coverage for routine care Original Medicare doesn't include.
Annual Medicare Reviews
Make sure your plan still fits your needs.
Plan Selection & Enrollment
Get expert guidance every step of the way.
understand the basics
What is Medicare?
Medicare is a federal health insurance program for people age 65 and older, certain younger individuals with disabilities, and people with End-Stage Renal Disease (ESRD) or ALS.
Original Medicare includes Part A and Part B
It is managed by the federal government. While it covers essential hospital and medical care, it does not pay for all healthcare costs—which is why many people add Medicare Supplement (Medigap), Medicare Advantage, or Part D Prescription Drug coverage.
Part A: Hospital Insurance
What it covers: Inpatient hospital care, skilled nursing facility stays, hospice care, and certain home health services.
Deductible: You must meet the Part A deductible before Medicare pays for covered inpatient care.
Premium: Most people pay $0 if they or their spouse paid Medicare taxes for at least 10 years (40 quarters).
Copays & Coinsurance: Applies to hospital stays lasting 61–90 days, inpatient mental health stays, and skilled nursing facility stays (days 21–100).
Part B: Medical Insurance
What it covers: Doctor visits, outpatient medical care, durable medical equipment (DME), outpatient therapy, and preventive services.
Premium: Monthly premium required (deducted from Social Security or paid directly; varies based on income and enrollment timing).
Deductible: An annual deductible must be met before Part B coverage kicks in.
Coinsurance & Copays: Typically, you pay 20% of the Medicare-approved amount after meeting your deductible.
Preventive Care: Most covered preventive services (like annual wellness visits) are covered at 100% with $0 copay.
Eligibility & Enrollment
Am I Eligible & When Do I Enroll?
Most people become eligible for Medicare at 65, but some qualify earlier. Knowing when your enrollment window opens helps you avoid gaps in coverage and lifelong late penalties.
Age 65 or Older
Eligibility may depend on citizenship or residency, Social Security or Railroad Retirement benefits, and your or your spouse's work history.
Before Age 65
You may qualify through disability
benefits, ALS, or End-Stage
Renal Disease. Specific eligibility
conditions apply.
Your Initial Enrollment Period
A 7-month window around your 65th birthday
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Missing your enrollment window may lead to ongoing Part B and/or Part D penalties unless an exception applies.
Eligibility fit
Explore Your Medicare Options
Most people add to Original Medicare in one of two ways. Here's how your options compare:
Medicare Advantage (Part C)
Bundles Medicare Part A and Part B into a single plan provided by private insurance companies.
Key Features: Often includes routine dental, vision, hearing, and built-in prescription drug coverage (MAPD).
Cost Structure: Requires you to continue paying your Part B premium plus any plan premium. Includes an annual Maximum Out-of-Pocket (MOOP) limit to protect you financially.
Prescription Drug Coverage (Part D)
Standalone coverage for prescription medications, designed to work alongside Original Medicare.
Key Features: Covers retail and mail-order medications divided into plan formulary tiers.
Cost Structure: Once you reach the annual out-of-pocket threshold, you pay $0 for covered Part D drugs for the rest of the calendar year.
Medicare Supplement (Medigap)
Private insurance policies designed to fill the "gaps" in Original Medicare (Part A & B).
Key Features: Helps cover deductibles, coinsurance, and copayments left over by Original Medicare.
Cost Structure: Works exclusively with Original Medicare (cannot be combined with Medicare Advantage).
Coverage Comparison Table
| Coverage Option | Premiums | Deductibles & Copays | Limits & Extras |
|---|---|---|---|
|
Medicare Advantage / Part C |
Part B + any plan premium | Plan-specific costs | Annual medical out-of-pocket limit; often extra benefits |
|
Prescription Drug Plan / Part D |
Separate plan premium | Costs vary by drug tier | $0 covered drug costs after annual threshold |
|
Medicare Supplement / Medigap |
Part B + Medigap premium | Helps cover eligible Original Medicare costs | Benefits vary by policy |
Need Help Navigating Your Options?
Don't navigate Medicare alone. Benefits Connects is here to guide you through plan comparisons, network checks, and enrollment at no cost to you.
970-800-2261
247 Mountain Ave, Berthoud, CO 80513
Testimonials
John Doe
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Jane Doe
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