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Health Insurance & Medicare

Medicare doesn't have to be overwhelming.

Here's what I help with, how each plan type works, and how to figure out what's right for your situation.

How Medicare works, the short version

Medicare has multiple parts. Part A covers hospital stays. Part B covers doctor visits and outpatient care. Part C (Medicare Advantage) bundles A and B through a private insurer, often with extras. Part D covers prescription drugs. Medicare Supplement (Medigap) fills the gaps that Original Medicare doesn't cover.

Medicare Advantage (Part C)

What it is

An alternative to Original Medicare offered through private insurers like Aetna, Humana, and United Healthcare. Bundles Part A and Part B, usually includes Part D, and often adds dental, vision, hearing, and wellness benefits.

Who it's for

Seniors who want an all-in-one plan with extra benefits beyond what Original Medicare covers. People who prefer a single plan managing everything.

Key things to know

Network restrictions apply (HMO, HMO-POS, PPO, PFFS). May have lower premiums but copays and deductibles apply. Plans change every year, so what's best this year might not be best next year. This is where annual reviews matter.

Prescription Drug Plans (Part D)

What it is

Standalone prescription drug coverage. Covers the cost of medications with a formulary (list of covered drugs) that varies by plan.

Who it's for

Anyone on Original Medicare who doesn't have drug coverage through a Medicare Advantage plan. Also important for anyone taking regular medications.

Key things to know

Formularies differ between plans. The cheapest plan isn't always the best if it doesn't cover your specific medications. Late enrollment penalties apply if you go without creditable drug coverage.

Special-Needs Plans (SNP)

What it is

A type of Medicare Advantage plan designed for people with specific diseases, conditions, or characteristics. Tailored benefits and provider networks.

Who it's for

People with chronic conditions (diabetes, heart failure, etc.), those who are dual-eligible for Medicare and Medicaid, or those in certain institutional settings.

Key things to know

Not everyone qualifies. Must meet specific criteria. Benefits are designed around the specific condition or situation.

Medicare Supplement (Medigap)

What it is

A secondary policy that covers costs Original Medicare doesn't: deductibles, copayments, coinsurance, and sometimes foreign travel emergency care. Standardized plans labeled A through N.

Who it's for

People who want the freedom of Original Medicare (any doctor that accepts Medicare, no network) with financial predictability. People who travel frequently or see specialists often.

Key things to know

The best time to enroll is during your 6-month Medigap Initial Enrollment Period (IEP), which starts when you turn 65 and enroll in Part B. During this window it's guaranteed issue, no health questions. Outside this window, you can be denied or charged more based on health.

Hospital Indemnity Insurance

What it is

Supplemental coverage that pays a fixed cash benefit directly to you when you're hospitalized. Not a replacement for health insurance, it's an additional financial cushion.

Who it's for

People on Medicare Advantage plans that have hospital copays. Anyone who wants extra protection against the financial impact of a hospital stay.

Key things to know

Pays regardless of what other insurance covers. Can be used for anything: bills, rent, groceries, lost income during recovery.

Standalone Dental and Vision Plans

What it is

Individual dental and vision insurance plans available separately from your medical coverage. These plans cover routine checkups, cleanings, exams, and more.

Who it's for

Anyone who doesn't have dental or vision coverage through their current plan. Especially common for Medicare beneficiaries whose plan doesn't include these benefits.

Key things to know

Coverage and costs vary by plan. Some plans focus on preventive care while others cover major procedures. I help you compare options so you get the coverage you actually need.

What I don't offer (and why it matters)

Knowing what falls outside my scope saves you time and helps you find the right resource faster.

ACA Marketplace Plans

I do not sell Affordable Care Act marketplace plans (Obamacare). If you're under 65 and need individual health coverage, healthcare.gov is your starting point. My health focus is Medicare and Medicare-adjacent supplemental products.

Short-Term Medical Insurance

These are temporary gap plans and I do not offer them. They typically exclude pre-existing conditions and have limited coverage.

Group Health Insurance

Employer-sponsored group health is handled through your employer's HR department or a group benefits broker. I work with individuals directly.

Enrollment timing matters

Medicare has specific windows. Missing them can mean penalties or gaps in coverage.

Annual Enrollment Period (AEP)

October 15 - December 7

This is when you can switch Medicare Advantage plans, change prescription drug plans, or drop Advantage and return to Original Medicare. If you already have Medicare, this is your annual window to make changes.

Open Enrollment Period (OEP)

January 1 - March 31

If you enrolled in a Medicare Advantage plan during AEP and are unhappy with your choice, this is your one-time opportunity to switch to a different Medicare Advantage plan or return to Original Medicare with a standalone Part D plan. You can only make one change during this window.

Medicare Supplement Initial Enrollment Period (IEP)

6 months starting at age 65 + Part B enrollment

This is your one guaranteed-issue window for Medigap. No health questions, can't be denied. Miss it and you may face medical underwriting.

Initial Enrollment Period (IEP)

3 months before your 65th birthday through 3 months after

This is when you first enroll in Medicare Parts A and B. Missing this window can result in late enrollment penalties that last permanently.

Special Election Period (SEP)

Triggered by a qualifying life event

If something changes in your life, such as moving to a new address, losing employer health coverage, gaining or losing Medicaid eligibility, or other qualifying events, you may be eligible to make plan changes outside the standard enrollment windows. There are many qualifying situations, and if you need to make a change but don't have another enrollment period available, we can discuss your options.

Not sure which window applies to you? That's exactly what the consultation covers.

Health and Medicare carriers I represent

Aetna

Common Medicare questions

When should I enroll in Medicare?

Your Initial Enrollment Period starts 3 months before your 65th birthday and ends 3 months after. Missing this window can result in permanent late enrollment penalties. If you're still working with employer coverage, different rules may apply. I help you navigate the exact timing for your situation.

What is the difference between Medicare Advantage and Medigap?

Medicare Advantage (Part C) replaces Original Medicare with an all-in-one plan from a private insurer, often including drug coverage and dental/vision. Medigap supplements Original Medicare by covering out-of-pocket costs like deductibles and copays. The best choice depends on whether you prefer provider flexibility (Medigap) or bundled benefits (Advantage).

Does Medicare cover prescription drugs?

Original Medicare (Parts A and B) does not cover most prescription drugs. You need a standalone Part D plan or a Medicare Advantage plan that includes drug coverage. Without creditable drug coverage, you may face late enrollment penalties that increase your premiums permanently.

How much does Medicare cost?

Most people pay $0 for Part A. Part B premiums start at $202.90/month in 2025 (income-dependent). Medicare Advantage plans can have $0 premiums but include copays. Medigap premiums vary by plan type and location. I compare costs across carriers to find your best option.

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