Medicare
Turning 65, already on Medicare and want a second look, or just trying to make sense of Advantage versus Medigap? Here is how the pieces fit together and how I help you choose, with no cost to you.
Important Medicare disclosure
We do not offer every plan available in your area. Currently we represent 4 organizations which offer [number] products 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 solicitation for insurance. JB Financial Service Agency is not connected with or endorsed by the U.S. government or the federal Medicare program.
Original Medicare has two parts. Part A covers hospital stays and Part B covers doctor visits and outpatient care. From there you have a choice. You can keep Original Medicare and add a Medicare Supplement (Medigap) plus a Part D drug plan, or you can pick a Medicare Advantage (Part C) plan that bundles everything through a private insurer, usually with drug coverage and extra benefits. I walk you through which path fits your doctors, your prescriptions, and your budget.
What it is
Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. This is the hospital side of Original Medicare.
Who it's for
Almost everyone 65 and older. You are usually enrolled automatically if you are already drawing Social Security.
Key things to know
Most people pay $0 for the Part A premium because they or a spouse paid Medicare taxes for at least 10 years. Deductibles and coinsurance still apply per benefit period.
What it is
Covers doctor visits, outpatient care, preventive services, lab work, and durable medical equipment. This is the medical side of Original Medicare.
Who it's for
Anyone enrolling in Medicare who wants coverage for routine medical care outside the hospital.
Key things to know
Part B has a standard monthly premium set by Medicare each year, with higher amounts at higher income levels. Delaying Part B without qualifying coverage can trigger a permanent late enrollment penalty.
What it is
An alternative to Original Medicare offered through private insurers. Bundles Part A and Part B, usually includes Part D, and often adds dental, vision, hearing, and wellness benefits.
Who it's for
People who want an all-in-one plan with extra benefits and are comfortable using a plan network.
Key things to know
Network restrictions apply (HMO, HMO-POS, PPO, PFFS). Premiums can be low or $0, but copays and deductibles apply. Plans change every year, so what fits this year might not fit next year. This is where annual reviews matter.
What it is
Standalone prescription drug coverage with a formulary, which is the list of medications the plan covers. Prices and covered drugs vary by plan.
Who it's for
Anyone on Original Medicare who does not have drug coverage through a Medicare Advantage plan, and anyone taking regular medications.
Key things to know
The cheapest plan is not always the best if it does not cover your specific medications. Going without creditable drug coverage can lead to a permanent late enrollment penalty.
What it is
A secondary policy that covers costs Original Medicare leaves behind: deductibles, copayments, and coinsurance. Plans are standardized and labeled A through N.
Who it's for
People who want the freedom of Original Medicare (any doctor that accepts Medicare, no network) with predictable out-of-pocket costs.
Key things to know
The best time to enroll is during your 6-month Medigap Open Enrollment Period, which starts when you turn 65 and enroll in Part B. During that window it is guaranteed issue with no health questions. Outside it, you can be denied or charged more based on your health.
Depending on your plan and your situation, these can fill gaps that Medicare alone leaves open.
A type of Medicare Advantage plan with tailored benefits for people who have certain chronic conditions, are dual-eligible for Medicare and Medicaid, or live in certain institutional settings. Not everyone qualifies.
Supplemental coverage that pays a fixed cash benefit directly to you during a hospital stay. Often paired with Medicare Advantage plans that carry hospital copays. The money can be used for anything.
Separate dental and vision plans for routine checkups, cleanings, exams, and more. Common for people whose Medicare plan does not include these benefits.
Medicare has specific windows. Missing them can mean penalties or gaps in coverage.
Not sure which window applies to you? That's exactly what the consultation covers.
Medicare carriers I represent
I do not offer every plan available in your area. The carriers shown are the ones I am appointed with.
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 are still working with employer coverage, different rules may apply. I help you navigate the exact timing for your situation.
Not always. If you have qualifying coverage through a job where you or your spouse are actively working, you may be able to delay Part B without a penalty and enroll later through a Special Enrollment Period. The rules depend on the size of the employer and the type of coverage. This is an easy place to make a costly mistake, so it is worth a quick conversation before you decide.
Medicare Advantage (Part C) replaces Original Medicare with an all-in-one plan from a private insurer, often including drug coverage and dental or 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).
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.
Most people pay $0 for Part A. Part B has a standard monthly premium set by Medicare each year, with higher amounts at higher income levels. Medicare Advantage plans can have $0 premiums but include copays. Medigap premiums vary by plan type and location. I compare costs across the carriers I work with to find your best option.
No. I am an independent licensed insurance agent, not a government employee, and this website is not connected with or endorsed by the U.S. government or the federal Medicare program. I also do not offer every plan available in your area, so the information here is limited to the plans I do offer. You can always compare every option at Medicare.gov, by calling 1-800-MEDICARE, or through your local State Health Insurance Program (SHIP).
Free consultation. No obligation. I compare the plans I offer to help you find a good fit for your doctors and prescriptions.
Justin Bautista, Licensed Insurance Producer · License # pending · JB Financial Service Agency (DBA pending NJDOBI approval)
We do not offer every plan available in your area. Currently we represent 4 organizations which offer [number] products 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 solicitation for insurance. JB Financial Service Agency is not connected with or endorsed by the U.S. government or the federal Medicare program. This page is for informational purposes and does not constitute an offer of insurance. Plans are issued by the carriers shown above; final terms, coverage, and eligibility are determined by the carrier's underwriting.
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