Medicare
Medicare, in the order you decide it.
Turning 65, still working, or on a plan that no longer fits: the questions are the same. Which doctors you keep, where your prescriptions land, and what can change next year. Justin Bautista, our licensed producer, works through them with you and compares the plans we can offer. There is no fee for the help; the carriers pay us.
Important Medicare disclosure
We do not offer every plan available in your area. Currently we represent 4 organizations which offer 1755 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.
This is a solicitation for insurance. JB Financial Services Agency is not connected with or endorsed by the U.S. government or the federal Medicare program.
Showing totals for the 25 states we serve. Choose your state and county for the numbers in your area.
The one decision
It comes down to one choice.
Everyone starts with Original Medicare: Part A for hospital care and Part B for medical care. From there you pick one of two paths, and three questions decide which.
Original Medicare, built up
Keep Parts A and B, then add a Medicare Supplement (Medigap) to cover the out-of-pocket gaps and a standalone Part D plan for prescriptions. Any doctor that accepts Medicare, no network.
Medicare Advantage (Part C)
Get your Part A and Part B through one bundled plan from a private insurer. Usually includes Part D and extra benefits like dental and vision, in exchange for using a plan network.
01 Your doctors
Do the ones you want to keep accept Original Medicare, or sit in a plan's network?
02 Your prescriptions
Where does each one land on a plan's drug list, and in which tier?
03 How you pay
A steady monthly premium, or lower premiums with copays as you go?
The anatomy of Medicare
The building blocks.
Five pieces make up almost every Medicare setup. Here is what each one does.
- A
Part A (Hospital)
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 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.
- B
Part B (Medical)
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 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.
- C
Part C (Medicare Advantage)
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 to know
- You use the plan's network (HMO, HMO-POS, PPO or PFFS). Premiums can be low or $0, but copays and deductibles apply as you go. Premiums, networks and drug lists can change every January, which is why the plan is worth rechecking each fall.
- D
Part D (Prescription Drugs)
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 to know
- The lowest premium can cost more over the year if your medications sit in a high tier or off the list, so the comparison starts from your prescriptions, not the price. Going without creditable drug coverage can add a permanent late enrollment penalty.
- MG
Medicare Supplement (Medigap)
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 to know
- Your Medigap Open Enrollment Period is the six months after Part B starts. In that window the insurer cannot turn you down or price you on your health. Outside it, in most states, it can. Plans are standardized by letter, so Plan G covers the same benefits from every insurer; only the price differs.
Beyond the basics
Add-ons worth knowing about.
Depending on your plan and your situation, these can fill gaps that Medicare alone leaves open.
Special-Needs Plans (SNP)
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.
Hospital Indemnity Insurance
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.
Standalone Dental and Vision
Separate dental and vision plans for routine checkups, cleanings, exams, and more. Common for people whose Medicare plan does not include these benefits.
Mark your calendar
Enrollment timing matters.
Medicare has specific windows. Missing them can mean penalties or gaps in coverage.
- Initial Enrollment Period (IEP)3 months before your 65th birthday through 3 months after
This is when you first sign up for Medicare Parts A and B. Missing this window can result in late enrollment penalties that last permanently.
- Medigap Open Enrollment Period6 months starting at age 65 and Part B enrollment
Your one guaranteed-issue window for a Medicare Supplement. No health questions and you cannot be denied. Miss it and you may face medical underwriting later.
- Annual Enrollment Period (AEP)October 15 - December 7
If you already have Medicare, this is your yearly window to switch Medicare Advantage plans, change Part D drug plans, or drop Advantage and return to Original Medicare.
- Medicare Advantage Open Enrollment Period (OEP)January 1 - March 31
If you are in a Medicare Advantage plan and unhappy with it, you get one chance during this window to switch to a different Advantage plan or return to Original Medicare with a standalone Part D plan.
- General Enrollment Period (GEP)January 1 - March 31
If you missed your Initial Enrollment Period and do not qualify for a Special Enrollment Period, this is when you can sign up for Part B. Late penalties may apply.
- Special Enrollment Period (SEP)Triggered by a qualifying life event
Life events such as losing employer coverage, moving, or changes to Medicaid eligibility can open a window to enroll or change plans outside the standard periods. If you need a change but have no other window available, we can talk through your options.
Not sure which window you are in? Justin confirms it at the start of the call, before any plan is discussed.
The consultation
What gets checked before you pick a plan.
Thirty to sixty minutes with Justin, by Google Meet or phone. Bring your Medicare card if you have one, your prescription list with dosages, and the names of the doctors you want to keep.
- Your window
- Which enrollment period you are in, and whether a late penalty is in play.
- Your doctors
- Each one, against Original Medicare and against the network of every Advantage plan under consideration.
- Your prescriptions
- Each one, against every plan's drug list and tier, so the yearly cost is compared, not just the premium.
- Your county's plans
- The plans we can offer where you live, side by side, with the premiums and copays as filed.
- Each fall
- What changed in your plan for the coming year, and whether it still fits.
Medicare carriers we represent
We do not offer every plan available in your area. The carriers shown are the ones Justin is appointed with and ready to sell for.
Good questions
Common Medicare questions.
- When do I have to do something?
- Your Initial Enrollment Period runs from three months before the month you turn 65 to three months after. Missing it can mean a permanent late enrollment penalty on Part B. If you are still working with employer coverage, the timing is different (next question). Justin confirms which window you are in before anything else.
- I am still working at 65. Do I need Part B yet?
- Not always. If you or your spouse are actively working and the employer coverage counts as qualifying, you may be able to delay Part B without a penalty and enroll later through a Special Enrollment Period. Whether it qualifies depends 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 checking before you decide either way.
- Can I keep my doctors?
- With Original Medicare plus a Medigap plan, you can see any provider in the country that accepts Medicare; there is no network. With Medicare Advantage, it depends on the plan's network, and networks can change each year. Bring the names of the doctors you want to keep. Checking them against each plan is part of the consultation.
- What is the difference between Medicare Advantage and Medigap?
- Medicare Advantage (Part C) replaces how you receive Parts A and B: one bundled plan from a private insurer, usually with Part D and extras like dental or vision, in exchange for using its network and paying copays as you go. Medigap keeps Original Medicare and adds a policy that pays the deductibles and coinsurance Medicare leaves behind, for a steady monthly premium. One is pay-as-you-go with a network; the other is pay-monthly with any Medicare provider.
- Where do my prescriptions fit?
- Original Medicare does not cover most prescriptions. You get drug coverage either from a standalone Part D plan or from a Medicare Advantage plan that includes it. Every plan has its own drug list and tiers, so the same medication can cost very different amounts from one plan to the next. Bring your list with dosages; that is the first thing Justin checks.
- Why do two Plan G policies cost different amounts?
- Because Medigap benefits are standardized by letter but prices are not. Every insurer selling Plan G covers the same things. Each one sets its own premium, uses its own rating method (community-rated, issue-age or attained-age, which changes how the premium moves as you get older), and raises rates on its own schedule. Comparing the price and the rating method is the whole job.
- Can I switch later?
- Medicare Advantage and Part D plans can be changed every fall during the Annual Enrollment Period, October 15 to December 7, and once more from January through March if you are in an Advantage plan. Medigap is different: you can apply at any time, but outside your Medigap Open Enrollment Period the insurer can ask health questions and decline you, in most states. That is why the first Medigap choice deserves care.
- How much does Medicare cost?
- Most people pay $0 for Part A. Part B has a standard monthly premium set by Medicare each year, higher at higher incomes. Medicare Advantage plans can have a $0 premium but charge copays and deductibles as you use care. Medigap premiums vary by plan letter, insurer, age and location. Justin compares the plans we can offer for your county so you see the real numbers side by side.
- Are you connected with Medicare or the government?
- No. JB Financial Services Agency is an independent insurance agency and Justin Bautista is an independent licensed insurance agent, not a government employee. This website is not connected with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area, so the information here is limited to the plans we do offer. You can compare every option at Medicare.gov, by calling 1-800-MEDICARE, or through your local State Health Insurance Program.
Bring your doctors and your prescriptions. We do the comparing.
A free consultation with Justin, by Google Meet or phone. The carriers pay us, not you.
Justin Bautista, Licensed Insurance Producer · NJ License #3001996877 · JB Financial Services Agency
NPN: 20367089
We do not offer every plan available in your area. Currently we represent 4 organizations which offer 1755 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.
This is a solicitation for insurance. JB Financial Services 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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