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Annual Enrollment: Oct 15 – Dec 7

Medicare & Medicaid

Turning 65 shouldn't require a translator. We explain Parts A through D, compare Advantage and Medigap options side by side, and make sure you never pay a late penalty you could have avoided.

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The alphabet, decoded

Parts A through D in plain English

Part A
Hospital

Inpatient stays, skilled nursing after a hospital stay, hospice. Premium-free for most people who worked 10+ years.

Part B
Medical

Doctor visits, outpatient care, preventive services, equipment. Carries a monthly premium set each year.

Part C
Medicare Advantage

A private, all-in-one alternative to A + B — often bundles drugs, dental and vision, within a network.

Part D
Prescription drugs

Standalone drug coverage that pairs with Original Medicare. Skipping it without other coverage risks a lifetime penalty.

The one big decision

Original Medicare + Medigap, or Medicare Advantage?

Neither is 'the good one.' They're different bargains — here's the honest ledger.

Original Medicare + Medigap (+ Part D)Medicare Advantage (Part C)
How it worksGovernment A + B, a private supplement fills the 20%, a drug plan rides alongOne private plan replaces A + B, usually with drugs built in
DoctorsAny provider in the U.S. that takes Medicare — no networks, no referralsPlan networks (HMO/PPO); the KC-area networks differ, and we check yours
Monthly costHigher — Part B plus the Medigap and drug plan premiumsLower — often $0 beyond Part B
When you use careVery predictable; Medigap absorbs most of the 20%Copays as you go, up to an annual out-of-pocket cap
ExtrasNone built inOften dental, vision, hearing, fitness
Mark the calendar

Your enrollment windows

Medicare is deadline-driven — and the deadlines carry lifetime penalties. These four dates do most of the work.

Start here
Around your 65th
Initial Enrollment

Your 7-month window: 3 months before your 65th birthday month, the month itself, and 3 after.

Oct 15 – Dec 7
Annual Enrollment (AEP)

Join, drop or switch Advantage and drug plans for the coming year.

Jan 1 – Mar 31
Advantage Open Enrollment

Already on Advantage? Make one switch — or return to Original Medicare.

Jan 1 – Mar 31
General Enrollment

Missed your initial window? Enroll here; coverage starts the month after you sign up.

Medicaid & dual eligibility

If income is tight, say so — it changes the math

Medicaid (MO HealthNet in Missouri, KanCare in Kansas) is income-based coverage. Qualify for both Medicare and Medicaid, and special D-SNP plans coordinate the two — often with extra benefits. No judgment, just arithmetic: it's one of the first things we check.

Seniors laughing together over coffee outdoors
Asked at every kitchen table

Medicare FAQ

What is Medicare?
Federal health insurance for people 65 and over, and some younger people with disabilities. Parts A and B come from the government; C and D are offered through private carriers.
Who is eligible?
Most people at 65. You (or a spouse) generally need about 10 years of work credits for premium-free Part A. Some people qualify earlier through disability or certain conditions.
What are Parts A, B, C and D?
A covers hospital stays. B covers doctors and outpatient care. C — Medicare Advantage — is a private all-in-one alternative to A and B. D covers prescription drugs.
When do I enroll?
Your Initial Enrollment Period runs 7 months around your 65th birthday: three months before, your birthday month, and three months after. If you miss it, the General Enrollment Period runs January 1 – March 31.
Am I enrolled automatically?
Only if you're already drawing Social Security — then Parts A and B start automatically at 65. Otherwise you apply through Social Security, and we'll walk you through it.
What happens if I enroll late?
Parts B and D carry lifetime late-enrollment penalties unless you had other creditable coverage, like an employer plan. This is the most expensive mistake we help people avoid.
What does Medicare cost?
Part A is premium-free for most people. Part B has a monthly premium set each year by Medicare. Advantage, Medigap and drug plan costs vary widely — which is where comparison earns its keep.
What's the 80/20 split?
After the Part B deductible, Original Medicare pays 80% of covered costs and you pay 20% — with no annual cap. That uncapped 20% is the gap Medigap policies exist to fill.
Does Medicare cover long-term care?
No. Extended nursing-home or custodial care isn't covered by Medicare. That's a separate planning conversation, and we'll tell you honestly what it involves.
What is Medigap?
A supplement to Original Medicare that picks up some or most of your 20% share. Plans are standardized by letter (Plan G, Plan N, and so on), so comparing is mostly about price and service.
Can I switch between Original Medicare and Advantage?
Yes — during the Annual Enrollment Period, October 15 – December 7. If you're on Advantage, the January 1 – March 31 window allows one switch. Moving back to Medigap can involve health questions, so ask us first.
What is Medicaid?
State-and-federal coverage based on income — MO HealthNet in Missouri, KanCare in Kansas. It is separate from Medicare, with its own eligibility rules.
Medicare vs Medicaid — the difference?
Medicare is age- and disability-based; Medicaid is income-based. They cover different things, and for people who qualify, they can work together.
Can I have both?
Yes — that’s "dual eligibility." Special plans called D-SNPs coordinate the two and often add benefits. If your income is limited, this is absolutely worth checking.
Required disclosureWe do not offer every plan available in your area. Currently we represent 6 organizations which offer 38 to 54 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. Counts reflect the 2026 plan year and are reviewed each Annual Enrollment Period — see Licensing & Disclosures.

Turning 65? Take it one step at a time.

Bring us your questions — we’ll map your enrollment windows and compare your options at no cost.

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