• Original Medicare (A & B): Federal program. Any provider that accepts Medicare. No drug coverage; no out-of-pocket max.
• Medicare Advantage (Part C): Private plans that replace A & B, usually include Part D, and often extras (dental/vision/hearing). Has an annual MOOP.
• Medigap: Private “supplement” to Original Medicare that helps pay A/B deductibles/coinsurance. No networks. No drugs—pair with Part D.
• Part D: Prescription drug coverage (standalone or inside Advantage).

No. You choose one path: Original + Medigap (+ Part D) or Medicare Advantage (usually with drugs).

Maximum Out-Of-Pocket: the most you’ll pay for Part A/B services in a year under a Medicare Advantage plan. After you hit it, covered Part A/B services are $0 for the rest of the year.

Original + Medigap: Any provider that takes Medicare.
Advantage: Check the plan’s network; PPOs allow out-of-network at higher cost.

Often for HMO Advantage plans. PPOs usually don’t require referrals, but prior authorization can still apply for certain services.

Emergency/urgent care is covered. Routine care is typically in-network only (HMOs). PPOs may allow out-of-network with higher cost. Original + Medigap lets you see any Medicare provider nationwide.

Consider enrolling to avoid a potential late enrollment penalty later. You can choose a low-premium plan and switch annually during AEP.

The plan’s covered drug list grouped by tiers (generics to specialty). Tiers affect copays. Always check your exact meds/doses and preferred pharmacy.

Yes. You can fill at any network pharmacy (costs differ by “preferred” vs “standard” pharmacies).

Part B premium (most people pay it), plus plan premiums (if any), copays/coinsurance, and drugs. Advantage plans include a MOOP; Medigap premiums vary by letter plan and carrier.

Possibly for Part B and Part D if you go without creditable coverage when first eligible. Timing matters—ask before you delay.

You may qualify for Extra Help (drug costs) and/or Medicaid. These can reduce premiums and copays. We’ll check eligibility.

AEP: Oct 15–Dec 7 (changes start Jan 1).
OEP: Jan 1–Mar 31 (if you’re in Advantage).
SEPs: For qualifying events like moving or losing coverage.

See enrollment windows

You’ll likely get a Special Enrollment Period to pick a plan in your new service area.

Depends on the window. AEP changes start Jan 1. Other windows vary by your enrollment date—ask us for exact timing.

It’s a trade-off: Advantage → lower premiums, networks, MOOP, extras. Medigap → higher premium, no networks, predictable costs, add Part D.

Your doctors/hospitals, medications + dosages, preferred pharmacy, and budget preferences. We’ll do the comparisons.

Yes—CMS rates plans 1–5 stars for quality and member experience. Higher is better, but benefits and costs still matter most to your situation.

Original Medicare doesn’t. Many Advantage plans include some DVH benefits. You can also buy standalone supplemental DVH coverage.

Add-on policies (hospital indemnity, cancer/critical illness, accident, DVH) that pay cash toward costs. See Supplemental Coverage.

Yes. There’s no extra cost to you. We’re paid by the carriers; your plan premium is the same.