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MEDICARE GUIDANCE

Navigating Medicare

The Right Plan for a Changing Market

The Medicare market is experiencing significant and frequent changes. Plans, networks, and benefits that were ideal last year may not be the best choice for you this year. Navigating these updates on your own can be confusing and risky.

To ensure you have the most suitable and cost-effective coverage, we strongly recommend a personalized consultation. We can help you compare the latest plans and find one that truly fits your health needs and budget.

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Dolland Insurance offers plans from a number of insurance companies, and is not affiliated or connected with any government program or agency.

DOWNLOADABLE RESOURCES

Helpful PDF Guides

Click on the topics below to download helpful PDF guides and checklists directly from Medicare.gov.

Medicare & YouThe complete annual handbook covering all parts of Medicare, enrollment, and your rights as a beneficiary.
Choosing A Medigap PolicyA step-by-step guide to comparing Medigap supplement plans and understanding standardized benefits by letter.
Your Guide to Medicare Drug CoverageHow Part D prescription drug plans work, including formularies, tiers, copays, and how to compare plans.
Medicare Coverage Outside the United StatesWhat Medicare covers when you travel or live abroad, and when you may need supplemental travel coverage.
Medicare & the Health Insurance MarketplaceHow Medicare interacts with ACA Marketplace plans and what to do if you have coverage through both.
How Medicare Works with Other InsuranceExplains coordination of benefits when you have employer, retiree, union, or other coverage alongside Medicare.
Medicare's Coordination of BenefitsA getting-started guide to understanding which insurer pays first when multiple plans are involved.
Your Medicare BenefitsA comprehensive A-to-Z reference of covered services, preventive care, and what Medicare pays for each.
Medicare Coverage of Ambulance ServicesWhen Medicare covers ground and air ambulance transport, and what costs you may still owe.
Medicare Coverage of Durable Medical Equipment & Other DevicesCoverage rules for wheelchairs, walkers, CPAP machines, and other durable equipment prescribed by your doctor.
Medicare & Home Health CareEligibility rules for skilled nursing and therapy services delivered in your home under Original Medicare.
Medicare Coverage of Skilled Nursing Facility CareHow Part A covers short-term skilled nursing stays after a qualifying hospital admission, and what limits apply.
Medicare CostsA clear breakdown of what Medicare costs in premiums, deductibles, and coinsurance for Parts A, B, C, and D.

For additional publications visit medicare.gov/publications

FOR VETERANS

TRICARE & VA Resources

Veterans and military retirees have coverage options that work alongside Medicare. These official guides explain how TRICARE and VA health benefits coordinate with your Medicare coverage.

TRICARE and Medicare EligibilityHow TRICARE eligibility interacts with Medicare, and what determines when you must enroll.
TRICARE and Medicare: Turning 65How TRICARE coverage changes when you turn 65 and become eligible for Medicare, and what steps to take.
TRICARE and Medicare: Under 65How Medicare and TRICARE work together for beneficiaries under 65 who qualify for Medicare due to disability.
TRICARE For Life HandbookThe complete handbook for TRICARE For Life, the Medicare-wraparound coverage for military retirees and their families.
TRICARE Choices in the United StatesAn overview of available TRICARE plan options for beneficiaries living in the United States.
VA Health Care Benefits OverviewThe official VA guide to health benefits eligibility, enrollment, and how VA care coordinates with other coverage.

COMMON QUESTIONS

Medicare FAQ

Part A is hospital insurance. It covers inpatient hospital stays, care in a skilled nursing facility following a qualifying hospital stay, hospice care, and some home health care. Most people do not pay a premium for Part A if they or their spouse paid Medicare taxes for at least 10 years while working.

Part B is medical insurance. It covers outpatient services including doctor visits, preventive care, lab tests, mental health services, durable medical equipment, and some home health care. Part B requires a monthly premium, and most beneficiaries pay the standard amount set each year by CMS.

Part C, also called Medicare Advantage, is an alternative to Original Medicare offered by private insurance companies approved by Medicare. These plans bundle Part A and Part B coverage — often with Part D drug coverage and extras like dental, vision, and hearing — into a single plan with its own network, copays, and rules.

Part D is prescription drug coverage offered through private insurers. It helps lower the cost of prescription medications, including many brand-name and generic drugs. Each Part D plan has its own formulary (list of covered drugs), tiers, copays, and deductibles. Enrollment is optional, but late enrollment penalties apply if you go without creditable drug coverage.

Your Initial Enrollment Period (IEP) is a 7-month window that begins 3 months before the month you turn 65, includes your birthday month, and extends 3 months after. Enrolling during the first 3 months ensures your coverage starts on the first day of your birthday month with no gaps.

If you miss your IEP without qualifying for a Special Enrollment Period, you can enroll during the General Enrollment Period (January 1 – March 31 each year), with coverage starting July 1. You may also face a late enrollment penalty: a 10% surcharge on your Part B premium for each full 12-month period you were eligible but didn't enroll.

A Special Enrollment Period (SEP) allows you to sign up for Medicare outside of standard windows without penalty in qualifying life situations — most commonly when you lose employer-sponsored health coverage because you or your spouse stopped working. You generally have 8 months from that loss of coverage to enroll in Part B without penalty.

Medigap plans are sold by private insurers to fill the cost-sharing gaps in Original Medicare — covering expenses like copays, coinsurance, and deductibles that Medicare Parts A and B leave to you. Plans are standardized by letter (A, B, C, D, F, G, K, L, M, N) so benefits are identical across insurers; only premiums differ. We help you choose based on carrier strength and their rate increase history. You must have Original Medicare (Parts A and B) to purchase Medigap.

Medicare Advantage replaces Original Medicare through a private plan with network-based care, often including extra benefits and lower premiums — but with restricted provider networks and potential prior authorization requirements. Medigap supplements work alongside Original Medicare, giving you access to any provider who accepts Medicare nationwide, with predictable out-of-pocket costs. They serve different needs depending on your health usage and budget.

Yes, but timing and health status matter. During the Annual Enrollment Period (October 15 – December 7), you can switch from Medicare Advantage back to Original Medicare. However, if you want to purchase a Medigap plan outside of your Medigap Open Enrollment Period — which is the 6 months starting the month you turn 65 and enroll in Part B — insurers in most states can use medical underwriting and may decline coverage based on health conditions.

EXTERNAL RESOURCES

Helpful Links

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