Medicare Made Simple — We’ll Guide You Through Every Step

Understanding Your Medicare Options

Medicare isn’t one plan — it’s four parts that work together (and sometimes overlap). Here’s what each piece does:

Part A — Hospital Insurance

Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people pay no monthly premium for Part A because they (or a spouse) paid Medicare taxes while working. Deductibles and coinsurance still apply when you’re admitted.

Part B — Medical Insurance

Covers doctor visits, outpatient care, preventive services, lab work, and durable medical equipment. Part B has a standard monthly premium (adjusted for income) plus an annual deductible, after which Medicare typically pays 80% of approved charges and you pay the remaining 20%.

Part C — Medicare Advantage

An “all-in-one” alternative to Original Medicare offered by private insurance companies. Advantage plans bundle Parts A and B, usually include Part D drug coverage, and often add extras like dental, vision, hearing, and gym memberships.

Pros: lower premiums, everything in one card, extra benefits. Trade-offs: provider networks, prior-authorization rules, and plan availability that varies by county.

Part D — Prescription Drug Plans

Stand-alone drug coverage that pairs with Original Medicare (or comes built into most Advantage plans). Every Part D plan has its own formulary — the list of drugs it covers — so the right plan depends on the medications you actually take. Picking the wrong plan can cost hundreds to thousands of dollars per year.

Medicare Supplement (Medigap)

Private insurance that fills the “gaps” in Original Medicare — deductibles, coinsurance, and copays you’d otherwise pay out of pocket. Medigap plans are standardized (Plan G, Plan N, etc.), so the same Plan G from two carriers has identical benefits — the only difference is price and customer service. You keep your doctors and any Medicare-accepting provider nationwide.

When Do I Sign Up?

Initial Enrollment Period (IEP)

A 7-month window around your 65th birthday: the 3 months before your birthday month, your birthday month, and the 3 months after. Sign up during this window to avoid delays in coverage.

Special Enrollment Periods (SEPs)

Life events can trigger an SEP outside the normal windows — examples: losing employer health coverage, moving out of your plan’s service area, qualifying for Medicaid, or leaving a Medicare Advantage plan within the first year. SEPs are often short (as little as 60 days), so don’t wait.

Annual Open Enrollment: October 15 – December 7

Every year, you can switch Medicare Advantage or Part D plans, or move between Original Medicare and Advantage. Changes take effect January 1. This is the best time to re-shop if your medications, doctors, or needs have changed.

Late-enrollment penalties — don’t ignore them

If you skip Part B or Part D when you’re first eligible and don’t have other creditable coverage, you’ll pay a permanent monthly penalty for the rest of your life. The Part D penalty is 1% of the national base premium for every month you delay; the Part B penalty is 10% for each 12-month period you delay. These add up fast.

Why Use an Independent Agent Like Dave?

• No cost to you. Agents are paid by the insurance carrier, not the client. The plan premium is the same whether you enroll on your own or through Dave.
• Access to dozens of plans, not just one company’s offerings. Dave represents Aetna, Anthem, Humana, Cigna, UnitedHealthcare, MedMutual, Manhattan Life, and more — so the recommendation actually fits you.
• Ongoing support when your needs or plans change. Prescription changes, plan changes at renewal, questions about a bill — you call Dave, not a 1-800 number.
• Local. 937 area code. Dayton-based. Not a national call center.