Insurance Questions? We Have Straight Answers.

A lot more than most people think. Original Medicare (Parts A and B) doesn't cover routine dental, vision, or hearing care; routine foot care; long-term custodial care; most care outside the U.S.; and — critically — about 20% of the cost of covered services with no annual out-of-pocket cap. Prescription drugs aren't covered by Original Medicare either; you need a separate Part D plan or a Medicare Advantage plan that includes drug coverage.

Medigap (Medicare Supplement) works with Original Medicare to cover the 20% Parts A and B leave behind. You can see any provider that accepts Medicare, with no networks or referrals, and you pay a predictable monthly premium. Medicare Advantage (Part C) replaces Original Medicare with an all-in-one private plan — usually with an HMO or PPO network, often a $0 premium, drug coverage, and extras like dental and vision, but with cost-sharing every time you use care up to a yearly out-of-pocket maximum.

Your Initial Enrollment Period (IEP) is a 7-month window: the 3 months before your 65th birthday month, your birthday month, and the 3 months after. If you miss it and don't have qualifying coverage, you can face lifetime late-enrollment penalties on Part B and Part D. Annual Enrollment Period (AEP) is Oct 15 – Dec 7 each year, when anyone on Medicare can switch plans. Medigap has separate rules — your one-time 6-month Medigap Open Enrollment starts the month you're both 65 and enrolled in Part B.

The coverage gap ("donut hole") is a temporary stage of Part D where you pay a higher share of drug costs after you and your plan have spent a combined threshold. The Inflation Reduction Act closed the worst of it — in 2025, your share is capped at 25% of brand-name and generic drug costs in the gap, and there's now a $2,000 annual out-of-pocket cap on Part D drugs.

Not by default. Original Medicare (Parts A and B) doesn't cover most outpatient prescription drugs. You need either a stand-alone Part D plan (paired with Original Medicare and/or Medigap) or a Medicare Advantage plan that includes drug coverage (MAPD). We always compare Part D plans on total annual cost — premium + deductible + copays for your specific medications — not just the monthly premium.

On Original Medicare + Medigap, yes — as long as the provider accepts Medicare, which most do. On Medicare Advantage, you're limited to the plan's network. Before we recommend any Advantage plan, we check that your current doctors, hospitals, and specialists are in-network so there are no surprises.

Maybe not. If you're working and covered by a large-employer group plan (20+ employees), you can usually delay Part B without penalty and enroll later during a Special Enrollment Period. But there are traps — smaller-employer plans, COBRA, and retiree coverage are treated differently and can trigger lifetime penalties. We help you sort this out before you make the wrong call.

IRMAA (Income-Related Monthly Adjustment Amount) is a surcharge on Part B and Part D premiums for higher-income beneficiaries. It's based on your tax return from two years ago. If a major life event has lowered your income since then (retirement, loss of a spouse, divorce), you can appeal IRMAA using Form SSA-44.

No. Our service is free to you. Carriers pay us when you enroll, so you pay the same monthly premium as buying direct — sometimes less. We're not affiliated with any single carrier; we represent 40+ Medicare carriers and recommend whichever plan fits your situation best.