The ABCs of Medicare Explained

Understanding the different parts of Medicare helps you choose the right coverage for your needs.

Medicare Part A – Hospital Coverage

Medicare Part A is often called hospital insurance.

It generally covers:

  • Inpatient hospital stays

  • Skilled nursing facility care (not long-term custodial care)

  • Hospice care

  • Limited home health services

Most individuals qualify for premium-free Part A based on their work history.

Medicare Part B – Medical Coverage

Medicare Part B covers outpatient and medically necessary services.

This includes:

  • Doctor visits and specialist appointments

  • Preventive services and screenings

  • Lab work and diagnostic tests

  • Vaccinations

  • Ambulance services

  • Durable medical equipment

  • Mental health services

Together, Medicare Parts A and B are known as Original Medicare..

Medicare Part C – Medicare Advantage Plans

Medicare Part C, also known as Medicare Advantage, is offered by private insurance companies approved by Medicare.

These plans combine:

  • Medicare Part A

  • Medicare Part B

Many Medicare Advantage plans also include:

  • Prescription drug coverage (Part D)

  • Vision benefits

  • Dental coverage

  • Hearing benefits

Common types of Medicare Advantage plans include:

  • HMO (Health Maintenance Organization)

  • PPO (Preferred Provider Organization)

  • Private Fee-for-Service (PFFS)

  • Special Needs Plans (SNPs)

Each year during the Annual Election Period, beneficiaries can compare plans, costs, and benefits.

Need Help Comparing Medicare Plans in Green Valley or Sahuarita?

Choosing between Medicare Advantage, Medicare Supplement (Medigap), and Part D plans depends on:

  • Your healthcare needs

  • Your prescription medications

  • Your budget

  • Your preferred doctors and hospitals

If you’re turning 65 in Southern Arizona or reviewing your current coverage, working with a licensed local Medicare agent can help you make an informed decision.

Getting Started with Medicare in Green Valley & Sahuarita

Understanding Medicare doesn’t have to feel overwhelming. Whether you’re turning 65, retiring soon, or helping a loved one enroll, here’s a clear breakdown of how Medicare works and when to apply.

Who Is Eligible for Medicare?

Most people become eligible for Medicare at age 65.

You may qualify for Medicare if:

  • You are a U.S. citizen age 65 or older

  • You are a permanent legal resident who has lived in the U.S. for at least five consecutive years

  • You are under age 65 and have received Social Security Disability benefits for 24 months

  • You have been diagnosed with End-Stage Renal Disease (ESRD)

  • You have been diagnosed with Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s disease)

If you’re unsure about your eligibility, speaking with a licensed Medicare agent can help clarify your specific situation.

When Should You Apply for Medicare?

You are first eligible to enroll in Medicare when you turn 65.

If you are already receiving Social Security benefits, you will typically be automatically enrolled in:

  • Medicare Part A (Hospital Insurance)

  • Medicare Part B (Medical Insurance)

Your coverage will begin on your 65th birthday.

If you are not yet receiving Social Security benefits, you must actively enroll during your Initial Enrollment Period (IEP).

What Is the Initial Enrollment Period?

Your Initial Enrollment Period:

  • Begins three months before your 65th birthday

  • Includes your birthday month

  • Ends three months after your birthday

This gives you a seven-month window to enroll.

Important: If your birthday falls on the first day of the month, your enrollment period begins one month earlier.

Missing your enrollment window can result in late penalties, so it’s important to plan ahead