Medicare
Original Medicare and Medicare Advantage — explained, compared, simplified, with free local help.
Medicare is federal health insurance for people 65 and older and some younger people with disabilities. You choose Original Medicare (Parts A and B) with an optional supplement and drug plan, or a Medicare Advantage plan. TrueCare explains each option and compares plans in Houston for free.
You have a 7-month Initial Enrollment window around your 65th birthday. To change coverage later, the Annual Enrollment Period runs October 15 – December 7. Schedule a free review before your window closes.
Original Medicare and Medicare Advantage
If you are newly eligible for Medicare, you have a 7-month opportunity window to enroll. Otherwise, if you want to change your Medicare coverage, you must do so during the open enrollment period between October 15th and December 7th. During this time, you can change your Original Medicare coverage to a Medicare Advantage (MA) plan or switch between MA plans. Your new coverage starts January 1st.
Your Medicare options
Medicare-eligible individuals have two options for obtaining health insurance: Original Medicare or a Medicare Advantage plan. Original Medicare, the government program geared primarily for seniors, has several parts:
- Part A — hospitalization insurance. Helps cover inpatient care in hospitals and skilled nursing facilities, plus hospice and some home health care. It does not cover custodial or long-term care. Most people who have lived in the U.S. for five years and qualify at 65 pay no premium.
- Part B — medical insurance. Helps pay for doctors’ services and outpatient care, including some physical/occupational therapy and medically necessary home health care. For most people the federal government pays about 75% of the cost; higher-income beneficiaries pay more.
- Part D — prescription drug insurance. The monthly premium varies by plan and income. CMS estimated average 2022 premiums for basic Part D plans at about $33.00 per month.
- Medicare Supplement (“Medigap”). Private insurers underwrite these standardized plans, identified by letters in most states. They help pay out-of-pocket costs under Original Medicare such as copayments, coinsurance and deductibles, and some cover care while traveling outside the U.S.
Medicare Advantage: pros & considerations
Pros. Many MA plans offer richer benefits and/or lower copayments and deductibles. Some cover medical care received outside the U.S., and — unlike Original Medicare — MA plans limit your annual out-of-pocket expenses (for 2022, the most you would pay for covered hospitalization and medical expenses was $7,550 per year, after which the plan pays 100%).
Other considerations. Your ultimate costs depend on more than premiums. Each plan can set different out-of-pocket costs, including the annual deductible, copayments/coinsurance, whether you use network providers (PPO/HMO plans may cover less out of network), and the annual out-of-pocket limit.
As Medicare specialists, we help you choose from the variety of Medicare Advantage plans available in your area. You may also want to review your overall coverage with a policy review or add dental & vision coverage.
See if you qualify for extra benefits
Many Medicare Advantage plans now include extras that Original Medicare doesn’t — things like dental, vision and hearing coverage, fitness memberships, over-the-counter allowances, and help with prescription costs. Some people also qualify for assistance programs that lower their premiums and drug costs. There’s no pressure and no cost to find out what you’re eligible for.
Prefer to learn first? We host free Medicare education sessions and webinars throughout the year — no sales pitch, just clear answers. Ask about an upcoming session →
Medicare FAQs
When can I enroll in Medicare?
Your Initial Enrollment Period is a 7-month window around your 65th birthday (the 3 months before, your birthday month, and the 3 months after). To change coverage afterward, the Annual Enrollment Period runs October 15 to December 7, with new coverage starting January 1.
What is the difference between Medicare Advantage and Medigap?
Medicare Advantage (Part C) is an all-in-one alternative to Original Medicare, often including drug coverage and extras like dental and vision, usually within a network. Medigap (Medicare Supplement) works alongside Original Medicare to help pay out-of-pocket costs like coinsurance and deductibles. We’ll help you weigh which fits your health needs and budget.
Does it cost anything to work with a Medicare agent?
No. Our Medicare help is free — we’re compensated by the carriers, and your plan premium is the same whether you enroll with us or on your own. The difference is you get a local advocate who reviews your options every year.
What extra benefits might I qualify for?
Depending on the plan and your situation, you may have access to dental, vision and hearing coverage, fitness memberships, over-the-counter allowances, and prescription savings. Some people also qualify for assistance programs that lower premiums and drug costs. We’ll check what you’re eligible for at no cost.
Will a Medicare plan cover my current doctors and prescriptions?
It depends on the plan. Before you enroll, we verify whether your doctors are in-network and confirm your prescriptions are covered on the plan’s formulary, so there are no surprises.
Get unbiased Medicare guidance
A licensed Houston Medicare agent will help you compare plans and check for extra benefits at no cost.