MEDICARE PLAN GUIDE
Find the Right Plan for Your Life.
Medicare offers several coverage options, each designed to meet different healthcare needs. Mark helps you understand how each plan works so you can compare your choices and select coverage that fits your doctors, prescriptions, and healthcare priorities.
A
Medicare Part A
Hospital insurance
B
Medicare Part B
Medical insurance
C
Medicare Advantage
Combines Parts A & B
D
Prescription Drug Coverage
Prescription drug plans
S
Medicare Supplement
Medigap coverage
UNDERSTANDING YOUR OPTIONS
Every Medicare Plan Type, Explained.
Medicare is not one-size-fits-all. The right plan depends entirely on your doctors, medications, health conditions, and budget.
C
Part C
Medicare Advantage
An all-in-one alternative to Original Medicare offered by private insurers. Many plans include prescription drug coverage along with dental, vision, and hearing benefits.
STRENGTHS
- Often $0 monthly premium
- Drug coverage included
- Dental, vision, hearing extras
- Out-of-pocket maximum cap
CONSIDERATIONS
- Network restrictions apply
- Prior auth may be required
- Coverage varies by county
Typical Monthly Premium
$0 to $60 per month
Compare Advantage Plans with Mark
D
Drug Coverage
Medicare Part D
Standalone prescription drug coverage for people enrolled in Original Medicare or a Medicare Supplement plan. Formularies and costs vary by plan.
STRENGTHS
- Prescription coverage
- Pairs with Supplement plans
- Helps lower drug costs
- Low-cost generics often $0
CONSIDERATIONS
- Formularies change annually
- Tier placement affects costs
- Prior auth may apply
Typical Monthly Premium
$20 to $80 per month
Compare Part D Plans with Mark
S
Medigap
Medicare Supplement
Works alongside Original Medicare to help cover copays, coinsurance, and deductibles. See any provider nationwide who accepts Medicare.
STRENGTHS
- No network restrictions
- Predictable out-of-pocket
- Ideal for frequent travelers
- Accepted wherever Medicare is
CONSIDERATIONS
- Higher monthly premiums
- No built-in drug coverage
- Requires separate Part D plan
Typical Monthly Premium
$80 to $300 per month
Compare Supplement Plans with Mark
A+B
Original Medicare
Parts A and B
Original Medicare includes Part A for hospital coverage and Part B for medical coverage. Many beneficiaries choose a Medicare Supplement with Part D or a Medicare Advantage plan.
STRENGTHS
- Accepted by most providers
- No network restrictions
- Part A often premium-free
- Nationwide coverage
CONSIDERATIONS
- No out-of-pocket maximum
- No prescription drug coverage
- 20% coinsurance with no cap
Part B Standard Premium 2026
$202.90 per month
Review Original Medicare with Mark
SIDE BY SIDE
Advantage vs. Supplement vs. Original Medicare.
Compare the Medicare coverage options side by side to better understand the differences. Mark helps you choose the combination that best fits your healthcare needs and budget.
| Feature | Original Medicare | Medicare Advantage | Medigap + Part D |
|---|---|---|---|
| Monthly Premium | $202.90 (Part B) | Often $0 to $60 | $202.90 + $80 to $200+ |
| Network Restrictions | None | HMO or PPO networks | None |
| Out-of-Pocket Maximum | No cap | Annual cap included | Predictable costs |
| Drug Coverage | Not included | Usually included | Requires Part D |
| Dental, Vision, Hearing | Not included | Often included | Not included |
| Use Any Medicare Provider | Yes | Depends on plan type | Yes |
| Best For | Foundation coverage | Low premium, extra benefits | Predictability and travel |
Feature
Original Medicare
Medicare Advantage
Medigap + Part D
Monthly Premium
$185 (Part B)
Often $0 to $60
$185 + $80 to $200+
Network Restrictions
None
HMO or PPO networks
None
Out-of-Pocket Maximum
No cap
Annual cap included
Predictable costs
Drug Coverage
Not included
Usually included
Requires Part D
Dental, Vision, Hearing
Not included
Often included
Not included
Use Any Medicare Provider
Yes
Depends on plan type
Yes
Best For
Foundation coverage
Low premium, extra benefits
Predictability and travel
WHO QUALIFIES
Medicare Eligibility, Explained.
Most people become eligible for Medicare at age 65, but there are several enrollment pathways and timing rules that affect when and how you enroll. Mark helps you understand your options and enroll at the right time.
1
Age 65 Eligibility
You become eligible for Medicare at 65. Your Initial Enrollment Period opens 3 months before your birthday month and closes 3 months after.
2
Disability Eligibility
You may qualify before age 65 if you’ve received SSDI benefits for 24 months or have ALS or end-stage renal disease (ESRD).
3
Still Working at 65
If you have qualifying employer coverage, you may be able to delay Part B without a penalty. Mark reviews your situation to help determine your enrollment options.
Key Enrollment Dates
- Initial Enrollment Period: 7-month enrollment window
- Annual Enrollment: October 15 – December 7
- Medicare Advantage Open Enrollment: January 1 – March 31
- Special Enrollment Period: Qualifying life events
- General Enrollment Period: January 1 – March 31
Late Enrollment Penalties
- Part B penalty: 10% per 12 months delayed without creditable coverage
- Part D penalty: 1% per month without creditable drug coverage
- Both penalties are permanent and added to your premium for life
- Mark helps you understand your enrollment timeline and avoid unnecessary penalties.
ENROLLMENT WINDOWS
When You Can Enroll or Switch Plans.
Medicare has specific enrollment periods throughout the year. Understanding which one applies to you can help you avoid delays in coverage and potential late enrollment penalties.
Oct 15 to Dec 7
Annual Enrollment Period
The main opportunity to join, switch, or drop a Medicare Advantage or Part D plan. Changes take effect January 1, so it’s a good time to review your coverage.
7 Months
Initial Enrollment Period
Begins 3 months before the month you turn 65 and ends 3 months after. This is your first opportunity to enroll in Medicare.
Jan 1 to Mar 31
Medicare Advantage Open Enrollment
If you are already in a Medicare Advantage plan, you can switch to a different Advantage plan or return to Original Medicare during this period.
Triggered by Event
Special Enrollment Period
Certain life events, such as losing employer coverage, moving, or gaining Medicaid eligibility, may qualify you for a Special Enrollment Period depending on your situation.
Jan 1 to Mar 31
General Enrollment Period
If you missed your Initial Enrollment Period and don’t qualify for a Special Enrollment Period, you can enroll in Part A and Part B during this window. Late enrollment penalties may apply.
Always Free
Mark Reviews Your Window
Not sure which enrollment period applies to you? Mark helps you understand your enrollment timeline so you can make informed decisions and avoid unnecessary late enrollment penalties.
SPECIAL NEEDS PLANS
Plans Designed for Complex Health Needs.
Special Needs Plans (SNPs) are a type of Medicare Advantage plan designed for people with certain chronic conditions, dual eligibility, or institutional care needs. Many people who qualify don’t realize these plans are available.
C-SNP
Chronic Condition SNP
Designed for people with qualifying chronic health conditions. Provides coordinated care and benefits tailored to your healthcare needs.
- Diabetes
- COPD and respiratory conditions
- Chronic heart failure
- Cardiovascular disorders
- Chronic kidney disease
D-SNP
Dual Eligible SNP
For people who qualify for both Medicare and Medicaid. Often includes $0 premiums, coordinated care, and extra benefits.
- Enrolled in both Medicare and Medicaid
- Often $0 monthly premium
- Coordinated care between programs
- Extra benefits beyond standard coverage
- Available in qualifying service areas
I-SNP
Institutional SNP
For beneficiaries living in a nursing facility or enrolled in a Program of All-Inclusive Care for the Elderly (PACE), with care coordinated around their ongoing needs.
- Nursing home residents
- Assisted living facility residents
- PACE program participants
- Coordinated care model
- Designed for qualifying individuals
COMMON QUESTIONS
Medicare Plans, Answered.
What Is The Difference Between Medicare Advantage And Medigap?
Medicare Advantage replaces Original Medicare with an all-in-one private plan. Medigap works alongside Original Medicare to help cover out-of-pocket costs. Advantage often has lower premiums, while Medigap offers greater provider flexibility.
Do I Need A Separate Part D Plan With Medicare Advantage?
Usually not. Most Medicare Advantage plans include Part D prescription drug coverage, although some plans do not. Mark reviews each plan’s drug coverage and formulary before making a recommendation.
Can I switch plans after I enroll?
Yes. During the Annual Enrollment Period (October 15 to December 7), you can change Medicare plans. Certain qualifying life events may also allow changes through a Special Enrollment Period.
How do I know which plan covers my doctors?
Provider directories aren’t always accurate or up to date. Mark verifies your doctors, specialists, and preferred providers before recommending a plan that fits your healthcare needs.
What is a formulary and why does it matter?
A formulary is a plan’s list of covered prescription medications. Drug tiers and costs vary between plans, so Mark compares your medications to each formulary before recommending coverage.
Is there a penalty for enrolling in Medicare late?
Yes. Delaying enrollment without qualifying coverage may result in permanent late enrollment penalties. Mark helps you understand your enrollment timeline so you can avoid unnecessary penalties.
READY TO GET STARTED?
Compare Your Medicare Options With Confidence.
Schedule a no-cost consultation to review the Medicare plans available in your area. Mark compares your doctors, prescription medications, and healthcare needs to help you make an informed decision.