Pick your state for the requirements, costs, and guidance that actually apply to you:
Important Medicare disclaimer: We do not offer every plan available in your area. Please contact Medicare.gov or 1‑800‑MEDICARE to get information on all of your options.
Not connected with or endorsed by the United States government or the federal Medicare program. Maru Insurance is a licensed independent insurance agency. Enrollment in a plan may be limited to certain times of the year.
Medicare is the federal health program for people 65 and older and for some younger people with qualifying disabilities. It comes in parts, and the choices you make when you first enroll shape your costs and your access to doctors for years. Maru is a licensed independent agency that helps Washington and Florida beneficiaries understand how the pieces fit and compare the specific plans available where they live.
The parts of Medicare
| Part / plan | What it covers |
|---|---|
| Part A | Hospital and inpatient care (most people pay no premium) |
| Part B | Doctor visits, outpatient care, and preventive services |
| Part C (Medicare Advantage) | A private-plan alternative that bundles A and B, and usually D |
| Part D | Prescription drug coverage (standalone or inside Advantage) |
| Medigap (Supplement) | Private coverage that pays Original Medicare's out-of-pocket costs |
Two ways to round out your coverage
Most people choose between two paths. One is Original Medicare plus a Medicare Supplement (Medigap) policy and a standalone Part D drug plan — this keeps the freedom to see any provider that accepts Medicare and makes costs predictable. The other is a Medicare Advantage plan, which bundles your coverage through a private insurer that typically uses a network and often includes drug coverage and extras. You generally cannot combine a Medigap policy with a Medicare Advantage plan. We explain both honestly so you can pick the one that fits.
When to enroll
Your Initial Enrollment Period runs for seven months around your 65th birthday. There is also an Annual Enrollment Period each fall (October 15 to December 7) when you can change plans, and a Medigap Open Enrollment window that gives you a one-time guaranteed right to buy a supplement without health questions. Missing these windows can mean higher costs or medical underwriting later, so timing matters. Enrollment in a plan may be limited to certain times of the year.
Washington and Florida notes
Washington offers a consumer-friendly Medigap "birthday rule" that lets you switch to an equal or lesser supplement each year without new underwriting. Florida's large retiree population means many plan choices and heavy marketing, where independent, pressure-free guidance is especially valuable. In both states, Maru compares the options actually available to you and coordinates your drug coverage so the whole picture works together.
Medigap vs. Medicare Advantage: an honest comparison
Most people round out Original Medicare in one of two ways. Neither is "better" in the abstract — the right one depends on how you like to get care, your prescriptions, your budget, and whether you travel. Here's a fair side-by-side:
| Original Medicare + Medigap + Part D | Medicare Advantage (Part C) | |
|---|---|---|
| Provider choice | Any provider in the U.S. who accepts Medicare — no networks. | Usually a network (HMO or PPO); care outside it may cost more or not be covered. |
| Monthly cost | A Medigap premium plus a Part D premium, in exchange for very predictable costs. | Often a low or $0 plan premium, with copays as you use care. |
| Out-of-pocket predictability | Very high — a good Medigap plan covers most gaps. | Costs vary with use, but every plan has an annual out-of-pocket cap. |
| Extra benefits | Not included; you'd add dental, vision, or hearing separately. | Often bundles extras like dental, vision, hearing, or fitness. |
| Drug coverage | Added through a standalone Part D plan you choose. | Usually built into the plan. |
| Switching later | Changing Medigap after your one-time open enrollment can involve health questions. | You can change plans each year during Annual Enrollment. |
We don't earn more by steering you toward one path — our job is to lay out the trade-offs clearly and help you pick the one that fits.
The parts of Medicare, explained in plain language
Medicare is built from parts that each do a different job. Understanding what each one does — and what it leaves out — is the first step to choosing coverage that actually fits your life.
| Part | What it covers | Good to know |
|---|---|---|
| Part A — Hospital | 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 long enough while working. |
| Part B — Medical | Doctor visits, outpatient care, preventive services, lab work, and durable medical equipment. | Part B has a monthly premium and an annual deductible, and it typically pays 80% of approved costs, leaving you the other 20% with no cap. |
| Part C — Medicare Advantage | A private-plan alternative that bundles Part A and Part B, and usually Part D, into one plan. | Plans use networks and set an annual out-of-pocket maximum. Extras like dental, vision, or hearing are sometimes included. |
| Part D — Drugs | Prescription-drug coverage, offered as a standalone plan or built into a Medicare Advantage plan. | Each plan has its own list of covered drugs (a formulary). Going without creditable drug coverage can trigger a lifelong penalty. |
| Medigap — Supplement | Private coverage that pays much of what Original Medicare leaves you to pay, like deductibles and coinsurance. | Medigap works only with Original Medicare — not with Medicare Advantage — and does not include drug coverage. |
Medicare enrollment periods and deadlines
Timing is one of the most important parts of Medicare. Enrolling in the right window protects you from penalties and gaps — and some windows only come around once. Here are the periods that matter most:
| Window | When | What it's for |
|---|---|---|
| Initial Enrollment Period (IEP) | The 7 months around your 65th birthday — the 3 months before your birthday month, the month itself, and the 3 months after. | Your first chance to sign up for Parts A, B, and D and to buy a Medigap policy with the strongest protections. |
| Medigap Open Enrollment | A one-time 6-month window that starts the month you're 65 and enrolled in Part B. | You can buy any Medigap plan sold in your state with no health questions — a guaranteed right that usually doesn't return. |
| Annual Enrollment Period (AEP) | October 15 – December 7 every year. | Switch Medicare Advantage or Part D plans for the coming year; changes take effect January 1. |
| Medicare Advantage Open Enrollment | January 1 – March 31 every year. | If you're already in a Medicare Advantage plan, make a one-time change or return to Original Medicare. |
| General Enrollment Period | January 1 – March 31 every year. | A fallback to enroll in Part B if you missed your IEP (a late penalty may apply). |
| Special Enrollment Periods (SEPs) | Triggered by life events — losing employer coverage, moving, and more. | Let you make changes outside the standard windows when something qualifying happens. |
What Original Medicare doesn't cover
Original Medicare is strong, but it has real gaps. Knowing them up front helps you decide what extra coverage — if any — is worth it for you. Original Medicare generally does not cover:
- Routine dental care, dentures, most vision and eyeglasses, or hearing aids
- Prescription drugs you take at home (that's Part D's job)
- Long-term custodial care, such as an extended nursing-home stay
- Most care outside the United States
- An annual cap on your out-of-pocket spending under Parts A and B
A Medigap policy, a Medicare Advantage plan, or standalone add-ons can each fill different gaps. We help you weigh which gaps are worth covering for your health and budget — without pushing you toward anything you don't need.
Help paying for Medicare
Several programs can lower what you pay for Medicare, and many people who qualify never apply. If money is tight, it's worth checking — we can point you in the right direction at no cost:
- Extra Help (Low-Income Subsidy). Federal help that lowers Part D drug costs, including premiums, deductibles, and copays, for people with limited income and resources.
- Medicare Savings Programs. State programs (such as QMB, SLMB, and QI) that can help pay Part B premiums and, in some cases, other costs.
- Free counseling. Your State Health Insurance Assistance Program offers free, unbiased Medicare help — SHIBA in Washington and SHINE in Florida.
Questions worth asking before you choose a plan
Whether you work with us or shop on your own, these questions cut through the noise and keep the decision focused on what matters to you:
- Are my doctors and preferred hospital in the plan's network?
- Are all of my prescriptions on the plan's drug list, and at what tier?
- What will I actually pay in a normal year — and in a bad one?
- Do I travel or split time between states, and will my coverage travel with me?
- How much provider freedom do I want versus a lower premium?
- If my health changes later, can I switch — and would I face health questions?
A quick Medicare glossary
| Term | What it means |
|---|---|
| Premium | The amount you pay each month to keep a plan, whether or not you use care. |
| Deductible | What you pay out of pocket before your coverage starts paying. |
| Coinsurance / copay | Your share of a cost after the deductible — a percentage (coinsurance) or a flat amount (copay). |
| Formulary | The list of prescription drugs a Part D or Advantage plan covers, organized in tiers. |
| Network | The doctors, hospitals, and pharmacies a plan has contracted with. |
| Out-of-pocket maximum | The most you'll pay in a year under a Medicare Advantage plan before it covers 100%. |
| Guaranteed issue | Your right to buy certain coverage without answering health questions. |
Frequently asked questions
What's the difference between the enrollment windows I keep hearing about?
Will I be penalized if I sign up late?
Does Medicare cover dental, vision, or hearing?
Is there help if I can't afford my Medicare costs?
Does it cost anything to work with a Medicare agent?
Should I choose Medicare Advantage or a Medigap plan?
Do you offer every Medicare plan in my area?
When can I enroll or make changes?
Licensed independent insurance agent (NPN 22261820) · WA & FL
Written and reviewed by Vadim Marusin, a licensed independent insurance agent. Maru Insurance is an independent agency (WA License WAOIC #1365574, FL License #G363233) representing multiple A-rated carriers across Washington and Florida.
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