Medicare Made Simple: Your Step-by-Step Guide
Turning 65? New to Medicare? Already have coverage? Learn what you need to know, one simple step at a time.
What You'll Learn
Who Can Get Medicare?
Most people become eligible for Medicare at age 65. Some people qualify earlier.
Age 65 or Older
Most people qualify for Medicare at age 65 if they meet the program's eligibility requirements.
Certain Disabilities
Some people under 65 qualify after receiving certain disability benefits.
Certain Medical Conditions
People with ALS or qualifying permanent kidney failure may qualify before age 65.
The Four Parts of Medicare
Each part helps cover different healthcare needs.
Part A — Hospital
Helps cover inpatient hospital stays, certain skilled nursing facility care, hospice, and some home health services.
Part B — Medical
Helps cover doctor visits, outpatient services, preventive care, and medically necessary services.
Part C — Medicare Advantage
A private Medicare-approved plan that provides your Part A and Part B benefits. Most plans also include drug coverage.
Part D — Prescriptions
Helps pay for covered prescription medications. Available through standalone drug plans or many Medicare Advantage plans.
What Is Medicare Advantage?
Medicare Advantage is another way to receive your Medicare benefits through a Medicare-approved private insurance plan.
Hospital and Medical
Includes your Medicare Part A and Part B benefits, except hospice care, which Original Medicare generally covers.
Prescription Coverage
Most Medicare Advantage plans include prescription drug coverage, but covered medications and costs vary.
Additional Benefits
Some plans offer dental, vision, hearing, fitness, or other benefits. Availability and limits depend on the plan.
When Can You Enroll?
Your enrollment dates depend on whether you're new to Medicare or already have coverage.
October 15 – December 7, 2026
Annual Enrollment: People with Medicare can generally join, switch, or drop Medicare Advantage or Part D coverage. Changes take effect January 1, 2027.
Your 7-Month Window
Your initial Medicare enrollment period generally starts three months before your 65th birthday month and ends three months after. Special rules can apply.
January 1 – March 31, 2027
Medicare Advantage Open Enrollment: If you're already in a Medicare Advantage plan, you can generally make one eligible change or return to Original Medicare.
Special Enrollment Periods
Moving, losing certain coverage, qualifying for Medicaid, or other circumstances may allow enrollment outside regular dates. Specific rules apply.
What Should You Look for in a Plan?
Start with these six important questions before making a decision.
Your Doctors
Can you keep seeing your current doctors and specialists?
Your Medications
Are your prescriptions covered, and how much will they cost?
Your Monthly Costs
What are the premiums, copays, deductibles, and other expenses?
Hospitals and Networks
Are your preferred hospitals included? Do you need referrals?
Extra Benefits
Does the plan include dental, vision, hearing, or other useful benefits? What are the limits?
Your Financial Protection
What is the annual out-of-pocket maximum for covered Part A and B services?
What Do You Need to Get Started?
Have these items ready when comparing Medicare plans.
If already enrolled, have your Part A and Part B start dates.
Plans are available based on where you live.
Include your primary doctor, specialists, and preferred hospitals.
Include medication names, dosages, and preferred pharmacy.
Know what coverage you have now, including employer or retiree coverage.
If applicable, this may help identify additional plan options.
How Do You Get Medicare Advantage?
Getting started can be simple when you know the steps.
Get Medicare Parts A and B
If you're new to Medicare, sign up through Social Security when eligible. Some people are enrolled automatically.
Compare Available Plans
Review doctors, prescriptions, costs, benefits, and networks. Confirm the plan is available where you live.
Enroll When Eligible
Once you've selected a plan, complete enrollment during an eligible period and keep your confirmation.
Our Agents Work with Leading Insurance Companies
Explore Medicare coverage options from established insurance companies. Available plans depend on your location and eligibility.
Plan availability varies by ZIP code, eligibility, and agent appointments. Not every company or plan may be available to every individual. Carrier logos are the property of their respective owners.
Still Have Questions About Medicare?
You don't have to figure everything out alone. Get assistance from Raul Aquino, a licensed insurance agent serving Riverside County in English and Spanish.
Frequently Asked Questions
Do I have to pay for Medicare Advantage?
Some plans have a $0 monthly plan premium, but you generally still pay your Medicare Part B premium. Other costs may apply.
Can I keep my doctor?
It depends on the plan and provider network. Always verify your doctors and hospitals before enrolling.
Can I have Medicare and Medi-Cal?
Yes, some people qualify for both. Certain Medicare Special Needs Plans are designed for people who have Medicare and Medicaid, called Medi-Cal in California.
What if I travel?
Emergency and urgent care coverage rules differ from routine out-of-network care. Review the plan's travel and network rules before enrolling.
Can I change plans later?
You may be able to change plans during Annual Enrollment or another qualifying enrollment period. The rules depend on your situation.
Is Medicare Supplement the same as Medicare Advantage?
No. Medicare Supplement (Medigap) helps pay certain out-of-pocket costs under Original Medicare. Medicare Advantage is a different way to receive your Medicare Part A and B benefits. You cannot use Medigap to pay Medicare Advantage costs.
Important Medicare Information
This page provides general educational information. It is not a complete description of any plan's benefits, costs, or eligibility rules. PlanRight is not affiliated with or endorsed by the U.S. government or the federal Medicare program.
Plan availability, provider networks, benefits, and costs vary by location and eligibility. Enrollment is subject to applicable Medicare enrollment periods and plan rules.
For official information: Medicare.gov | 1-800-MEDICARE (1-800-633-4227) | TTY: 1-877-486-2048
To sign up for Medicare Parts A or B, visit: Social Security