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About Medicare

We walk alongside you to guide you through your Medicare benefits.

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What is Medicare?

Medicare is a federal health coverage program for people over 65, and/or younger people with certain disabilities.

How are the parts of Medicare divided?

Original Medicare consists of Part A and Part B. Most Medicare beneficiaries pay an additional charge for Part B coverage.

Part AHospital Coverage

Eligible individuals are automatically enrolled in Part A when they turn 65.

Part BMedical coverage

You have to sign up for Part B. If you don’t sign up when you are eligible, you may have to pay a penalty.

Original Medicare (Part A and Part B) does not cover everything.

80%Covers only approximately 80% of medical and hospital costs. Does not include coverage for prescription medications.
MedicareOriginal
20%You are responsible for covering 20% ​​of the additional costs not covered by Original Medicare.
Covers~ 80%Your cost 20%

There are options to cover these costs.

Part C and Part D are important options that can help you pay for most of the additional expenses not covered by Original Medicare.

Part CKnown as Medicare Advantage

This coverage can offer the following:

  • Access to doctors and specialists

  • Original Medicare deductibles and copayments

  • Additional hearing, vision, and dental services

  • Prescription drug coverage

Part DPrescription Drug Coverage

You should know the following information:

  • Coverage is optional and is only offered through private plans.

  • If beneficiaries do not enroll when they first become eligible, and do so later, they may have to pay a penalty.

Medicare Original vs Medicare Advantage

Coverage comparison
Part A+BMedicare Original
Part CMedicare Advantage
  • Hospital coverage
    Included
    Included
  • Visits to doctors, other healthcare professionals, and preventive care coverage
    Included
    Included
  • Prescription drug coverage
    Not included
    Included
  • Coverage for routine hearing and vision services
    Not included
    Included
  • Coverage for routine and comprehensive dental services
    Not included
    Included

*Medicare Advantage benefits may vary by plan.

How to know if you are eligible

Medicare Original

More than+65 years

  • Having received monthly Social Security benefits or having a spouse entitled to Social Security benefits.

Less than-65 years

  • Having received monthly Social Security benefits or having a spouse entitled to Social Security benefits.

  • You have a qualifying disability or a special condition.

Medicare Advantage

If you already haveMedicare Original

  • You are enrolled in Part A and Part B.

  • You live in Puerto Rico.

Highlighted

Important Periods

Initial Registration

You have a 7-month window to join Medicare for the first time: from 3 months before to 3 months after you turn 65.

7-month window
  1. 3 months before
  2. Your 65th birthday
  3. 3 months later
  • Annual Enrollment Period

    October 15 – December 7

    See more

    Specific period to choose or change Part C (Medicare Advantage) or Part D (Prescription Drug) coverage.

  • Medicare Advantage Open Enrollment Period

    January 1 – March 31

    See more

    A period during which the beneficiary can make a one-time choice to switch to another Medicare Advantage plan or switch to Original Medicare.

  • Special Enrollment Period

    See more

    A period during which you can join a Part C or Part D plan under certain circumstances, including:

    • When you turn 65
    • If you are eligible for Medicaid benefits
    • If the plan you have is cancelled
    • If you are moving from or to Puerto Rico
    • If you move to a nursing home

Before choosing a Medicare Advantage plan

  1. 1

    When choosing your Medicare plan, you need to ensure it fits YOUR specific situation. That is why you should analyze YOUR specific conditions and needs.

  2. 2

    The first thing you should do is prepare a list of your health conditions and your doctors, evaluate how important it is to continue seeing them, and verify that they participate in the Medicare Advantage plan you are considering.

  3. 3

    Next, make a list of the medications you take to ensure the plan covers them.

  4. 4

    Also, consider your daily life and financial situation. Many Medicare Advantage plans offer assistance such as transportation to medical appointments, supplemental funds for food and utility expenses, and home delivery of over-the-counter (OTC) items.

  5. 5

    The important thing when choosing a plan is to ensure it covers your healthcare while also addressing your daily living needs.

Frequently Asked Questions

To make things easier for you, we’ve prepared a list of frequently asked questions.

Medicare is a federal health insurance program for people aged 65 and older and/or those under that age with certain disabilities.

Original Medicare consists of Part A (hospital coverage) and Part B (medical coverage). Part C (Medicare Advantage) and Part D (prescription drugs) are options that help cover expenses not covered by Original Medicare.

Original Medicare covers approximately 80% of medical and hospital costs and does not include prescription drug coverage. You are responsible for the remaining 20% ​​of the expenses.

You have a 7-month window: from 3 months before to 3 months after turning 65.

If you are age 65 or older and have received monthly Social Security benefits, or have a spouse entitled to them. Individuals under age 65 with a qualifying disability or a special condition may also be eligible.

Be enrolled in Medicare Part A and Part B and live in Puerto Rico.

Part C (Medicare Advantage) combines Original Medicare benefits and may include hearing, vision, dental, and prescription drug coverage. Part D specifically covers prescription drugs and is optional.

Yes. If you do not enroll in Part B or Part D when you are first eligible and do so later, you may have to pay a penalty.

Do you still have questions?

Send us your question, and we will get back to you shortly.

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