How Does Medicare Work?

Here’s a draft blog entry for the topic “How Does Medicare Work?” tailored for your Maine-based Medicare insurance business. Let me know if you'd like to add local resources or adjust the tone.

How Does Medicare Work?
A Simple Guide for Maine Residents

If you're approaching age 65 or helping a loved one navigate health insurance, you've probably heard of Medicare—but understanding how it works can feel overwhelming. Let's break it down in plain English.

What Is Medicare?

Medicare is a federal health insurance program for:

• People age 65 or older

• Certain younger individuals with disabilities

• People with End-Stage Renal Disease (ESRD) or ALS

It helps cover many health care costs, but it's not completely free—and it doesn’t cover everything.

The Four Parts of Medicare

Part A – Hospital Insurance
Covers inpatient care in hospitals, skilled nursing facilities, hospice, and some home health care. Most people don’t pay a premium for Part A if they (or their spouse) paid Medicare taxes while working.

Part B – Medical Insurance
Covers doctor visits, outpatient care, preventive services, and durable medical equipment. There is a monthly premium for Part B, which most people pay out of their Social Security check.

Part C – Medicare Advantage Plans
These are private plans (approved by Medicare) that bundle Parts A and B, and often include Part D (drug coverage) and extras like dental or vision. You still must pay your Part B premium.

Part D – Prescription Drug Coverage
Helps pay for prescription medications. These plans are offered by private insurers and vary in cost and coverage.

What Medicare Doesn’t Cover

Medicare doesn’t pay for everything. Common exclusions include:

• Most dental care

• Eye exams for glasses

• Hearing aids

• Long-term custodial care

That’s where Medicare Supplement (Medigap) plans or Medicare Advantage plans can help fill in the gaps.

When to Enroll

Your Initial Enrollment Period (IEP) is a 7-month window:

• Starts 3 months before your 65th birthday

• Includes the month you turn 65

• Ends 3 months after

Missing your enrollment window could result in penalties or coverage delays.

Maine-Specific Considerations

In Maine, you have access to a wide range of Medicare Advantage and Medigap plans. Some areas may have more plan options than others, so it’s helpful to work with a local agent who understands the regional differences.

Need Help Navigating Medicare?

Understanding Medicare is one thing—choosing the right coverage is another. I help Maine residents simplify their options and find plans that fit their needs and budget.

Feel free to reach out for a no-cost consultation. Whether you're brand new to Medicare or just looking to review your current coverage, I’m here to help.

Let’s make Medicare simple—together.