Understanding Medicare


No Cost Services To Help You Find The Right Medicare Coverage For Your Needs

No Obligation to Enroll

If you are an American Citizen and you have turned 65 or older, then you have the option to enroll in Medicare. Medicare Parts A and B (often times referred to as Original Medicare), cover some of your basic hospital and doctor expenses. Original Medicare leaves a lot of out of pocket. Medicare supplements or Medicare Advantage plans can protect you from expenses that are not covered effectively. We have years of experience helping our clients understand what Original Medicare does and does not cover and finding what plan options make the most sense for their particular circumstance.

Medicare Health Insurance Definitions

A payment, often monthly, to an insurance plan to receive coverage
The amount you must pay for your health care before your insurance provider begins to pay
A fixed percentage paid by the beneficiary for the services provided
A fixed dollar amount paid for the services provided by the beneficiary
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Medicare 101

Understanding Medicare

Basics of Medicare

Medicare is offered to Americans 65 and older. If you’re eligible for Medicare, here are some things you should know.

1: Medicare is not free. There are monthly premiums and cost-sharing for things like deductibles and coinsurance.

2: There are over 56 million people on Medicare

3: There are over 800,000 providers who accept Medicare in the US.

4: In some cases, people under the age of 65 can qualify based on health conditions or disability.

5: Your initial enrollment period is 7 months long and begins 3 months before your turn 65.

6: There are some penalties if you miss the enrollment period and don’t have any other credible health coverage.

Medicare Enrollment

Enrollment Opportunities

Initial Election Period for Part C & D

When you first turn 65 (or become eligible for Medicare prior to age 65 through special circumstance) and have enrolled in Part A & B of Medicare, you will have a 7-month window to enroll in a Medicare Advantage Plan (Part C) or Prescription Drug Plan (Part D). This 7-month window is the 3 months prior to your Part A & B starting, the month they take effect, and the 3 months following that effective month.

Open Enrollment for Medigap

If someone would like to purchase a Medigap Plan (Medicare Supplement) instead of a Medicare Advantage Plan, they have a 6 month “Open Enrollment window” starting the day their Part B takes effect where they can do so without being subjected to medical underwriting by an insurance carrier. Medigap Plans can also be purchased at any time throughout the year, but they would be subject to underwriting if outside of the Open Enrollment.

Annual Enrollment Period (AEP) for Part C & D

For Medicare Recipients that have Medicare Part A and/or Part B they are eligible to enroll into or change their Medicare Prescription Drug Plan (Part D) between October 15th and December 7th and all those enrollments will take effect on January 1st.

For Medicare Recipients that have Medicare Part A and Part B they are eligible to enroll into or change their Medicare Prescription Drug Plan (Part D) or Medicare Advantage Plan (Part C) between October 15th and December 7th and all those enrollments will take effect on January 1st.

Medicare Advantage and Prescription Drug Plans change from year to year, so it’s a good idea to check with us to see if there is a new plan that might save you money and/or get you additional benefits that you are entitled to!
Finding a Health Insurance Broker

When are the Enrollment Periods?


The Medicare Annual Enrollment Period (AEP) is October 15th-December 7th and all plans will take effect January 1st.  Medicare recipients can add, switch, or drop a plan.  You are also allowed to enroll in as many plans as you want and typically the last enrollment completed during the enrollment period will be the one that goes into effect January 1st of the following year.

Open Enrollment for Medigap

If someone would like to purchase a Medigap Plan (Medicare Supplement) instead of a Medicare Advantage Plan, they have a 6 month “Open Enrollment window” starting the day their Part B takes effect where they can do so without being subjected to medical underwriting by an insurance carrier. Medigap Plans can also be purchased at any time throughout the year, but they would be subject to underwriting if outside of the Open Enrollment.

Long Term Care Facility

Are there times I may be able to enroll outside the enrollment periods? 

Talk with someone about the following:

  • If you have a qualifying chronic condition
  • If you have a low income subsidy or Medicaid
  • If you’ve moved to a new zip code  
  • Changing to a plan with a 5 star rating
  • Change in extra help or Medicaid 
  • Leaving group coverage or retirement coverage
  • If you have VA benefits
  • If you move into or out of a Long-term care facility or skilled nursing facility.

Medicare Supplement vs Medicare Advantage

Medicare Supplement Insurance Plans are also called Medigap Plans. These types of policies can help with the cost of your deductibles, copayments, coinsurance and excess charges depending on the coverage you choose, as there are several different Medigap options. Medicare Supplements are more “pay up front” with a higher monthly premium and very little cost as you use them. Medicare Supplements follow the coverage and freedoms of Medicare, meaning they work the same everywhere in the US and are not a network-based type of coverage.

Medicare Advantage Plans will minimize your overall risk, while keeping your monthly costs at a minimum due to being a network-based type of coverage. Medicare Advantage plans are more “pay as you go” with little to no monthly premium, but have copays for most services and feature a cap on your maximum out-of-pocket expenses. Medicare Advantage plans also typically include additional benefits at no extra cost that are not included with traditional Medicare coverage (Part A & B).

Ambulatory Services

What are the Parts (A) and (B) referenced in Medicare?


  • Inpatient care including skilled nursing facilities
  • Hospice care



  • Doctor Services (Not Routine Physicals)
  • Outpatient Surgeries
  • Diagnostic Tests
  • ER Visits
  • Ambulatory Services
  • Durable Medicare Equipment (like wheelchairs, walkers, hospital beds)
  • Outpatient Mental Health
  • Outpatient Physical and Occupational Therapy
  • Speech/Language Therapy
Home Delivered Meals

Benefits for Medicare recipients

Most Medicare Advantage Plans offer both Medical and Prescription Drug Coverage. They also include many additonal benefits such as dental, hearing, and vision. Plan benefts will vary by plans and zip codes.

Routine Transportation
Fitness Program Medicare

What is Medigap?

Medigap is Medicare Supplement Insurance that helps fill “gaps” in Original Medicare and is sold by private companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay some of the remaining health care costs, like:

  • Copayments
  • Coinsurance
  • Deductibles

Some Medigap policies also cover services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, here’s what happens:

  • Medicare will pay its share of the Medicare-Approved Amount for covered health care costs.
  • Then, your Medigap insurance company pays its share.

Medigap policies don’t cover everything

Medigap policies generally don’t cover: 

    • Long-term care (like non-skilled care you get in a nursing home)
    • Vision or dental services
    • Hearing aids
    • Eyeglasses
    • Private-duty nursing
Qualifying for Medigap Plans

Who qualifies for a Medigap plan?

Anyone that is eligible for Medicare parts A&B could qualify for a Medicare Supplement plan as long as they are not under contract with a Medicare Advantage plan and they can pass underwriting!

Some people may qualify for a Medicare Supplement without underwriting


Open Enrollment:

  • Open Enrollment (OE) is a 6 month period that begins the first month someone is enrolled in Part B
  • During OE there is no underwriting to qualify for a Medicare Supplement plan
    • This means there is no disqualification for pre-existing conditions!
  • Can change policy as many times as necessary during this 6 month window

Guaranteed Issue:

  • Guaranteed Issue (GI) is for those that have involuntarily lost creditable coverage
  • This window allows 60 days before and 63 days after the end of coverage to qualify for certain Medicare Supplement plans without underwriting
  • Can change policy as many times as necessary during this window
  • Generally occurs after moving to a new service area or changes to standing coverage
Medicare Supplement

Most Common Medigap Plans

Plan F:

  • Covers 100% of cost not covered by Part B – no copayments or coinsurance ever!
  • Covers 100% of Part B Deductible
  • Only pay Part B Premium and Plan F Premium
  • Can go to any doctor or hospital in the US as long as they accept Original Medicare
  • Plan is no longer available to people who were not eligible for Medicare before January 1, 2020

Plan G:

  • Most comprehensive plan available to those eligible for Medicare after January 1, 2020
  • Covers 100% of costs associated with Part B aside from Part B deductible – no copayments or coinsurance ever!
  • Great option for saving money due to increasing Plan F rates

Plan N:

  • Typically lower premiums than Plan G or Plan F
  • Covers most Part B copayments and coinsurance
    • Up to $50 ER visits
    • Up to $20 doctor visits
    • Does not cover Part B Excess Charges – could be responsible for up to 15% above what Medicare allows for billing in certain states
      • Not very common, but can be seen from specialists, surgeons, etc. 
      • Not allowed in CT, MA, MN, NY, OH, PA, RI, VT

What states are Apollo licensed for Medicare?

Apollo is licensed in 35 states to help find a medicare plan that meets your needs and is able to aid in the enrollment process. These states include: AL, AR, AZ, CA, CO, FL, GA, IA, IL, IN, KS, KY, LA , MD, MI, MN, MO, MS, MT, NC, NE, NJ, NM, NV, OH, OK, PA, SC, TN, TX, UT, VA, WA, WI, WY.


FAQ on Medicare


Turning 65 for Medicare

I’m about to turn 65—WHAT DO I DO?

If you are currently collecting Social Security Income (SSI) congratulations you will be automatically enrolled in Original Medicare—parts A & B.

If not then you will need to actively sign up by the following:

  • Calling the social security office
  • Going to www.socialsecurity.gov and applying online
  • Visiting your local social security office in person

How much will I pay for this coverage?

For most Americans, Medicare Part A will have no monthly premium—If you’ve worked 40 quarters paying into medicare OR  you were married for 10 years to a spouse that worked and paid in during 40 quarters even if you are not currently married to them.

Medicare Part B for most Americans will be around $170.10 per month. If you are drawing Social Security already, the premium can be taken out automatically before you receive your Social Security Check.

Some Americans may elect to defer getting Part B if they are still covered under an employer (or Spouse’s employer) group health plan. Employer Group Health Plans are not always the right fit for clients so we can help you ensure you are not over spending.

If you do not elect to get Part B when you are first eligible, and you are not covered on an Employer Group Health Plan you may incur a late enrollment penalty when you do elect to get Part B.

Payment for Medicare
Social Security

I received my Medicare card. Is it important?

Yes!  Your medicare number is what allows someone to determine your current plan and enroll you into any additional plans.  Up until 2018 it was your social security number.  If you are looking at one with your social security number on it then that number has changed…you will want to find one that is a combination of letters and numbers.

I’ve got original Medicare A&B—does this mean I don’t need to pay attention anymore?

Unfortunately while original medicare is cheap to have your out of pocket expenses are substantial.  Generally speaking you are covering 20% of costs.  More often than not, top carriers may offer plans that are low cost or no cost plan with more applicable benefits.

No Cost Plan
On the Phone with a Broker

Why should I talk to a sales agent?

First and foremost the services of the sales agents are ABSOLUTELY FREE. Your sales agent will have access to dozens of top rated carriers to find that plan that suits you.  This can all be done over the phone in the convenience of your house.  There will be no need to spend hours filling out paperwork and everything you need to get started can be sent right to your doorstep.

Apollo Fights For You


When it comes to Medicare, there are lots of questions—and good answers are hard to come by. We are here to be your advocates for comprehensive health care solutions. We are here to guide you through the process of your transition to Medicare. From the time you or a family member is curious about eligibility and how to move forward, we’ll help to ensure you have the best coverage for your needs.
Understanding Medicare
Medicare Coverage


At Apollo, we understand what family means to you, and we do everything possible to help you plan for the best and worst case scenarios of your future. We want to get to know you, your story, and your family. Medicare can be confusing and overwhelming. We are here to make it simple for you and your family. We are a solution hub for everything Medicare and strive to meet the unique needs of each member of the Apollo family.

Contact Apollo Today!

After breaking down all your Medicare questions, we would love to help you out in any way possible. If you are looking for help with your health insurance needs or Medicare needs, give us a call!

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By submitting the information above, you are agreeing to be contacted by a Licensed Sales Agent by email or phone call to discuss information about Medicare Insurance Plans.  This is a solicitation for insurance.

By providing your contact information, you are granting permission for a licensed sales agent to contact you by phone, mail, or email to answer your questions or provide additional information about Medicare Advantage Plans, Medicare Prescription Drug Plans and Medicare Supplement Insurance

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No obligation to enroll

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options 24 hours a day, 7 days a week. Please note that each insurer has sole financial responsibility for its products.
Not connected with or endorsed by the U.S Government or the federal Medicare program. This is a solicitation of insurance. A licensed insurance agent/producer may contact you. Apollo Insurance Group represents Medicare Advantage (HMO, PPO, PFFS, and PDP) organizations with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

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Insurance can be complicated. Between the dozens of providers, changing laws, different kinds of insurance, and so many options, it's a challenge to navigate and find the right plan for your budget and needs.

That's where an insurance broker can help. Apollo are the experts in health insurance and will fight for you. There's no extra cost to you and you'll have an insurance person to always turn to.

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Do you want to provide an affordable insurance option for your employees?

Or maybe your employees are already insured but the cost has increases. It may be time to shop for a better group plan. Having health insurance through an employer is an additional way to acquire and keep talent. Connect with Apollo to find the best group insurance plan for you and your employees.

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Life Insurance
Let's be honest, we often don't think about the extremes of what could happen in life. Life insurance is the least purchased kind of insurance even though plans start at only a few dollars a month. If you want to make sure your family is taken care of, this simple insurance can have a huge effect in case of death.

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Dental Insurance

A good smile can be worth a million dollars.

Everyone can benefit to good oral care and the cost of emergencies can be quite large. Luckily there are flexible dental insurance plans for everyone. Contact us to get a dental plan that works for your budget.

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Vision Insurance

Our eyes are one of our most precious organs, and we only have two, so proactive protection and care is key to maintaining these vital organs! Particularly for children, they don’t yet know how beautiful the world is through perfect vision, it is our responsibility as parents and caretakers to be in-tune with the world through their eyes. On the flip side, as we age our eyes do as well, and thus the frequency for vision checks increases exponentially.

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