Medicare 101

Our mission is to make Medicare easier to understand while helping every client feel informed, supported, and confident in their healthcare coverage decisions. Whether you’re turning 65, retiring, helping a loved one, or reviewing your current plan, Masshealthquote is here to guide you every step of the way.

Step one

Are you eligible?

Three quick questions. Real answer at the end — not a sales pitch.

The Building Blocks

The four parts

A and B are Original Medicare, run by the federal government. C and D are private plans you can add. Click any card.

Hospital Insurance

Inpatient hospital stays, skilled nursing facility care, hospice, and some home health care. Most people pay $0 premium for Part A if they or a spouse paid Medicare taxes for 10+ years.

Medical Insurance

Doctor visits, outpatient care, preventive screenings, and durable medical equipment. The standard 2026 premium is set by Medicare and adjusted yearly.

Medicare Advantage

Private plans that bundle A and B (and usually D) into one package. Often include dental, vision, hearing, and fitness benefits Original Medicare doesn't cover.

Prescription Drugs

Stand-alone drug plan that pairs with Original Medicare. Drugs sit in tiers — generic, preferred brand, specialty — that determine your copay.

When To Enroll

The windows that matter

Miss an enrollment window and you could face penalties added to your premium for the rest of your life. Here are the dates.

A typical Medicare year

Two key windows repeat every year:

iep

Initial Enrollment Period

7 months around your 65th birthday

Starts 3 months before your birth month, includes your birth month, and continues 3 months after. This is your most important window — do not miss it.

aep

Annual Enrollment Period

Oct 15 – Dec 7 every year

Anyone on Medicare can add, drop, or switch coverage. Changes take effect January 1.

oep

Open Enrollment Period

Jan 1 – Mar 31 every year

If you’re on a Medicare Advantage plan, you can switch plans or return to Original Medicare. One change only.

sep

Special Enrollment Period

Triggered by qualifying life events

Moving, losing employer coverage, or qualifying for Extra Help. Usually a 2-month window.

medigap oep

Medicare Supplement OEP

6 months from your Part B start date

Your one-time guaranteed-issue window. Insurance companies cannot deny you or charge more for pre-existing conditions.

PART B SEP

After Employer Coverage

8 months after employer coverage ends

If you delayed Part B because you had qualifying employer coverage, this is your penalty-free window to sign up.

Don't Leave Money On The Table

Late penalties are permanent.

Miss an enrollment window without qualifying coverage and Medicare adds a penalty to your premium for life. Here’s how it works.

Part B Late Penalty

If you don't sign up for Part B when first eligible — and you don't have qualifying employer coverage — your monthly premium goes up by 10% for each full 12-month period you delayed.

Part D Late Penalty

Go 63 or more consecutive days without Part D or other creditable drug coverage and Medicare adds a penalty for every month you went without.

How to avoid all of it

The simplest path: enroll during your IEP, the 7-month window around your 65th birthday. If you have employer coverage past 65, sign up within 8 months of losing it.

Parts A and B leave real gaps. The good news: most of these can be addressed by adding Part C, Part D, or a Medicare Supplement.

Most prescription drugs

Routine dental

Eye exams & glasses

Hearing aids

Gym & wellness

Long-term care

Care outside U.S.

Daily living help

Extended stays

READY TO GET STARTED?

Let’s Simplify Medicare Together.

Whether you are turning 65, reviewing your current coverage, comparing prescription drug options, or helping a loved one understand Medicare, Almond Insurance is here to provide clear answers and no-pressure guidance.