Learning about Medicare for the first time?
PrimeTime Health Plan is ready to meet you at the starting point, as we have since we first began developing local Medicare solutions in 1997.
Parts A and B make up the federal government’s Medicare program, also known as “Original Medicare.” Most people can sign up for Parts A and B around the time they turn 65 years old, in addition to any other parts they choose.
| Part | Helps pay for... | Cost |
| A - Hospital Insurance |
Inpatient care at:
|
Free, if you’ve worked and paid Medicare taxes for at least 10 years. May also be eligible if a spouse (current or former) meets the 10-year requirement. |
| B - Medical Insurance |
|
Monthly premium (can vary depending on income). The standard for 2026 is $202.90. This is deducted each month from your Social Security check. |
Parts C and D are run by private insurance companies which provide plans approved by the federal government.
| Part | Definition | Requirements |
|
C – Medicare Advantage |
An alternative to original Medicare that bundles Parts A and B and usually Part D (see definition below). Plans usually offer benefits not included in original Medicare, such as:
PrimeTime Health Plan offers Medicare Advantage plans with valuable benefits in these areas, as well as telehealth, over-the counter and a gym membership through SilverSneakers. We also offer Part D. Explore our plans. |
You must sign up for Part A and Part B before enrolling in a Medicare Advantage plan. Costs and coverage vary. |
| D – Prescription drug coverage | Outpatient prescription drugs – drugs you take on your own, not in a hospital or doctor’s office. | You must sign up for Parts A or B before enrolling in Part D. Costs and coverage vary. |
|
Various Letters – Medigap or Medicare Supplement Plans |
Policies are standardized. Those with the same letter offer the same benefits no matter where you live or the insurance company you choose. Visit PrimeTime Choices to see our Medigap plans. |
Plans to supplement your Original Medicare covering out-of-pocket costs, like deductibles, copayments and coinsurance. Typically DO NOT include: long-term care, vision/dental care, hearing aids and glasses. |
You enroll through Social Security. Click here to enroll online. You may also call Social Security in most time zones Monday – Friday from 8 a.m. to 7 p.m. Call 1-800-772-1213 or TTY+1-800-325-0778.
There are different guidelines, depending on your situation.
| You are ... | Enrollment Guidance |
| turning 65 or just turned 65. | You have a seven-month period to sign up – from three months before the month you turn 65 to three months after, including your birthday month. This seven-month period is called the “Initial Enrollment Period” or IEP. Coverage begins the first day of the month after you sign up, but not prior to your birthday month. |
| still working (or spouse is) after the age of 65 and receiving health insurance through an employer. |
Enroll within eight months after you or your spouse stops working, even if you choose COBRA or other insurance coverage. Tip: You may want to sign up for Part A during your IEP regardless, since most people don’t pay a premium. If you’re planning to retire and want coverage to start when the job-based insurance ends, make sure to sign up the month before your last day. |
| receiving Social Security or Railroad Retirement Board (RRB) benefits prior to age 65. | No action needed. You are automatically enrolled in Medicare on the first day of the month you turn 65. |
| under the age of 65 and receiving Disability benefits. | You may be eligible to enroll. Contact Social Security. |
| diagnosed with permanent kidney failure. | Call 800-772-1213 and communicate that you have end-stage renal disease (ESRD) to begin enrollment. |
You may be subject to a late enrollment penalty. You may also have to wait until the general enrollment period to sign up for Part B (Jan. 1 to March 31 each year).
Yes. If you postpone, you can face late penalties and, possibly, delayed coverage. The exception is if you already have “creditable” drug coverage from a former employer, union, the Veterans Affairs department, etc. Click here to understand creditable drug coverage.
You’re rolling the dice on your financial future and the ability to enjoy retirement the way you want if you only have Parts A and B (Original Medicare). That dream trip, school fund for the grandkids, sports event or theater tickets … could evaporate if you get hit by an unexpectedly high medical bill.
That’s because there are NO OUT-OF-POCKET LIMITS for Parts A (hospital and skilled nursing care) or B (outpatient services, doctor visits, preventive care and durable medical equipment). Also, as mentioned above, Original Medicare has NO PRESCRIPTION DRUG COVERAGE.
Unfortunately, there’s no way to predict if you will need high-cost prescriptions or long hospital/nursing home stays that escalate beyond your means.
Whereas a Medicare Advantage plan can’t refuse to accept you due to past or current medical conditions (with the exception of kidney failure), a Medigap plan can take health problems into account during certain time periods or impose a “pre-existing condition waiting period” for up to six months after enrollment.
If your head is spinning, you’re not alone.
Drop by or call us with any questions (contact information below). We’ll give you what you need to make informed decisions about Medicare. Our caring team offers in-person meetings and webinars on general Medicare education. Learn with us.
Take advantage of local specialists who take the time to answer your questions. You should not be rushed when learning about something as important as your healthcare.
Learn More from Our Local Specialists.
We are here to help you.
- Call us at 330-363-7407 (TTY 711) from 8 a.m. to 8 p.m., Monday through Friday. Talk to a local specialist or schedule a 1-on-1 meeting to discuss your options.
- Join us for a free informational webinar to ask questions and learn more about PrimeTime Health Plan's Medicare Advantage plans.
