Medicare Center
Your Complete Guide to Medicare in Michigan
Medicare doesn't have to be confusing. Our Medicare Center breaks down every part of Medicare, explains your enrollment windows, and helps you compare plans — all in plain language, at no cost to you.
Understanding the Parts of Medicare
Medicare is divided into parts, each covering different types of care. Understanding what each part covers — and what it doesn't — is the foundation of making a smart Medicare decision.
Hospital Insurance
Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health services. Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes for at least 10 years.
What it covers
- Inpatient hospital stays
- Skilled nursing facility care (after a qualifying hospital stay)
- Hospice care
- Some home health services
Does not cover: Long-term custodial care, most dental, vision, or hearing services.
Medical Insurance
Medicare Part B covers medically necessary services like doctor visits, outpatient care, preventive services, and durable medical equipment. Part B requires a monthly premium, which is income-based.
What it covers
- Doctor visits and outpatient care
- Preventive services (screenings, vaccines)
- Durable medical equipment (wheelchairs, walkers)
- Mental health services
Does not cover: Prescription drugs (covered under Part D), most dental, vision, and hearing care.
Medicare Advantage
Medicare Part C (Medicare Advantage) is an all-in-one alternative to Original Medicare offered by private insurance companies approved by Medicare. These plans must cover everything Original Medicare covers, and most include additional benefits.
What it covers
- Everything in Parts A and B
- Usually includes Part D prescription drug coverage
- Often includes dental, vision, and hearing benefits
- May include fitness, transportation, and over-the-counter benefits
Does not cover: Coverage varies by plan. Always verify your doctors and medications are in-network before enrolling.
Prescription Drug Coverage
Medicare Part D adds prescription drug coverage to Original Medicare (Parts A and B) or some Medicare Cost Plans. Part D plans are offered by private insurance companies approved by Medicare.
What it covers
- Brand-name and generic prescription drugs
- Drugs on the plan's formulary (drug list)
- Vaccines not covered under Part B
- Insulin and diabetes supplies (in many plans)
Does not cover: Drugs not on the plan's formulary. Coverage and costs vary significantly by plan.
Medicare Supplement (Medigap)
Original Medicare (Parts A and B) leaves significant gaps — including deductibles, copays, and coinsurance — that can add up quickly. Medicare Supplement plans, also called Medigap, are sold by private insurance companies to fill these gaps.
Plan G
The most comprehensive Medigap plan available to new Medicare enrollees. Covers all gaps in Original Medicare except the Part B deductible.
Plan N
Covers most gaps with lower premiums than Plan G. Requires small copays for some office and emergency room visits.
Plan A
The most basic Medigap plan. Covers Part A coinsurance and hospital costs, Part B coinsurance, and the first three pints of blood.
Plan K
Covers 50% of most gaps with a lower premium and an out-of-pocket limit. Good for those who want catastrophic protection at a lower cost.
Important: Medigap plans are standardized by the federal government — Plan G from one company covers the same benefits as Plan G from another. The key differences are premium price and company reputation. We compare rates across multiple carriers to find you the best value.
Medicare Enrollment Periods
Enrolling at the right time is critical. Missing your window can result in permanent late enrollment penalties that increase your premiums for life.
7-month window around your 65th birthday
Initial Enrollment Period (IEP)
Begins 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. This is your first opportunity to enroll in Medicare Parts A, B, and D.
Enrolling late in Part B results in a 10% premium increase for each full 12-month period you were eligible but didn't enroll.
October 15 – December 7 each year
Annual Enrollment Period (AEP)
During AEP, you can switch Medicare Advantage plans, switch from Medicare Advantage to Original Medicare, or change your Part D plan. Changes take effect January 1.
No penalty for switching during AEP, but you must act before December 7.
January 1 – March 31 each year
Medicare Advantage Open Enrollment (OEP)
If you're already enrolled in a Medicare Advantage plan, you can switch to a different MA plan or return to Original Medicare (and join a Part D plan). You can only make one change during OEP.
No penalty, but limited to one plan change.
Triggered by qualifying life events
Special Enrollment Period (SEP)
You may qualify for a Special Enrollment Period if you lose employer coverage, move out of your plan's service area, your plan leaves Medicare, or you qualify for Medicaid.
Missing your SEP window may require waiting until AEP.
Original Medicare vs. Medicare Advantage
| Feature | Original Medicare | Medicare Advantage |
|---|---|---|
| Coverage | Parts A and B only | Parts A, B, and usually D in one plan |
| Prescription Drugs | Requires separate Part D plan | Usually included |
| Doctor Network | Any Medicare-accepting provider nationwide | Usually limited to plan's network |
| Extra Benefits | None | Often includes dental, vision, hearing, fitness |
| Monthly Premium | Part B premium only (no additional plan premium) | Part B premium plus plan premium (often $0) |
| Out-of-Pocket Limit | No annual limit | Annual out-of-pocket maximum |
| Referrals | Not required | May be required for specialists (HMO plans) |
Coverage
Original Medicare
Parts A and B only
Medicare Advantage
Parts A, B, and usually D in one plan
Prescription Drugs
Original Medicare
Requires separate Part D plan
Medicare Advantage
Usually included
Doctor Network
Original Medicare
Any Medicare-accepting provider nationwide
Medicare Advantage
Usually limited to plan's network
Extra Benefits
Original Medicare
None
Medicare Advantage
Often includes dental, vision, hearing, fitness
Monthly Premium
Original Medicare
Part B premium only (no additional plan premium)
Medicare Advantage
Part B premium plus plan premium (often $0)
Out-of-Pocket Limit
Original Medicare
No annual limit
Medicare Advantage
Annual out-of-pocket maximum
Referrals
Original Medicare
Not required
Medicare Advantage
May be required for specialists (HMO plans)
The right choice depends on your situation. The best plan for you depends on your doctors, medications, health needs, and budget. We help you compare both options side by side — at no cost to you.
Important: 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 (TTY: 1-877-486-2048), 24 hours a day/7 days a week, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options.
Not connected with or endorsed by the U.S. government or the federal Medicare program.
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