


What it is: U.S. federal health insurance program.
Who it covers:
Adults 65 and older.
People under 65 with qualifying disabilities (after waiting period).
Individuals with End-Stage Renal Disease (ESRD) or ALS (special rules).
Guaranteed coverage: Eligible individuals cannot be denied based on age, health status, or pre-existing conditions.
Part A (Hospital Insurance): Inpatient care, skilled nursing, home health, hospice.Usually premium-free (10+ years work history).Deductibles + daily copays apply.
Part B (Medical Insurance): Doctor visits, outpatient, preventive care, labs, DME.Monthly premium (income-based), annual deductible, 20% coinsurance.
Part D (Prescription Drugs): Private drug plans.Each plan has own formulary, tiers, network, costs.Late penalty if you delay without credible coverage.
What it is: Online platform (HealthCare.gov or state exchange) for individuals/families to buy health insurance.
Guaranteed coverage: No denials for pre-existing conditions.
All plans must cover 10 Essential Health Benefits: Doctor & hospital care, ER, maternity/newborn, mental health & substance use, prescriptions, labs, pediatric (incl. dental/vision), rehab/habilitation, preventive care, chronic disease management.
Premium Tax Credit (PTC):
Lowers monthly premium based on income & household size.
Available up to ~150–400%+ of Federal Poverty Level (FPL).
Many qualify for very low.
Cost-Sharing Reductions (CSR):
Extra savings on deductibles, copays, OOP max.
Only on Silver plans & for incomes ~100–250% FPL.
Reconciliation at tax time: IRS adjusts subsidy based on actual income.
Add-ons: Part D (drugs) + Medigap (supplement).
Pros:
Nationwide access, no networks or referrals.
Predictable costs with Medigap.
Best for frequent travelers & multiple specialists.
Cons:
Multiple premiums (B, D, Medigap).
No built-in extras (dental, vision, hearing, transportation, gym, etc)
Private plans bundling A + B + usually D.
Extras included: dental, vision, hearing, OTC, transportation, gym, flex cards.
Types: HMO, PPO, PFFS, SNP (e.g., D-SNP, C-SNP).
Pros:
One card, extra benefits.
Out-of-pocket max protection.
Often low.
Cons:
Networks + prior authorizations.
Benefits can change yearly.
Travel limits outside service area (except emergencies).
Some people combine Medicare with other benefits:
Employer/Union Coverage: Retiree health benefits alongside Medicare.
VA / TRICARE for Life: Military or veterans’ health coverage coordinating with Medicare.
Dual Eligible (Medicare + Medicaid): Access to Special Needs Plans (D-SNP).
Bronze: Lowest premiums, highest costs when you use care. For minimal users.
Silver: Mid premiums, access to CSR savings.
Best value for subsidy-eligible.
Gold: Higher premiums, lower cost-sharing.
Good for frequent care users.
Platinum: Highest premiums, very low cost-sharing.
Rare, best for heavy care users.
HMO: Lowest cost; in-network only; referrals needed.
EPO: In-network only; usually no referrals.
PPO: More flexibility; some out-of-network coverage; higher premiums.
⚠️ Tip: Always check if your doctors, hospitals, and pharmacies are in-network.



Medicare AEP
If you don’t make changes during AEP (Oct 15 – Dec 7), you’ll usually have to wait until next year, unless you qualify for a Special Enrollment Period (SEP) (e.g., moving, losing coverage, Medicaid eligibility, certain health conditions). Your current coverage will continue into 2026 if no changes are made.
Yes. You can submit multiple requests during AEP, but only the last one before Dec 7 will take effect on Jan 1. If you have a Medicare Advantage plan, you also have the MA OEP (Jan 1 – Mar 31) to make one more change or go back to Original Medicare + Part D.
Switch between Original Medicare and Medicare Advantage. Change from one MA plan to another.
Join, drop, or switch a Part D drug plan.
All AEP changes start on Jan 1 of the following year.
You may qualify for Special Enrollment Periods and can change plans multiple times during the year.
ACA MARKETPLACE AEP
If you don’t enroll or renew during Open Enrollment (Nov 1 – Jan 15), you can only get coverage if you qualify for a Special Enrollment Period (SEP) (e.g., loss of other coverage, moving, marriage/divorce, birth/adoption, income changes). Otherwise, you’ll need to wait until the next year.
Yes. You can change plans as many times as you want during Open Enrollment; only the last plan selected before Jan 15 will take effect. After Jan 15, changes are only allowed with a SEP.
Enroll by Dec 15 → Coverage starts Jan 1.
Enroll Dec 16 – Jan 15 → Coverage starts Feb 1.
Yes. Most people qualify for tax credits and cost-sharing reductions based on income and household size.
Income details, household members, immigration documents (if applicable), list of preferred doctors and prescriptions.
Your coverage won’t begin until you make the first payment.