New to Medicare? Here’s What You Need to Know

Do I qualify for Medicare?

What does Medicare cover?

What are my plan options?

You likely have a lot of questions if you’re new to Medicare. Here are answers to some of the most common questions we hear.

Who qualifies for Medicare?

Medicare is available for people ages 65 years old and older. People may also qualify for Medicare due to certain disabilities.

When can I enroll in Medicare?

There is a seven-month window around your 65th birthday when you can enroll. You can sign up three months before the month of your birthday through three months after the month you turn 65 years old.

What if I already have health coverage through an employer plan?

Even if you currently have health coverage through an employer plan, it’s smart to review your Medicare options. Many people choose to leave their employer plan because they can get better coverage through Medicare at a lower cost.

What happens if I miss the initial enrollment period?

If you miss the initial enrollment period, and don’t have other health coverage (such as through an employer plan), you could be subject to a penalty. There are several types of penalties, the most common being a 10 percent penalty fee for every 12 months you’re not enrolled in a plan.

When should I start researching plans and begin the application process?

You should start researching plans nine months prior to your 65th birthday. I recommend starting the application process three months prior to your 65th birthday.

What are Medicare Parts A, B, C and D?

Medicare is divided into four parts: A, B, C and D. Parts A & B make up Original Medicare.

  • Part A – This covers in-patient hospital and nursing home care.
  • Part B – This is for anything done in an outpatient setting – for example, a visit with your primary care provider or lab work.
  • Part C – Also known as Medicare Advantage, these are plans purchased through private insurance companies. This all-in-one option includes Part A, B and usually D. Part C also includes Medicare Supplement or Medigap plans that can be purchased through private insurers to get coverage for things Original Medicare doesn’t cover.
  • Part D – This is prescription drug coverage and can be added to Original Medicare plans as well as in addition to Medicare Supplement or Medigap plans.

How do I determine which coverage option is right for me?

You should consider what features and benefits are most important to you and then compare those with the available plans. Some things to consider include typical healthcare expenses during the year, the types of prescription drugs you take and your preferred providers.

What if I have questions while I’m going through the application process?

A Network Health sales advisor or broker can help you review plan options and find one that fits your needs. We also offer in-person meetings and Zoom meet-ups to help people learn more about applying for Medicare and picking the right plan.

Learn more about your Medicare options at