Get help with your Medicare choices

Medicare is a health insurance program through the federal government. It mainly pays for health care costs for adults ages 65 and older. It pays for:

• Hospital stays
• Doctor visits
• Preventive care to help keep you healthy before you get sick
• Medicine prescriptions
• And more.

Medicare has 4 different parts. Each part pays for certain services.

It has 4 parts: A, B, C and D.

Parts A and B

Parts A and B are part of Original Medicare which is offered by the federal government.

• Part A helps pay for hospital stays, skilled nursing facility care and hospice or end-of-life care.
• Part B helps pay for doctor visits, preventive services and X-rays and other tests.

Parts C and D

Parts C and D are offered by health insurance companies.

• Part C is also known as Medicare Advantage. It combines Parts A and B and often pays for medicines, dental and vision care. You can get these plans from an insurance company. People who are looking for better care at lower costs often choose a Medicare Advantage plan over Original Medicare.
• Part D helps with the cost of medicines. 

The biggest difference is in how the 2 programs are structured and what they pay for:

Original Medicare is a plan provided by the federal government and includes Part A and Part B. Original Medicare does not usually pay for medicine or other types of services, such as dental, vision or hearing care.

Medicare Advantage is a plan known as Part C and is offered by insurance companies, not the federal government. These plans include everything in Part A and B, plus more services, including:

• Prescription medicine, also known as Part D
• Dental care
• Vision care
• Hearing services
• Fitness programs

If you have a Medicare Advantage plan, you’re often given a provider network of primary care doctors and specialists to choose from for your care.

With a Medicare Advantage plan, you have an annual limit every year to how much you need to pay out-of-pocket. The cost of Medicare Advantage plans includes paying for both the part C plan itself and for Medicare part B.

The choice between the 2 plans depends on:

• The types of services you prefer
• Your health care needs
• Your choice of doctor
• Your budget

You can enroll (sign up) for Medicare during a few different time frames: 

Initial Enrollment Period

When you first sign up for Medicare, you have a 7-month window. This is known as your Medicare Initial Enrollment Period. It begins 3 months before your 65th birthday, includes your birthday month and ends 3 months after you turn 65.

It’s important to sign up during your enrollment window. If you do not sign up during this time, you may have to pay an extra amount, called a late enrollment penalty. Or you may have a gap in health insurance coverage.

Annual Enrollment Period

This period is also known as the Medicare Open Enrollment Period. It runs from October 15 through December 7 each year. This is when you can make changes to your Medicare plan. 

During this time, you can switch between Original Medicare and Medicare Advantage plans. Changes made during this period usually start on January 1st of the following year.

Special Enrollment Period

This is a time outside of the other enrollment periods when you can sign up for or make changes to your Medicare plan for a limited time. Special enrollment is for certain life events:

• Losing other health plans
• Moving to a new area
• Becoming eligible (able to get) Medicaid
• Qualifying for extra help with medicine costs

Check with a licensed insurance agent to get more information about special enrollment periods.

At Optum, our doctors accept many kinds of Medicare plans. Over 100 insurance companies across the country choose Optum doctors to be part of their network. This makes it easier to choose the most affordable plan for your needs.

When you choose a Medicare plan accepted by our doctors, you make it possible to switch to an Optum doctor with your Medicare Advantage plan if you’re not already seeing one. As an Optum patient with Medicare Advantage, you get a primary care doctor and care team focused on your unique health needs at age 65 and older.  

With Optum, you can count on:

• Faster, easier and more ways to get care — in the office, virtually or at home
• Extra support to help you reach your health goals
• Care to help you stay healthier and save money***

The best way to start learning about your Medicare choices is to talk with a licensed insurance agent at the phone number on this page. If you want to learn more about plans offered in your area, you can also:

• Attend a no-cost, in-person Medicare event
• View our doctors and the Medicare plans they accept