Medicare Basics Explained: What You Should Know

Understanding Medicare can feel like learning a new language. Between Parts A, B, and D—not to mention rules, penalties, and deadlines—it’s no wonder so many people feel overwhelmed.



This page breaks it all down in simple, real-world terms. Whether you’re in NW Oregon or SW Washington, we’re here to help you understand how Medicare works, what it covers (and does not), and which choices might be right for you.

A Clear Look at How Medicare Works

Who Medicare Covers

  • Adults age 65 and older
  • People under 65 with certain disabilities
  • Individuals with End-Stage Renal Disease (ESRD


If you’re unsure whether you qualify, visit our Medicare Eligibility page or contact us directly—we’ll walk you through it.

What Medicare Does & Doesn’t Cover

Original Medicare (Parts A & B) helps with hospital stays, doctor visits, preventive care, lab work, outpatient services, and more.


But it does not cover:

  • Most prescription drugs
  • Dental, vision, or hearing
  • Long-term or custodial care

 

For these gaps, we offer additional plan options to help.

A woman is sitting at a desk holding a piece of paper.
senior Medicare discussion Oregon home

Understanding Medicare Parts A, B & D

Part A covers hospital insurance: inpatient stays, skilled nursing, and some home health care. Most people don’t pay a premium for this.


Part B covers medical insurance: doctor visits, outpatient care, durable medical equipment, and preventive services. Most people pay a monthly premium for Part B (based on income).


Part D adds prescription drug coverage, offered by private companies approved by Medicare. We’ll help you find one that covers your medications affordably.

Other Medicare Options & Plan Comparisons

Original Medicare gives you flexibility to see providers nationwide, but doesn’t include everything. That’s why some people choose to add a Medigap plan or switch to a Medicare Advantage Plan (Part C)—a bundled alternative that includes hospital, medical, and sometimes drug, dental, and vision coverage.

We help you compare these options clearly. Visit our Medicare Advantage page to learn more.

And if you want to protect against out-of-pocket costs or fill in benefit gaps, ask us about Medigap and supplemental plans. Our one-on-one process helps you find what’s right—without the guesswork.

What We Are Asked Most

  • Do I need to sign up for Medicare if I’m still working?

    Maybe. If you have employer coverage and are over 65, you might be able to delay Part B without penalty. But every case is different—contact us and we’ll help you decide.

  • Does Medicare cover dental or vision?

    Not under Original Medicare. But we offer Dental Insurance and Vision Insurance designed to fill this gap.

  • What’s the difference between Part B and Part D?

    Part B is for doctor visits and outpatient care. Part D is for prescription drug coverage. You may need both, depending on your health needs.

  • What if I need all-in-one coverage?

    Medicare Advantage plans combine Parts A, B, and sometimes D—plus extra benefits. Visit our Medicare Advantage page for full details.

Source Attribution:
 This information was obtained from www.medicare.gov.