Medicare Solutions
You have worked hard your whole life and paid into the Medicare system with every paycheck received. As you approach your 65th birthday, it is time for you to take advantage of Medicare offerings afforded to you.
PIC is your resource to guide you through the overall Medicare enrollment process as well as identify subsequent policies that would help cover any healthcare costs that are not compensated by the Medicare program.
The following sections provide a crash course on the main components of Medicare and it's subsequent parts and/or additions - We encourage you to review and reach out with any further guidance to help you thrive in your golden-years.
Medicare Structure
Part A (Hospital Insurance)
Part A comprises in part of what the industry calls "Original Medicare". This is your taxpayer pre-funded Hospital Coverage and is accepted at any provider that accepts Medicare.
MARK YOUR CALENDARS -
Americans are enrolled during their Medicare Initial Coverage Election Period (ICEP) which is held starting 3 Months prior to your Birthday Month up to 3 Months post your birthday month.
There is no associated premium for Medicare Part A for those who have worked and paid into the Medicare system via income taxes withheld for at least 10 years (this is a Social Security stipulation)
Part A does NOT cover all Hospital services and costs in totality.
- Inpatient hospital or Skilled Nursing Facility (SNF) care Deductible: $1,736 (2026) Per "Benefit Period" (The day admitted + 60 Consecutive days = "Benefit Period"
- Post deductible, the following Co-Pays are the responsibility of the patient (as of 2026:
- Days 1-60: $0 after deductible
- Days 61-90: $434 copayment per day
- Days 91-150 (60 Additional Lifetime Reserve Days): $868 copayment per day
- Days 151+ (beyond reserve): All Costs
- No stated Out of Pocket Maximum for beneficiary
Part B (Medical Insurance)
Medicare Part B is the second half that constitutes "Original Medicare" - This is healthcare coverage for any services outside of a hospital or a Skilled Nursing Facility (SNF).
Americans are entitled to enroll in Part B at the same time they enroll with Part A during Medicare Initial Coverage Election Period (ICEP) which is held starting 3 Months prior to your Birthday Month up to 3 Months post your birthday month.
Late enrollment penalties applies to those who qualify for Part B and did not and also did not have equivalent coverage through a separate group policy.
Unlike Part A; Part B requires a monthly standard premium of which is generally pulled from monthly Social Security disbursements.
Medicare Part B includes an annual deductible which is adjusted yearly and then incurs a 20% co-insurance for beneficiaries on covered services at any provider that accepts Medicare.
NO OUT OF POCKET MAXIMUM STIPULATIONS
Part C (Medicare Advantage)
Medicare Advantage (MA) or Part C - Are private health plans regulated by Medicare that administer Medicare benefits that you would have with Part A and B, often also include prescription drug coverage (equivalent to Part D), as well as some other supplemental benefits and most importantly, assists with more favorable deductibles, Co-pays, Co-Insurance and an Out of Pocket Maximum stipulation.
Americans must be enrolled in Part A and Part B to be eligible for Part C. Applicants can enroll at the same time they enroll for Part A and B at ICEP or via the standard Medicare Annual Election Period (AEP).
All MA plans offer 12 month trial period - Of which you can switch back to original Medicare and/or purchase Medigap plan.
Part D (Prescription Drug Coverage)
Part D is your Pharmacy drug coverage also offered through private health carriers. Standalone drug plans are available to those who are qualified to obtain it and/or do not have equitable coverage through an alternate plan (such as a Medicare Advantage plan that includes Prescription Drug Coverage).
Enrollees must be entitled to Medicare Part A and/or enrolled with Part B.
Similar to Part B and C - These plans incur a separate premium, deductible, and provide per-prescription cost sharing benefits.
Late enrollment penalties applies to those who qualify for Part D and did not and also did not have equivalent coverage through a separate group policy.
Medicare Supplement (Medigap)
As an alternative Medicare Advantage Part C Plans, Medicare supplement plans (AKA: Medigap) are a nice compliment to help cover the "gaps" of copays, deductibles and many of the co-insurance charges an enrollee would incur utilizing original Medicare (Parts A and B).
These plans are available for those who have Part A and Part B already and are NOT enrolled in Part C. Medigap allows for a 6 month "guaranteed issue right" medigap open enrollment period starting at time enrollee is entitled to original Medicare. The Medigap provider MUST issue the beneficiary a policy regardless of pre-existing conditions (no medical underwriting).
Medigap plans are issued by private insurers and offer a variety of plan types to choose from that vary in their extension of benefits.
Enrollees can use Medigap plan/benefits anywhere in the country that accepts Medicare - However, these plans do not offer prescription coverage - Part D can be elected as a standalone coverage