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medicare

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MEDICARE

Disclaimer:
I do not offer every plan available in your area. Currently, I represent 6 organizations which offer 24 products in your area. Please contact Medicare.gov, 1-800-MEDICARE or your State Health Insurance Program (SHIP) to get information on all of your options.

Medicare is a health insurance program for:

  • People age 65 or older,

  • People under age 65 with certain disabilities,

  • People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).

MEDICARE HAS

PART A HOSPITAL INSURANCE

Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

PART B MEDICAL INSURANCE

Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.

PRESCRIPTION DRUG COVERAGE

Most people will pay a monthly premium for this coverage. Starting January 1, 2006, new Medicare prescription drug coverage will be available to everyone with Medicare. Everyone with Medicare can get this coverage that may help lower prescription drug costs and help protect against higher costs in the future. Medicare Prescription Drug Coverage is insurance. Private companies provide the coverage. Beneficiaries choose the drug plan and pay a monthly premium. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.

MEDICARE ADVANTAGE PLAN

A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren't paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.

MEDICARE SUPPLEMENTAL PLAN

A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.

A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

MEDICARE PRESCRIPTION DRUG PLAN

Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost.

A drug in a lower tier will generally cost you less than a drug in a higher tier. In some cases, if your drug is on a higher tier and your prescriber thinks you need that drug instead of a similar drug on a lower tier, you or your prescriber can ask your plan for an exception to get a lower copayment.

Medicare is a health insurance program for:

  • People age 65 or older,

  • People under age 65 with certain disabilities,

  • People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).

MEDICARE HAS

PART A HOSPITAL INSURANCE

Most people don't pay a premium for Part A because they or a spouse already paid for it through their payroll taxes while working. Medicare Part A (Hospital Insurance) helps cover inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities (not custodial or long-term care). It also helps cover hospice care and some home health care. Beneficiaries must meet certain conditions to get these benefits.

PART B MEDICAL INSURANCE

Most people pay a monthly premium for Part B. Medicare Part B (Medical Insurance) helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.

PRESCRIPTION DRUG COVERAGE

Most people will pay a monthly premium for this coverage. Starting January 1, 2006, new Medicare prescription drug coverage will be available to everyone with Medicare. Everyone with Medicare can get this coverage that may help lower prescription drug costs and help protect against higher costs in the future. Medicare Prescription Drug Coverage is insurance. Private companies provide the coverage. Beneficiaries choose the drug plan and pay a monthly premium. Like other insurance, if a beneficiary decides not to enroll in a drug plan when they are first eligible, they may pay a penalty if they choose to join later.

MEDICARE ADVANTAGE PLAN

A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you're enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren't paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.

MEDICARE SUPPLEMENTAL PLAN

A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.

A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

MEDICARE PRESCRIPTION DRUG PLAN

Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost.

A drug in a lower tier will generally cost you less than a drug in a higher tier. In some cases, if your drug is on a higher tier and your prescriber thinks you need that drug instead of a similar drug on a lower tier, you or your prescriber can ask your plan for an exception to get a lower copayment.

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frequently asked questions

When can I sign up for Medicare?

There are a few key windows, and missing them can cost you. Your Initial Enrollment Period is a 7-month window around your 65th birthday, it starts 3 months before the month you turn 65, includes your birthday month, and runs 3 months after. To avoid a coverage gap, it's best to sign up during the 3 months before your birthday. If you already have Medicare, the Annual Enrollment Period runs October 15 through December 7 each year, and any changes you make take effect January 1.

What does Medicare cost in 2026?

Most people pay nothing for Part A (hospital coverage) because they paid Medicare taxes while working. For Part B (medical coverage), the standard monthly premium is $202.90 in 2026, with an annual deductible of $283. After you meet the deductible, you typically pay 20% of the cost for most doctor services and equipment. Higher earners may pay more for Part B based on income. Part C (Medicare Advantage) and Part D (drug coverage) costs vary by plan.

What's the difference between Original Medicare and Medicare Advantage?

Original Medicare is run by the federal government and includes Part A and Part B. It lets you see any doctor that accepts Medicare, but it doesn't cover everything, things like prescription drugs, dental, vision, and hearing usually aren't included. Medicare Advantage (Part C) is offered by private insurers and bundles Parts A, B, and often D into one plan, frequently adding extras like dental or vision. The tradeoff is that Advantage plans usually require you to use a network of doctors. Which is better depends on your health needs, budget, and preferred doctors.

Do I need a separate plan for prescription drugs?

Possibly. Original Medicare (Parts A and B) does not cover most prescription drugs, so you'd need a standalone Part D plan to get that coverage. Many Medicare Advantage plans include drug coverage already. One important thing to know: if you don't sign up for drug coverage when you're first eligible and go without it, you may face a late-enrollment penalty that gets added to your premium for as long as you have the plan.

What happens if I sign up late?

Late penalties are real and they can be permanent, so this matters. For Part B, the penalty adds 10% to your monthly premium for every full 12-month period you delayed enrollment without other qualifying coverage and you generally keep paying it for as long as you have Medicare. There's a separate penalty for Part D drug coverage too. The good news: if you're still working and have coverage through your job (or your spouse's), you may qualify for a Special Enrollment Period that lets you delay without penalty.

What do I do when I turn 65?

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frequently asked questions

When can I sign up for Medicare?

There are a few key windows, and missing them can cost you. Your Initial Enrollment Period is a 7-month window around your 65th birthday, it starts 3 months before the month you turn 65, includes your birthday month, and runs 3 months after. To avoid a gap in coverage, it's best to sign up during the 3 months before your birthday. If you already have Medicare, the Annual Enrollment Period runs October 15 through December 7 each year, and any changes you make take effect January 1.

What does Medicare cost in 2026?

Most people pay nothing for Part A (hospital coverage) because they paid Medicare taxes while working. For Part B (medical coverage), the standard monthly premium is $202.90 in 2026, with an annual deductible of $283. After you meet the deductible, you typically pay 20% of the cost for most doctor services and equipment. Higher earners may pay more for Part B based on income. Part C (Medicare Advantage) and Part D (drug coverage) costs vary by plan.

What's the difference between Original Medicare and Medicare Advantage?

Original Medicare is run by the federal government and includes Part A and Part B. It lets you see any doctor that accepts Medicare, but it doesn't cover everything, things like prescription drugs, dental, vision, and hearing usually aren't included. Medicare Advantage (Part C) is offered by private insurers and bundles Parts A, B, and often D into one plan, frequently adding extras like dental or vision. The tradeoff is that Advantage plans usually require you to use a network of doctors. Which is better depends on your health needs, budget, and preferred doctors.

Do I need a separate plan for prescription drugs?

Possibly. Original Medicare (Parts A and B) does not cover most prescription drugs, so you'd need a standalone Part D plan to get that coverage. Many Medicare Advantage plans include drug coverage already. One important thing to know: if you don't sign up for drug coverage when you're first eligible and go without it, you may face a late-enrollment penalty that gets added to your premium for as long as you have the plan.

What happens if I sign up late?

Late penalties are real and they can be permanent, so this matters. For Part B, the penalty adds 10% to your monthly premium for every full 12-month period you delayed enrollment without other qualifying coverage and you generally keep paying it for as long as you have Medicare. There's a separate penalty for Part D drug coverage too. The good news: if you're still working and have coverage through your job (or your spouse's), you may qualify for a Special Enrollment Period that lets you delay without penalty.

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  • Sacramento / Northern California

  • Central Coast

  • Arizona

  • Greater Phoenix / Valley of the Sun

  • Tucson / Southern Arizona

  • Northern Arizona

  • West Valley & Yuma

  • East Valley & Pinal County

California, USA

proudly serving these areas

  • California

  • Greater Los Angeles

  • Inland Empire

  • Orange County

  • San Diego County

  • Central Valley

  • San Francisco Bay Area

  • Sacramento / Northern California

  • Central Coast

  • Arizona

  • Greater Phoenix / Valley of the Sun

  • Tucson / Southern Arizona

  • Northern Arizona

  • West Valley & Yuma

  • East Valley & Pinal County

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ALWAYS IMAGINED

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ALWAYS IMAGINED

Aguilera & Associates Insurance Services

CA LIC #0B01700 6620 Coyle Ave Suite 120, Carmichael, CA 95608

Cell (415) 271-5160

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service areas

Greater Los Angeles

Inland Empire

Orange County

San Diego County

Central Valley

San Francisco Bay Area

Sacramento / Northern California

Central Coast

service areas

Greater Phoenix / Valley of the Sun

Tucson / Southern Arizona

Northern Arizona

West Valley & Yuma

East Valley & Pinal County

operating HOURS

Mon: 9:00am - 5:00pm

Tue: 9:00am - 5:00pm

Wed: 9:00am - 5:00pm

Thu: 9:00am - 5:00pm

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Sat: CLOSED

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