Knowing Where to Start with
Medicare Begins
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Demystifying Medicare for New Jersey seniors, individuals, and small businesses with local, face-to-face expertise you can rely on.
Get guidance on the first steps to explore your Medicare options.
Understand your choices and how employer coverage may impact enrollment.
Learn the enrollment process, timelines, and important information.
Compare Medicare coverage choices to find the right fit for you.
Get clarity on Medicare costs and how to plan for your healthcare expenses.
What is Medicare?
At its core, Medicare is the federal health insurance program designed for adults aged 65 and older, as well as younger individuals with certain disabilities.
While it is an incredible benefit, it isn't completely free, and it isn't a single "one-size-fits-all" plan. Instead, it is a flexible system made of different parts—covering hospital stays, doctor visits, and prescription medications—that you customize to fit your health needs and retirement budget.
Our Promise: You don't have to navigate this transition alone. We are here to help you understand your choices, avoid lifelong late-enrollment penalties, and ensure you never face a gap in your coverage!
What are the Parts of Medicare?
Medicare is broken down into specific parts, each covering different aspects of your healthcare.
| Part | What It Covers | What You Need to Know |
|---|---|---|
| Part A & B | Original Medicare | Hospital and medical coverage managed by the federal government. Most people need to supplement this. |
| Part C | Medicare Advantage | Private insurance alternatives that bundle Parts A, B, and usually D, often including extra benefits like dental and vision. |
| Part D | Prescription Drugs | Standalone policies run by private companies to help lower your out-of-pocket medication costs. |
| Supplements | Medigap Policies | Private plans designed to pay for the "gaps" in Original Medicare, like deductibles, copays, and coinsurance. |
How do you Help You Navigate the Process?
Determine Your Timeline
Step 1
Understand your Initial Enrollment Period (IEP)—the 7-month window around your 65th birthday—or your Special Enrollment Period (SEP) if you are retiring later.
Evaluate Your Coverage Needs
Step 2
We look at your current doctors, regular prescriptions, and travel habits to determine whether a Medicare Supplement or a Medicare Advantage plan fits your lifestyle.
Compare Local NJ Plans
Step 3
As an independent authority, we analyze the top-rated plans available in your specific New Jersey county to find competitive rates and robust networks.
Enroll Safely & Seamlessly
Step 4
We handle the paperwork and submissions to ensure you transition into Medicare smoothly with zero gaps in your healthcare coverage.
The Different Parts of Medicare
Medicare is divided into multiple parts (A, B, C, D), each designed to cover different aspects of healthcare. Understanding these parts can help you make informed decisions about your coverage. Whether you need hospital care, doctor visits, prescription medications, or additional benefits like vision and dental coverage, Medicare offers various options to meet your healthcare needs. Below is a breakdown of each Medicare part and what it covers:
Medicare Part A – Hospital Insurance
Part A Includes:
You can think of Part A as your “Room & Board” while in the hospital. Most people receive Part A without a monthly premium if they or their spouse have paid Medicare taxes while working.
Medicare Part B – Medical Insurance
Part B Includes:
This plan also helps cover services like screenings, vaccinations, and durable medical equipment. Unlike Part A, Part B requires a monthly premium.
Medicare Part C- Medicare Advantage Plans
Medicare Advantage (Part C) plans are offered by private insurance companies approved by Medicare. These plans provide all the coverage of Parts A and B and often include additional benefits such as vision, dental, and prescription drug coverage. Medicare Advantage plans may have different costs and provider networks compared to Original Medicare.
Medicare Part D – Prescription Drug Coverage
Part D is designed to help cover the cost of prescription medications. Offered through private insurance companies, these plans vary in cost and coverage but ensure Medicare beneficiaries have access to essential prescriptions at lower prices.
Medicare Supplement -(Medigap) Plans
Medigap plans help cover out-of-pocket costs like copayments, coinsurance, and deductibles not covered by Original Medicare. These plans are offered by private insurers and can provide additional financial protection for those enrolled in Medicare.
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Frequently Asked Questions
It is best to begin exploring your options 3 to 4 months before you turn 65 or plan to retire. This gives you plenty of time to set up Social Security, review plan networks, and avoid any delayed coverage start dates.
It depends entirely on the size of your employer. If your company has fewer than 20 employees, Medicare usually becomes primary, meaning you likely need to enroll to avoid massive coverage gaps. For larger companies, you may be able to delay Part B safely.
For most people, your Initial Enrollment Period (IEP) is a 7-month window centered around your 65th birthday. Unless you are still working.
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Not necessarily. If you or your spouse are actively working and covered by an employer group health plan, you can often delay Medicare Part B and Part D without penalty.
No, but parts of it can be. Medicare is a cost-sharing program.
Original Medicare (Parts A & B) is run by the federal government. Medicare Advantage (Part C) is run by private insurance companies and work to cover the gaps in Medicare. They bundle your hospital, medical, and usually prescription drug coverage into one managed plan (like an HMO or PPO). They often feature low or $0 premiums and extra perks, but you must stay within a local network of doctors and may need referrals.
Parts A, B, C & D. Refer to above chart for full description
Original Medicare (Parts A & B) does not cover routine dental, vision, or hearing care. It won't pay for standard cleanings, eye exams, glasses, or hearing aids unless it is medically necessary due to an injury or illness (like cataract surgery).
*To get these covered, you either need to choose a Medicare Advantage plan (which often bundles these perks) or buy a standalone, private dental/vision/hearing policy.
Because Original Medicare only pays for 80% of your medical bills, a Medigap plan (Medicare Supplement) is private insurance designed to step in and pay the remaining 20%.
Part D plans are offered by private insurers, and you shouldn't just pick the cheapest premium. You want to choose based on your specific medications.
Yes, with Original Medicare—provided your doctor accepts Medicare "assignment" (which more than 95% of primary care physicians do nationwide).
If you choose a Medicare Advantage plan, your doctor must be contracted within that specific insurance company’s network. Always verify directly with your broker and your doctor’s office before enrolling, as networks can change.
If you are already receiving Social Security benefits, you will likely be enrolled in Parts A and B automatically when you turn 65. If you are not yet drawing Social Security, you must manually apply. In that case, you can apply online through the Social Security Administration website (SSA.gov). The application takes about 10–15 minutes, and your physical Medicare card will arrive in the mail a few weeks later. We are happy to help you with this enrollment with no fees to you
Have questions about Medicare?
Contact MediPlans NJ today to learn more about your options and find a plan that fits your needs.
Credentials
Written by: MediPlans NJ
Credentials: Licensed Independent Health & Medicare Insurance Advisors
Location: Cherry Hill, New Jersey
Editorial Integrity: This guide is published in compliance with CMS guidelines. MediPlans NJ provides independent, unbiased comparisons across Medicare Advantage, Medigap, and Part D plans to help consumers make confident decisions.
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