One of the most underused parts of Medicare is also one of the most valuable: preventive care that costs you nothing when you know where to look. Every year, beneficiaries leave benefits on the table simply because they don't realize the services are already included in their coverage. Free Annual Wellness Visit After your first 12 months of Part B coverage, you're entitled to a yearly wellness visit at no cost [2][7][8]. This isn't the same as a routine physical exam. Instea

Most people think about their Medicare coverage twice a year: once when they enroll, and again during the Annual Enrollment Period each fall. But mid-year is one of the most useful times to take a closer look at your plan, before the pressure of fall enrollment sets in and while you still have time to act on what you find. Pull claims history By this point in the year, you have six months of real claims data to work with, and that tells you far more than any plan brochure can

Most people know there's one key window to enroll in Medigap (Medicasre Supplement) without facing health questions or higher premiums: the six-month Medigap Open Enrollment Period that begins when you turn 65 and are enrolled in Medicare Part B. But what many people don't realize is that your state may give you additional opportunities to switch or enroll, sometimes every single year. States with Continuous or Year-Round Protections Three states offer some of the strongest M

Choosing a Medicare Supplement (Medigap) plan isn't just about choosing the plan with the lowest premium or the most coverage. It's about finding the right fit for your specific health situation, your budget, and how you use healthcare. Here's a framework to help you think through the evaluation. 1. Start With Your Health Needs Look at how often you use healthcare. How many doctor visits, specialist appointments, or procedures do you typically have in a year? Do you take regu

How Supplemental Coverage Affects Out-of-Pocket Costs One of the most common questions people have about Medicare is: what will I actually owe? The answer depends significantly on whether, and how, you supplement your Original Medicare coverage. What You Owe Under Original Medicare Alone in 2026 Without supplemental coverage, here's what the numbers look like: Part B Premium: $202.90/month for most beneficiaries in 2026 Part B Deductible: $283 annually for 2026. After that, y

When you become eligible for Medicare, one of the biggest decisions you'll face is how to structure your coverage. For many people, it comes down to two paths: staying with Original Medicare and adding a Medigap (Medicare Supplement) plan, or enrolling in a Medicare Advantage plan (Part C). Both options have real advantages and there is no one right option for everyone. The SGIA Benefit Consultants can help you determine what is best for your unique health and financial needs

If you have Original Medicare, you already know that Part A covers hospital stays and Part B covers doctor visits and outpatient care. But there's something important to understand about how these two parts work together: they don't cover everything and may need to be supplemented. What is a Medicare Supplement Plan? Original Medicare pays a large share of your approved medical costs, but it typically leaves you responsible for 20% of outpatient services with no cap on what y

Many people believe October is the only time they can think about their Medicare coverage. This is a common misconception, and reviewing your plan mid-year can ensure your coverage is always what you need. The Annual Enrollment Period (AEP) only applies to Medicare Advantage Plans and Part D Prescription Drug Plans, while Medicare Supplement plans can be changed at any time. When Can You Make Changes Outside of AEP? Special Enrollment Periods (SEPs): Certain life events open

If you are managing two or more chronic conditions, Medicare has a program specifically designed to help, and most people have never heard of it. It is called Chronic Care Management (CCM), and it is a covered benefit under Medicare Part B. Who Qualifies? You may be eligible for CCM if you have two or more chronic conditions that: Are expected to last at least 12 months or for the rest of your life Place you at greater risk of serious health decline or death Common qualifyin

Medicare is not a set-it-and-forget-it program. Certain life changes can affect when you can enroll, what you pay, and what options are available to you. Here is what you need to know. Turning 65: Your Initial Enrollment Period (IEP) is a 7-month window: Starts 3 months before your birthday month Includes your birthday month Ends 3 months after your birthday month If you sign up in the first 3 months, coverage generally starts on the first day of your birthday month. If you s

Did you know that moving could affect your Medicare coverage? Before you start packing boxes, here is what you need to know. If You Have a Medicare Advantage (Part C) Plan Medicare Advantage plans are tied to a specific service area. If you move outside that area, your plan generally will not cover routine care at your new location, although emergency and urgently needed care are always covered anywhere in the U.S. Moving outside your plan's service area triggers a Special

There are more ways to save on your Medicare prescriptions than most people realize. Here's what to know. All month we've been walking through how Medicare Part D works, from formularies to tiers to making sure your medications are covered. We're wrapping up May with something just as important: the practical tools and programs that can lower what you actually pay at the pharmacy. 1. Ask Your Doctor About Generics or Biosimilars Generic drugs are copies of brand-name drugs

Did you know your Medicare drug coverage can change every single year, even if you don't do anything? Here's what to watch for, and how we can help. One of the most common surprises Medicare beneficiaries face at the start of a new year is finding out that a medication they rely on has been dropped from their plan's coverage, moved to a higher cost tier, or now requires extra steps before it will be filled. The good news is that this is entirely preventable if you know what t

Why does one prescription cost you $5 while another costs $80, even with the same Medicare drug plan? The answer is drug tiers. If you've ever looked at your Part D plan and felt confused about why your medications cost what they do, you're not alone. Understanding drug tiers and how copays work can make a real difference in what you pay and which plan you choose. As always, the SGIA Medicare Benefit Consultants are here to help you understand, enroll in, and switch your Part

If you have Medicare, prescription drug coverage doesn't come automatically and understanding how it works can save you real money. Let's start with the basics. What is Medicare Part D? Medicare Part D is optional prescription drug coverage available to anyone with Medicare. You can get it two ways: a stand-alone Prescription Drug Plan (PDP) paired with Original Medicare, or bundled inside a Medicare Advantage plan. Either way, Part D is offered through private insurance co

Medicare covers more than most people realize. Many beneficiaries use their basic benefits but unknowingly leave some of the most valuable preventive services on the table. Here are some of the most commonly missed preventive benefits and what you should know about each one. The "Welcome to Medicare" Preventive Visit If you are new to Medicare, this one-time visit is available within your first 12 months of having Part B, and many people never schedule it. It includes: A revi

Many Medicare beneficiaries don't realize that some of the most valuable benefits included in their coverage cost nothing to use. Taking advantage of your no-cost preventive care benefits is one of the smartest financial decisions you can make. Preventive Care Is Already Included in Your Coverage Most preventive services under Medicare Part B are available at no cost when your provider accepts assignment , including: Your Annual Wellness Visit Cardiovascular and cancer scre

Knowing what Medicare covers is the first step, but scheduling and using your preventive care benefits is what makes the difference for your health. Many Medicare beneficiaries have access to these no-cost services but never use them simply because they are not sure how to get started. Here is a simple guide to help you take action. Step 1: Confirm Your Coverage Before scheduling any preventive service, it is important to confirm how you receive your Medicare coverage: If you

Spring is a great time to take stock of your health, and the good news is that Medicare already has you covered. Many Medicare beneficiaries don't realize just how many preventive services are included in their coverage at no cost. Taking advantage of these benefits every year is one of the best things you can do for your health and your budget. What Are Preventive Services? Preventive services are tests, screenings, counseling sessions, and visits designed to help you stay

Medicare fraud and elder financial abuse are real and growing concerns. Every year, scammers target Medicare beneficiaries in an attempt to steal personal information, bill Medicare for services never provided, or pressure individuals into changing plans. Knowing how these scams work is one of the most powerful ways to protect yourself. If you are ever questioning if something is a scam, contact SGIA Medicare Consultant to help protect your information and coverage. Why Med