How Do I Apply for Medicare?

by | Oct 9, 2025 | Medicare Advantage, Medicare Supplement, Original Medicare, Prescription Drug Coverage, Rules & Enrollment

Understanding the Medicare Application Process

Enrolling in Medicare is a major milestone in your healthcare journey, but it doesn’t have to be confusing. Whether you’re approaching age 65 or qualifying earlier due to disability, knowing when and how to apply ensures you avoid gaps in coverage or penalties. Here’s a step-by-step guide to applying for Medicare with confidence.

Eligibility: Who Can Apply for Medicare

You are generally eligible for Medicare if:

  • You’re 65 or older, and either a U.S. citizen or a permanent resident who’s lived in the U.S. for at least five years.

  • You’re under 65, but have received Social Security Disability Insurance (SSDI) for 24 months.

  • You have End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig’s Disease).

If you’re already receiving Social Security benefits, you’ll be enrolled automatically in Medicare Parts A and B. Otherwise, you’ll need to apply manually through the Social Security Administration.

How to Apply for Medicare Parts A & B (Original Medicare)

You can apply for Original Medicare in one of three ways:

Online: Visit SSA.gov/Medicare

By Phone: Call Social Security at 1-800-772-1213.

In Person: Visit your local Social Security office.

  • Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing, and hospice care.

  • Part B (Medical Insurance) covers doctor visits, preventive care, outpatient services, and durable medical equipment.

If you’re still working and covered under employer insurance, you may choose to delay Part B to avoid paying unnecessary premiums—but it’s important to confirm this with your HR department or a licensed Medicare advisor before making that decision.

Applying for Medicare Advantage (MAPD) Plans

After enrolling in Parts A and B, you may decide to choose a Medicare Advantage Plan (Part C) instead of using Original Medicare as your primary insurance. These plans are offered by private insurance companies and often include additional benefits such as:

  • Bundled Prescription drug coverage

  • Additional dental, vision, and/or hearing benefits

  • Wellness programs and gym memberships

Enrollment in a Medicare Advantage Plan is handled through the private insurer offering the plan, not through Medicare directly. The benefit of using a brokerage (like Emerald Medicare) to enroll in a MAPD plan is they will usually handle the enrollment & application process on your behalf, acting as the middleman between you and your insurance provider.

Medigap (Medicare Supplement) Plans

If you prefer to stay with Original Medicare, you can add a Medigap policy to help pay for costs that Parts A and B don’t cover—such as deductibles, coinsurance, and copayments.

  • You must have both Parts A and B to buy a Medigap plan.

  • Depending on your home state, you may or may not have to go through medical underwriting and wait for approval.

Just like with a Medicare Advantage (MAPD) Plan, the best & easiest way to enroll in a Medigap plan is to reach out to your Medicare broker, who will advise you on the coverage options available in your zip code. Otherwise, you can reach out to the carriers directly to get prices and/or compare options, and even enroll directly with the carrier by reaching out to their customer service and/or new enrollment department. 

Prescription Drug Plans (PDP – Part D)

If you choose Original Medicare (if you do NOT choose an MAPD plan) you’ll likely also need a standalone Part D prescription drug plan.

  • These plans are also available through private insurance companies.

  • Enrollment is typically completed via Medicare.gov or directly through the plan’s website.

  • Make sure to review each plan’s formulary (drug list) to ensure your prescriptions are covered affordably.

With Emerald Medicare, once you enroll in Original Medicare (Parts A/B), we walk you through all your coverage options and thoroughly explain how these options differ. We also handle your enrollment application(s) along with reviewing your list of Medications & Doctors to make sure there are no gaps in your coverage. 

Get Guidance from the Medicare Experts

Applying for Medicare doesn’t have to be stressful. At Emerald Medicare, our licensed experts can walk you through every step—from choosing Parts A and B to comparing Supplement, Advantage, and Part D options personalized to your needs.

Start your Medicare journey confidently—contact Emerald Medicare today!

(888) 683-6372 or (845) 358-1220

info@emeraldmedicare.com

High Deductible Medicare Supplement Plan G (HD-G): A Quick Guide

by | Sep 11, 2025 | Medicare Supplement

Why the High Deductible Medicare Supplement Plan G Could Be the Right Choice

Choosing the right Medicare Supplement plan can feel overwhelming. With so many options, it’s important to find a balance between affordable monthly costs and reliable coverage when you need it most. While the standard Medicare Supplement Plan G continues to be one of the most popular options, there’s another version that’s gaining attention: the High Deductible Plan G (HD-G).

At Emerald Medicare, our licensed experts help clients every day understand the differences between these plans so you can make the choice that fits both your health and your budget. Here’s what makes the High Deductible Plan G worth considering.

Lower Monthly Premiums

One of the biggest advantages of the High Deductible Plan G is the significantly lower monthly premium compared to standard Plan G. This means you pay less each month for your coverage, which can free up more money for other retirement expenses. For Medicare beneficiaries on a fixed income, that savings can make a real difference.

Comprehensive Benefits After the Deductible

In 2025, the annual deductible for the High Deductible G is $2,800. Once that deductible is met, the plan covers 100% of the same benefits as a traditional Plan G. That includes:

  • Medicare Part A coinsurance and hospital costs
  • Medicare Part B coinsurance or copayments
  • Skilled nursing facility coinsurance
  • Part A hospice care coinsurance or copayments
  • The Medicare Part A deductible
  • Medicare Part B excess charges
  • Coverage for foreign travel emergencies (80%, up to plan limits)

Essentially, after you meet the deductible, you enjoy the same comprehensive coverage and peace of mind that has made Plan G so popular.

A Smart Option for Healthy Individuals

High Deductible Plan G can be especially appealing if you’re generally healthy and don’t anticipate frequent doctor visits or hospital stays. You’ll save money on your monthly premiums, and while you may have to pay more out of pocket if an unexpected medical event occurs, your maximum yearly costs are capped at the deductible plus your premiums. This balance of affordability and protection makes HD-G an attractive choice for many Medicare recipients.

Nationwide Access and Flexibility

Just like a standard Plan G, the High Deductible G allows you to see any doctor or hospital in the U.S. that accepts Medicare. There are no networks and no referrals required. That flexibility ensures you can access the care you need, whether you’re close to home or traveling.

Predictable Costs with Peace of Mind

One of the challenges with Medicare alone is the potential for unpredictable out-of-pocket expenses. With the High Deductible Plan G, you know exactly what your worst-case scenario costs could be each year: the deductible amount plus your monthly premiums. This predictability gives you financial confidence and helps with budgeting in retirement.

Is High Deductible Plan G Right for You?

The High Deductible Plan G isn’t the perfect fit for everyone, but for many Medicare recipients, it strikes the right balance of lower monthly premiums and solid financial protection. If you’re healthy, budget-conscious, and want predictable maximum costs, HD-G may be the right choice for your Medicare coverage.

At Emerald Medicare, we specialize in helping you evaluate your options and choose the plan that works best for your unique needs. Our services are always 100% free, and our team is dedicated to making Medicare simple, clear, and stress-free.

Making the right Medicare decision doesn’t have to be confusing. If you’d like to learn more about whether High Deductible Plan G is a good fit for you, we’re here to help.

Click below to schedule an appointment with one of our Medicare Experts.

Or, Contact Us
📞 (888) 683-6372 or (845) 358-1220
📧 office@emeraldmedicare.com

Mark Brownstein, CSA® | Calendly

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An Essential Guide for Medicare Supplement Plans

by | Jan 30, 2025 | Medicare Supplement, Rules & Enrollment

As your dedicated team at Emerald Medicare, we understand that navigating the Medicare enrollment process can be overwhelming. That’s why we’re here to provide clarity on one of the most valuable options available to Medicare beneficiaries: Medicare Supplement Insurance, also known as Medigap. This comprehensive guide will walk you through what Medigap plans are, how they work, and how they can benefit you by filling the gaps left by Original Medicare.

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What are Medicare Supplement (Medigap) Plans?
A Comprehensive Guide

A Medigap plan (Plan G, Plan N, etc.) is private health insurance designed to work alongside Original Medicare (Parts A & B).

While Original Medicare provides broad coverage, it doesn’t cover everything. For example, beneficiaries are still responsible for certain deductibles, co-pays, coinsurance, and out-of-pocket costs. Medigap plans help cover these “gaps” in Medicare, providing financial protection and peace of mind.

Here’s how it works:

  • Original Medicare pays for its share of covered healthcare services (typically 80% of approved costs).
  • Medigap plans help pay for the remaining out-of-pocket costs, like the 20% co-insurance on doctor visits or hospital stays.

What Do Medigap Plans Cover?

Medigap plans can help pay for various out-of-pocket expenses that Original Medicare doesn’t cover. Depending on the Medigap plan you choose, it may cover:

  • Medicare Part A coinsurance and hospital costs
  • Medicare Part B coinsurance or copayments
  • The first three pints of blood used in a medical procedure
  • Part A hospice care coinsurance or copayments
  • Skilled nursing facility care coinsurance
  • Part A deductible
  • Part B deductible (for some older plans)
  • Part B excess charges
  • Foreign travel emergency coverage (up to plan limits)

Each Medigap plan is standardized, meaning that the benefits for each plan type are the same no matter which insurance company offers the plan. For example, Medigap Plan G from one insurance company will offer the same benefits as Medigap Plan G from another. However, premiums can vary based on things like your home state, income, and more, so it’s essential to compare offerings or work with a Medicare broker, like our team at Emerald Medicare, to find the best plan for your needs and budget.

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Why Should I Choose a Medigap Plan?

Medigap plans, as opposed to Medicare Advantage (Part C) plans, are particularly beneficial for individuals who:

  • Want predictable healthcare costs: If you want to avoid unexpected out-of-pocket expenses, a Medigap plan can provide peace of mind by covering those costs.
  • Travel frequently: Some Medigap plans offer coverage for medical care when traveling outside the U.S. (a benefit not offered by Original Medicare).
  • Need frequent medical care: If you visit doctors or specialists regularly or require frequent hospital stays, Medigap plans can help reduce the financial burden of these services.
  • Prefer flexibility in healthcare providers: Unlike Medicare Advantage plans, Medigap plans don’t have network restrictions. You can see any doctor or specialist nationwide who accepts Medicare.

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Medigap vs. Medicare Advantage: What’s the Difference?

It’s essential to understand that Medigap and Medicare Advantage plans are different, and you cannot have both – only one or the other.

  • Medigap works with Original Medicare (Parts A and B) to cover out-of-pocket medical costs, like co-insurance and/or certain deductibles. However, as prescription medications are not covered by Medigap plans, you are also required to enroll in a Part D plan (Prescription Drug Plan) when enrolling in a Supplemental plan. In tandem, A Medigap plan + a Prescription Drug Plan is a highly comprehensive option for a higher monthly premium – with less restrictions than Medicare Advantage. Any doctor’s office in America will accept your Medigap insurance as long as their office accepts Medicare.
  • Medicare Advantage (Part C) is an alternative to Medicare Supplement + Part D coverage that combines hospital, medical, and drug coverage into one all-encompassing plan, often including additional benefits like dental or vision. However, Medicare Advantage plans all have their own unique network of ‘preferred’ medical providers that beneficiaries are limited to, meaning the patient will be 100% financially responsible for services received from Out-Of-Network doctors. Furthermore, some Medicare Advantage plans provide less comprehensive drug coverage when compared to dedicated Prescription Drug Plans (Part D) and their formularies.

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How to Enroll in a Medigap Plan

You can enroll in a Medigap plan during your Initial Enrollment Period [IEP] – which begins as you approach age 65 – after enrolling in Original Medicare (Parts A & B). This six-month IEP window is critical because during this time, you have guaranteed issue rights, meaning insurance companies can’t deny you coverage or charge higher premiums based on your health status. After this period, you may still be able to apply for a Medigap plan, but insurers can use medical underwriting to determine your eligibility and rates.

How to Choose the Right Medigap Plan

Choosing the right Medigap plan depends on your specific healthcare needs, budget, and lifestyle. Here are a few tips to help you decide:

  1. Assess your current health needs: If you frequently visit doctors or specialists, a Medigap plan that covers Part B copayments and coinsurance can be very beneficial.
  2. Consider your travel habits: If you travel frequently, especially outside the U.S., look for a Medigap plan that includes foreign travel emergency coverage.
  3. Plan for the long term: While some Medigap plans may have higher premiums, they can save you money in the long run by limiting out-of-pocket expenses.
  4. Consult with a Medicare broker: A licensed Medicare broker, like the experts at Emerald Medicare, can help you compare different Medigap options, review costs, and find the plan that best suits your needs.

For advice on choosing a Prescription Drug Plan, read our Blog Post to learn more:  

Blog: How to Choose a Part D Plan

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Explore Medigap Options with Emerald Medicare

At Emerald Medicare, we’re here to help you make informed decisions about your healthcare. Medigap plans can be a great way to secure financial peace of mind while ensuring that you get the care you need. Our team of licensed Medicare experts will guide you through the process, helping you understand your options and choosing a plan that fits your unique needs.

If you’re interested in learning more about Medigap plans or need help finding the right one for you, we’re here to help. Click below to schedule an appointment with one of our expert brokers through Calendly, or contact us directly:

Contact Us:
Phone: (888) 683-6372 or (845) 358-1220
Email: office@emeraldmedicare.com

Click below to schedule an appointment with one of our Medicare Experts.

Mark Brownstein, CSA® | Calendly

How To Choose A Part D Plan

by | Oct 1, 2024 | Medicare Supplement, Prescription Drug Coverage

As your go-to team of Medicare experts, we’re here to help you navigate your options with confidence. We understand how crucial it is to have the right prescription drug coverage. Choosing a Medicare Part D plan can be overwhelming with so many options available, but with the right guidance, you can find the best available drug plan that fits your needs and budget each year. In this post, we’ll provide tips on how to select the best Medicare Part D plan based on your individual needs, ensuring that you have access to the medications you require without unnecessary expenses.

What is Medicare Part D?

Medicare Part D is the prescription drug coverage component of Medicare. It helps cover some of the cost of prescription medications, which are not included under Original Medicare (Parts A and B). Part D plans are offered by private insurance companies, whom have been approved by Medicare. These plans are typically combined with a stand-alone Medigap plan, or in some cases, a Medicare Advantage plan. The specifics of each plan—such as the drugs covered, co-pay costs, and pharmacy networks—can vary significantly depending on the plan year, insurance carrier, and more.

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Tips for Choosing the Right Part D Plan

1. Assess Your Prescription Drug Needs

Evaluate Your Medications: Start by making a list of all the prescription medications you currently take, including the dosage and frequency and your preferred pharmacies. This list will be important when comparing different Part D plans, as each plan has its own formulary (the list of covered drugs and costs).

Consider Future Needs: Think about any potential changes in your medication needs since you last made this Medicare decision. If your doctor has mentioned that you might need new medications in the future, choose a plan that includes those medications.

2. Compare Formularies

Check Drug Coverage: Not all Part D plans cover the same medications. With the assistance of a broker or by your own research, review the formularies of each plan to confirm that your current medications are covered and at what cost. Some plans may cover certain drugs at a lower cost than others, which can significantly affect your out-of-pocket expenses throughout the year.

Understand Tiers: Many Part D plans categorize drugs into tiers, with each tier having different costs. Typically, generic drugs are in lower tiers and are more affordable, while brand-name and specialty drugs are in higher tiers and cost more. Knowing what tier your medications fall into on each plan’s formulary is helpful when looking at yearly costs or discussing options with your doctor.

3. Evaluate Costs Beyond Premiums

Look at the Big Picture: Calculate your expected annual costs based on the medications you take and the coverage each plan offers using medicare.gov. If you notice a very expensive drug, look at discount cards such as GoodRx for lower cost options.

4. Review the Pharmacy Network

Check Preferred Pharmacies: Each Part D plan has a network of pharmacies where you can fill your prescriptions. However, some plans offer lower medication costs at partner, “preferred” pharmacies. It’s essential to compare drug prices from multiple pharmacies.

Mail-Order Options: If you prefer the convenience of having your medications delivered, look for a plan that offers a mail-order pharmacy option. This can in many cases save you money but certainly can save you time.

5. Use Medicare.gov for Research

The best way to compare Part D plans is by using a reliable Medicare broker or by accessing Medicare.gov, the official Medicare website. This is the same tool that your Emerald Medicare team utilizes to research and identify the best coverage options for your specific health needs. The website allows you to enter your medications and compare plans based on costs, coverage, tiers, pharmacies, zip code, and more.

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Block Out the Confusion with Emerald Medicare

Choosing the right Medicare Part D plan is a critical step in managing your healthcare costs and ensuring you have access to the medications you need. By carefully considering your medication needs, costs, and pharmacy preferences, and using trusted resources like Medicare.gov, you can make an informed decision on your Part D coverage each year.

As Medicare’s Open Enrollment Period approaches, the Emerald Medicare team is here to help. This will be an especially challenging year for changes occurring with Medicare Part D plans. We’re committed to delivering personalized assistance and finding the best Part D plan options to meet your needs for the current year. Click below to schedule an appointment with one of our expert Medicare advisors through Calendly, or contact us directly at the number / email below.

Contact Us:
Phone: (888) 683-6372 or (845) 358-1220
Email: office@emeraldmedicare.com

Click below to schedule an appointment with one of our Medicare Experts.

Mark Brownstein, CSA® | Calendly

Understanding Underwriting in Medicare Supplement

by | Aug 22, 2024 | Medicare Supplement, Rules & Enrollment

While Medicare Advantage (Part C) plans never require medical underwriting, understanding underwriting and guaranteed issue rights is key for anyone considering a Medicare Supplement Insurance plan (MediGap). By learning how these processes work and how underwriting requirements differ across states, individuals can make more informed decisions about their healthcare coverage options.

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What is Underwriting?

Underwriting is a process used by insurance companies to evaluate an individual’s health status, medical history, and other risk factors before issuing a MediGap policy. If a beneficiary is being underwritten, it helps insurance companies assess the likelihood of future claims, and thereby determine if the individual would be accepted into the plan or if any premiums adjustments would need to be made to offer coverage.

It’s important to note that there is NO underwriting for your initial enrollment into Medicare; this is when you turn 65, or leave your employer-provided credible coverage after the age of 65.

Why Do I Have to Go Through Underwriting to Get a Medicare Supplement Insurance Plan?
Underwriting is necessary for Medicare Supplement Insurance plans to ensure that individuals are eligible for coverage and to determine the cost of their policies. By assessing an applicant’s health status and medical history, insurers can better manage risk and maintain financial stability. Underwriting also helps prevent adverse selection, where individuals with higher healthcare needs are more likely to purchase coverage, leading to higher costs for everyone.

What is Guaranteed Issue?

Medigap guaranteed issue is a consumer protection where you can’t be turned down for a policy or be charged more than others in your age group. Guaranteed issue rights virtually allow individuals to enroll in a Medicare Supplement Insurance plan without undergoing underwriting during certain situations, such as when they are first eligible for Medicare or when they experience a qualifying event.

Which states have NO underwriting for Medicare Supplement Insurance plans?

Connecticut, Massachusetts, Maine, and New York are the 4 states that have no underwriting requirements for Medicare Supplement Insurance plans. In these states, individuals have guaranteed issue rights all year long, which means they will never undergo medical underwriting if they are able to apply for Medicare Supplement coverage. This ensures they cannot be denied coverage or charged higher premiums based on their health status upon enrolling in a new Medigap plan.

What if I live outside of Connecticut, Massachusetts, Maine, or New York?

In some other states, including California, Louisiana, Idaho, Illinois, Nevada, Oregon, and Maryland, specific rules grant Medicare-Supplement beneficiaries guaranteed issue rights during the month of their birthday. This means that enrollees are allowed to select any Medigap plan available in their area WITHOUT going through medical underwriting during a 30-day window following their birthday each year. It’s important to check in with your Medicare broker or a reliable Medicare-expert to confirm the terms & conditions for underwriting in your home state.

Contact Us:
Phone: (888) 683-6372 or 845-358-1220
Email: office@emeraldmedicare.com

Click below to schedule an appointment with one of our Medicare Experts.

Mark Brownstein, CSA® - Calendly

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