Learn About Medicare

We understand that Medicare can be confusing and the process of selecting a plan is complicated. We're here to help guide you through your Medicare journey.

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Medicare is a federal health insurance program many adults enroll in when they turn 65. There are four parts of coverage: A, B, C, and D.

  • Together, Medicare Part A and Part B are often called the Original Medicare.
  • Medicare Part C (Medicare Advantage) and Medicare Part D (prescription drug coverage) are offered by health insurance companies that contract with Medicare.
  • Medicare Supplement plans (also called Medigap plans) are also available through health insurance companies.

With Original Medicare, you can choose to also enroll in a Medicare Supplement plan and/or a Medicare Part D Prescription Drug plan, or you can choose a Medicare Advantage Part C plan — all give you more peace of mind with your coverage and health benefits.

Start gathering information and preparing for your Medicare coverage needs early!

Preparing for Medicare Checklist

The Basics of Medicare

Part A: Hospital BenefitsPart B: Medical BenefitsPart C: Medicare AdvantagePart D: Prescription Drug Coverage
  • Inpatient hospital care
  • Care in a skilled nursing facility
  • Home health care and hospice
  • Doctor visits and other provider services
  • Outpatient care
  • Durable medical equipment
  • Some preventive care services
  • Combines Part A & Part B coverage
  • Can include additional coverage:
    • Prescription drugs
    • Dental, vision, and hearing
  • Helps cover prescription drug costs
  • Covers both brand-name and generic prescription drugs

Medicare Supplement Plans

Once enrolled in Original Medicare (Parts A & B), you could choose a Medicare Supplement (Medigap) plan to help cover additional out-of-pocket costs. All Medicare Supplement Plans are standardized by the federal government and have letter names, like “Plan A,” “Plan G,” and “Plan N,” which means every company that sells Medicare Supplement plans offer the same set of benefits for that plan.

View Our Supplement Plans

All U.S. citizens and legal residents age 65 and up are eligible for Medicare, as well as people under 65 with a qualifying long-term disability, End Stage Renal Disease (ESRD), or Lou Gehrig's disease (ALS). When you enroll is an important piece of Medicare and helps determine your premium costs, coverage, and plan options. 

Did you become eligible for Medicare prior to January 1, 2020?

If you answered yes, and haven’t enrolled in Medicare or purchased a Medicare Supplement Plan yet, you have more options. When you are ready, you have several Medicare Supplement plan options—including C and F.

If you are newly Medicare eligible on or after January 1, 2020 — due to changes in federal law — you are not able to enroll in Medicare Supplement Plan C or Plan F, but you have other plan options.

The best time for you to enroll in Medicare depends on several factors, including your age, whether you are still receiving health insurance through an employer, and the size of your employer group.

It is important to enroll in your Medicare plans at the right time. If you wait too long, you may have to pay a lifelong penalty on your premiums.

Initial Enrollment Period

Your Initial Enrollment Period is a 7-month window around your 65th birthday. It starts 3 months before your birth month and ends 3 months after the month you turn 65.

For example, if you turn 65 in February 2025, your Initial Enrollment Period runs from November 1, 2024 through May 31, 2025. You should enroll in Medicare during your Initial Enrollment Period if you do not have any health insurance, are retired, are not employed or self-employed, or are receiving health coverage from a company with fewer than 20 employees.

If you enroll in the 3 months before your 65th birthday, your coverage will take effect on the 1st day of your birth month., unless you birthday falls on the 1st of the month. In this case, your coverage will begin the month prior to your birth month.​

Special Enrollment Period

If you will still be receiving health insurance through an employer with at least 20 employees when you turn 65, you can wait until that coverage ends to enroll in Medicare. When your eligible employer coverage ends, you will have a limited time to enroll in Medicare without penalty. This limited time period is your Special Enrollment Period.

General Enrollment Period

If you do not enroll in Medicare during your Initial or Special Enrollment periods, you can enroll during the General Enrollment Period (January 1-March 31 annually). By not enrolling during the Initial or Special Enrollment periods, you may be subject to a lifelong enrollment penalty.

What if I’m not retiring and remain working at age 65?
While you first become eligible for Medicare at 65, if you’re covered on a job-based health plan through your employer or spouses’ job, you may be able to delay your Medicare enrollment until you or spouse retires. Check with your employer’s human resources manager or benefits specialist to learn your options. You can also call us at (800) 255-4550 (TTY: 711) to discuss your unique situation.

What are the three steps to enrolling in the right Medicare plan for me?

  1. Confirm your Medicare enrollment eligibility (see the When to Enroll in Medicare section above) and determine when you need to enroll in Medicare. Our preparing for Medicare checklist can also help with your planning.
  2. Decide on your coverage needs ranging from medical and hospital services to prescription drug coverage. Some plans can provide additional benefits for dental, vision, and hearing.
  3. Enroll in Medicare, following the steps we have outlined on our Medicare Enrollment Process webpage, based on the plans you choose. Remember, you need to enroll in Medicare Parts A & B to enroll in additional Medicare coverage options.

What is the difference between a Medicare Advantage plan and Medicare Supplement (Medigap) plan?
Medicare Advantage and Medicare Supplement are different types of Medicare coverage. You cannot have
both at the same time.

Original Medicare Part A (Hospital) and Part B (Medical) pay for many, but not all of your health care costs. Medicare Advantage combines Medicare Part A & B coverage in one plan and can include other coverage like Part D Prescription Drug Coverage. Medicare Supplement is additional coverage to help pay the out-of-pocket expenses that Original Medicare leaves you responsible to pay.

How do I find out if my prescription drugs are covered by a Medicare Advantage or Part D Prescription Drug plan?
Most Medicare plans including prescription drug coverage have their own list of what drugs are covered, which is called a formulary. Plans include both generic and brand-name drugs and many plans place drugs into different “tiers” on their formularies, resulting in drugs to cost a different amount. For a full list of covered prescription drugs on a plan’s formulary, visit the plans website or call them to request their formulary. In most cases, plans have a drug tool to help you search online.

A Medicare drug plan can make changes to its drug list each year, so it’s important to check each year to see what plans cover.

How easy is it to switch a Medicare plan?
During certain times of the year, you may add, switch, or drop your Medicare plan like a Medicare Advantage or Part D prescription drug plan. One of these times is the Annual enrollment period (AEP) which takes place, which takes place October 15 – December 7. Your new coverage will go into effect January 1 of the next year. You may also be able to switch outside of AEP if you qualify for a Special Enrollment Period or Guarantee Issue right, such as moving outside of your plan’s service area.

Enroll in Medicare Parts A & B

You'll sign up for Medicare Part A and Part B through Social Security. We encourage you to begin planning early for your Medicare needs.

The purpose of this material is a solicitation for insurance. Blue Cross and Blue Shield of Vermont is not connected with or endorsed by the U.S. government or the Federal Medicare program.

Y0148_BCBSVTMdrInfo_M CMS Accepted 05262024

Vermont Blue Advantage® is a PPO and HMO plan with a Medicare contract. Enrollment in Vermont Blue Advantage depends on contract renewal.

S2893_2407; updated May 24, 2024

Blue Cross and Blue Shield of Vermont, in a joint venture with three other New England Blue plans, contracts with the Federal Government to offer Medicare prescription drug coverage, called Blue MedicareRxSM (PDP).

Blue MedicareRx (PDP) is a Prescription Drug Plan with a Medicare contract. Blue MedicareRx Value Plus (PDP) and Blue MedicareRx Premier (PDP) are two Medicare Prescription Drug Plans available to service residents of Connecticut, Massachusetts, Rhode Island, and Vermont.

Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Blue Cross and Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont are the legal entities which have contracted as a joint enterprise with the Centers for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue MedicareRx (PDP) plans. The joint enterprise is a Medicare-approved Part D sponsor. Enrollment in Blue MedicareRx (PDP) depends on contract renewal.