Medicare
Medicare Made Simple
Whether you're enrolling for the first time or reviewing your current coverage, we help Delaware residents navigate every Medicare decision with confidence.
Expert Medicare Guidance — For Every Stage
Medicare is one of the most important — and most confusing — insurance decisions you'll face. With dozens of plan options, strict enrollment windows, and real financial consequences for missing deadlines, having a licensed broker in your corner makes all the difference. John Alston specializes in helping Delaware residents understand their options and choose the plan that fits their health needs and budget.
Understanding Medicare: The Four Parts
Part A
Hospital Insurance
Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most people pay no premium for Part A if they or their spouse paid Medicare taxes for at least 10 years.
Most people pay $0 premium
Part B
Medical Insurance
Covers outpatient care, doctor visits, preventive services, and medically necessary services. Part B has a monthly premium and an annual deductible.
Standard premium: $185/month (2025)
Part C
Medicare Advantage
An all-in-one alternative to Original Medicare offered by private insurers. Plans must cover everything Parts A and B cover, and most include Part D drug coverage plus extras like dental and vision.
Often includes dental, vision & drug coverage
Part D
Prescription Drug Coverage
Adds prescription drug coverage to Original Medicare (Parts A & B) or some Medicare Cost Plans. Offered by private insurers approved by Medicare.
Avoid the late enrollment penalty
Enrollment Windows & Deadlines
Missing an enrollment window can mean delayed coverage or permanent late-enrollment penalties. Here are the key periods to know.
Initial Enrollment Period (IEP)
7-month window around your 65th birthday
Starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. This is your first opportunity to enroll in Parts A and B.
Annual Enrollment Period (AEP)
October 15 – December 7 each year
Also called Open Enrollment. During this window you can switch Medicare Advantage plans, switch from Original Medicare to Medicare Advantage (or back), and join, switch, or drop a Part D drug plan.
Special Enrollment Period (SEP)
Triggered by qualifying life events
If you delayed enrollment because you had employer coverage, you get an 8-month SEP after that coverage ends. Other qualifying events include moving, losing Medicaid eligibility, or your plan leaving your area.
Medicare Advantage Open Enrollment (OEP)
January 1 – March 31 each year
If you're already enrolled in a Medicare Advantage plan, you can switch to a different Advantage plan or return to Original Medicare (and add a Part D plan) during this period.
Which Medicare Path Is Right for You?
There's no single best option — the right choice depends on your doctors, prescriptions, budget, and how you prefer to access care.
Original Medicare
Parts A + B
Pros
- See any doctor who accepts Medicare — no network restrictions
- No referrals needed for specialists
- Predictable coverage nationwide
Cons
- No cap on out-of-pocket costs
- No drug coverage (need separate Part D)
- No dental, vision, or hearing
Medicare Advantage
Part C
Pros
- Often $0 or low monthly premium
- Includes drug, dental, vision, and hearing in many plans
- Annual out-of-pocket maximum protects you from catastrophic costs
Cons
- Network restrictions (HMO/PPO)
- May require referrals for specialists
- Plan benefits can change year to year
Medicare Supplement
Medigap
Pros
- Covers most or all of Original Medicare's gaps (deductibles, copays, coinsurance)
- See any Medicare-accepting provider nationwide
- Predictable, low out-of-pocket costs
Cons
- Higher monthly premium than Advantage
- Does not include drug coverage (need Part D)
- Medical underwriting may apply outside open enrollment
Common Medicare Questions
Get a Free Medicare Consultation
Medicare decisions have real financial consequences. Let John walk you through your options — no pressure, no jargon, just clear answers.