Medicare, made simplefor Newton, Hickory, and Catawba County
Everything you need to know to get started, in plain English. Read what you need, then call me with your questions.
Questions? Call or text (828) 238-2787
The four parts of Medicare
Medicare has four parts. Each one covers something different.
Part A
Hospital
Hospital stays, skilled nursing care after a hospital stay, and hospice. Most people pay no monthly premium.
Part B
Doctor visits
Doctor visits, tests, outpatient care, and medical equipment. You pay a monthly premium.
Part C
Medicare Advantage
Another way to get Parts A and B, through a private company that contracts with Medicare. Many include drug coverage.
Part D
Prescription drugs
Help paying for medicines, as a separate plan or built into many Medicare Advantage plans.
Parts A and B together are called Original Medicare, the plan run by the federal government.
Turning 65: when to sign up for Medicare
You have 7 months to sign up: the 3 months before the month you turn 65, your birthday month, and the 3 months after.
- Already getting Social Security? You're generally signed up for Parts A and B automatically. Your card usually arrives about 3 months before coverage starts.
- Not yet? Apply through Social Security, online at ssa.gov, by phone, or at a local office.
- Still working? With health coverage from your own or your spouse's current job, you may be able to wait on Part B. Ask your benefits office. COBRA and retiree coverage don't count.
- Don't wait too long. Signing up late without a qualifying reason can add a penalty to your Part B premium for as long as you have it.
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Sign up in the months before your birthday month, and Part B generally starts on the first day of your birthday month.
Medicare Advantage or a Medicare Supplement?
Once you have Parts A and B, there are two main paths. Neither is right for everyone, and you can't have both at the same time.
Medicare Advantage
Your coverage through a private company that contracts with Medicare.
- Usually a network of doctors and hospitals
- Copays when you get care
- Often includes drug coverage
- A yearly limit on what you pay for covered care
Original Medicare + Supplement
A Medicare Supplement (also called Medigap) helps pay costs Original Medicare doesn't.
- Generally any doctor in the U.S. that accepts Medicare
- Higher monthly premium, fewer costs when you use care
- Add a separate drug plan
- Good if you travel or live part of the year elsewhere
I offer Medicare Supplements in North Carolina only.
Your Medigap Open Enrollment Period: the 6 months starting the first month you're 65 or older and have Part B. It happens only once. During it, companies can't turn you down or charge more because of your health. Later, they may ask health questions.
Under 65 and on Medicare because of a disability? North Carolina law lets you buy Medigap Plans A, D, or G. You get a new chance to choose any plan when you turn 65.
The first question is always: are your doctors and hospitals in the plan's network? I'll check that with you before we compare anything else.
Medicare Part D: prescription drug coverage
Part D helps pay for prescriptions. Get it as a separate plan, or built into many Medicare Advantage plans.
- Each plan has its own list of covered drugs, and your cost can depend on your pharmacy.
- A yearly limit: in 2026 you pay no more than $2,100 for covered drugs. In 2027 the limit is $2,400.
- Pay over time: the Medicare Prescription Payment Plan can spread your drug costs into monthly payments. It doesn't lower the total.
- Don't go without: going 63 days or more without drug coverage after you're first eligible may mean a lasting penalty.
Bring your list of medicines
Name, dose, and how often you take each one, plus your pharmacy. I'll check how each plan covers them and what you'd pay for the whole year. Please don't text or email the list; we'll go over it together.
What Medicare costs in 2026
These amounts are set by Medicare and change every year. Amounts for 2027 come out in the fall.
Part B monthly premium
$202.90
Standard amount; higher incomes pay more
Part B yearly deductible
$283
Before Part B starts paying its share
Part A hospital deductible
$1,736
For each benefit period
Most you pay for covered drugs
$2,100
Part D yearly limit, not counting premiums. $2,400 in 2027.
Help paying your costs
Two programs help people with limited income and savings:
- Extra Help lowers drug costs. Apply through Social Security.
- Medicare Savings Programs can pay your Part B premium and sometimes more. Apply through your county's Department of Social Services.
The limits change every year, so apply even if you're not sure you qualify. I'm happy to explain how it works.
Your yearly review during Annual Enrollment
Change your plan each year
October 15 – December 7
Changes start January 1.
Plans can change their costs, drug lists, and doctors every year. Your plan mails an Annual Notice of Change each fall. Bring it to me and we'll check:
- your doctors and hospitals,
- your medicines and pharmacy, and
- what you'll pay next year.
Some years the answer is "keep what you have." You decide. In a Medicare Advantage plan? You can also make one change from January 1 to March 31.
Other places to get help
I'm always glad to help. You can also get free, unbiased Medicare information from these programs.
SHIIP
North Carolina's free Medicare counseling program, run by the NC Department of Insurance. Counselors don't sell plans.
Medicare
Plan information and answers, 24 hours a day, 7 days a week. Online at Medicare.gov.
1-800-MEDICARE TTY 1-877-486-2048
Social Security
Sign up for Parts A and B, apply for Extra Help, or ask about your benefits. Online at ssa.gov.
Common questions
Are the same Medicare plans available everywhere?
No. Plans vary by county, so what's offered in Catawba County may differ from Burke or Iredell. Ask me what's available where you live.
Can I keep my doctors?
It depends on the plan. With Original Medicare and a Supplement, you can generally see any doctor that accepts Medicare. Medicare Advantage plans usually have a network, so we check your doctors and hospitals first.
Can I change Medicare plans at other times of the year?
If you're in a Medicare Advantage plan, you can make one change from January 1 to March 31. Moving, losing other coverage, and some other life events may also allow a change.
Can a family member join our appointment?
Yes. Many people like to have a son, daughter, or friend on the call or in the room. Just let me know.
Where do I start with Medicare in Newton or Hickory?
Call or text me at (828) 238-2787. Have your Medicare card, your list of medicines, and your doctors' names handy. See the three steps.
Have a question about your Medicare?
Meet by phone, video, or in person.