Answers to the questions Illinois seniors ask most

Original Medicare (Parts A and B) is the federal program itself: you use any doctor or hospital that accepts Medicare, and you can add a Medicare Supplement and a Part D drug plan. Medicare Advantage (Part C) is an all-in-one alternative offered by private insurance companies — it replaces Original Medicare and usually bundles drug coverage and extras like dental and vision into one plan.

Part A covers hospital stays, skilled nursing facility care after a qualifying hospital stay, and some home health care. Most people who worked at least 40 quarters (about 10 years) pay no monthly premium for Part A. Deductibles and coinsurance still apply, which is why many Illinois seniors add a Medicare Supplement or choose an Advantage plan.

Part B covers doctor visits, outpatient care, lab tests, preventive services and durable medical equipment. Most new enrollees pay the standard monthly premium (about $185 in 2025, adjusted annually — we confirm the current figure during your review), plus an annual deductible and 20% coinsurance on most services unless a Supplement or Advantage plan covers it.

Often you can delay Part B without penalty if you're covered by your or your spouse's current employer group health plan and the employer has 20 or more employees. This is one of the most common — and most costly to get wrong — decisions we help with, so call us before you turn 65: (708) 658-0050.

Your Initial Enrollment Period lasts 7 months: it starts 3 months before the month you turn 65, includes your birthday month, and runs 3 months after. Enrolling during the first 3 months usually means coverage starts the month you turn 65.

The Annual Enrollment Period (AEP) runs October 15 through December 7 each year. During AEP anyone with Medicare can switch between Original Medicare and Medicare Advantage, change Advantage plans, or change Part D drug plans. Changes take effect January 1.

Missing Part B enrollment without other credible coverage typically triggers a 10% premium penalty for every full 12 months you were eligible but unenrolled — and that penalty lasts a lifetime. Late Part D enrollment adds a separate 1%-per-month penalty. Guaranteed-issue windows and Special Enrollment Periods can protect you in some situations, so it pays to check before you assume you've missed out.

Sometimes. Special Enrollment Periods exist for moves, losing employer coverage, Medicaid eligibility, star-rating changes and more. The January 1 – March 31 Medicare Advantage Open Enrollment Period also lets Advantage members switch plans once or return to Original Medicare.

A Medicare Supplement works alongside Original Medicare to pay costs Medicare leaves behind — deductibles, coinsurance and, depending on the plan, the Part B excess charges. Plans are standardized by letter (G, N, High-Deductible G and so on), so a Plan G from one carrier covers the same benefits as a Plan G from another; only the price, rating method and service differ.

Because each company prices the identical standardized plan differently — some use attained-age rating (prices rise as you age), some use community or issue-age rating. Shopping carriers when your premium rises is one of the biggest savings opportunities we handle for Illinois clients.

You can apply to switch at any time, but outside your 6-month guaranteed-issue window carriers may require medical underwriting and can decline or rate you. That's why choosing a plan you can stay with — and reviewing rates regularly — matters.

Plan G covers everything Medicare doesn't except the Part B deductible. Plan N trades modest copays and possible excess charges for a lower premium. If you see doctors rarely, Plan N can save money; heavy healthcare users often prefer G. We model both against your actual usage.

Medicare pays private insurers a fixed amount per member each month. Many plans pass part of that payment back as a $0 premium on top of your Part B premium. The plan still has deductibles, copays and network rules, so we compare total yearly cost — not just the headline premium.

HMO plans generally require you to use network doctors and hospitals and get referrals; PPO plans let you see out-of-network providers at a higher cost, usually without referrals. In the Chicago area both types are widely available, so your doctors drive the choice more than the plan does.

The coverage gap has been shrinking and is essentially closed for brand-name drugs; in 2025 a $2,000 annual out-of-pocket cap for prescriptions took effect. What matters most now is whether your specific drugs are on a plan's formulary and at what tier — we run that check for you every year at no cost.

Yes — during the October 15 – December 7 Annual Enrollment Period you can switch drug plans for the following year. Formularies and pharmacy networks change annually, so an annual review routinely saves clients hundreds of dollars.

No. Our guidance, plan comparisons and enrollment help are free to you — we're compensated by the insurance carriers when you enroll, and your premium is the same whether you enroll directly or through us.

Across our insurance offerings, we have access to more than 27 carriers, including Blue Cross Blue Shield of Illinois, UnitedHealthcare, Humana, Aetna. We don't offer every plan available in your area — see the required disclosure in our footer — and we'll always point you to Medicare.gov and 1-800-MEDICARE for the complete picture.

Statewide — with local focus in Cook, DuPage, Lake, Will and Kane counties, with our headquarters at 6500 W. College Dr., Palos Heights, IL 60463, and local hubs including Chicago, Naperville, Aurora, Schaumburg, Orland Park and Joliet. We meet by phone, video, or in person.

No. We are an independent, licensed insurance agency and are not connected with or endorsed by the U.S. government or the federal Medicare program.