Medicare Insurance Explained

Medicare Insurance was created for people over 65, young individuals with disabilities, and those with end-stage renal disease. This policy allows us to obtain different health coverages for our financial protection. It is a federal program managed directly by the government.

In this post, we will explain in detail what is Medicare , who qualifies for this program, its costs and coverages, the differences between Medicare and Medicaid, and whether it is possible to have both policies at the same time.

If you want more information on how to apply for Medicare, just call us at ☎️ 786-910-9487 so one of our agents can answer any questions you may have. At Dulcinea Insurance, we make sure to provide you with all the necessary information so you can make the best decision.

What is Medicare and how does it work?

The Medicare and Medicaid Act was signed in 1965 by President Johnson. This Act contemplates what is called Original Medicare (includes only Part A and Part B) and has been modified over time. For example, Medicare was initially created to protect people over 65 years of age who had worked 40 quarters contributing to social security and then, in 1972, Medicare was extended to disabled people with chronic kidney problems.

In 2003, Medicare Part D was added under the Medicare Prescription Drug, Improvement, and Modernization Act, which also introduced the most significant change to Medicare since its inception with the approval of Medicare Advantage.

What is the Medicare coverage?

Medicare insurance has four parts:

Medicare Part A: This coverage is designed for hospital stays and medical care in nursing facilities across the country, as well as some home health assistance during an emergency.

Medicare Part B: This is a medical policy that covers all outpatient healthcare services, treatments, and medical supplies, as well as preventive services.

Medicare Part C: This section is dedicated to Medicare Advantage (an alternative to Original Medicare). It is offered by private insurance companies and combines Parts A, B, and D into a single coverage plan.

Medicare Part D: This coverage is designed for prescription drugs if you have Original Medicare, cost plans, certain private plans, or a Medicare savings account, among others.

✅ Do you want to get a quote and enroll on your own in the best Medicare plans in your state? 👉 Click HERE.

This Medicare enrollment website Medicare.gov we provided earlier belongs to the agent portal of Luis Orlando Hernandez, our CEO and principal insurance agent. He is licensed to provide Medicare insurance guidance in most states across the U.S. and offers all the necessary tools for clients to enroll on their own, compare plans, and review Medicare coverage. However, if you have any questions regarding Medicare enrollment, we are here to assist you at our Medicare offices.

What does Medicare cover?

Medicare is the Federal Government Healthcare Program designed to protect people over 65 years of age who meet the requirements of the 40 quarters contributing to social security and those who have kidney disease.

By combining parts A, B and D you cover everything necessary to have comprehensive health coverage (hospital, doctors and medications) and if you have Medicare Advantage you can incorporate other additional protections such as dental, vision, hearing, podiatry, transportation, etc.

Within Medicare Advantage you can enroll in both HMO plans (you need referrals for specialists) and Medicare PPO plans (no referrals needed). Prices and coverage may vary depending on the type of plan you have. If you have Original Medicare, you can go directly to the specialists.

What are the Medicare requirements?

To get Medicare, you must be over 65 years old, have legally worked in the country for 40 quarters, and have contributed to Social Security. Additionally, among those who qualify for Medicare are individuals with severe kidney disease.

At Dulcinea Insurance we remind you that one of the Medicare requirements is that you must apply the same month that you turn the age required to receive the card with Part A and Part B. There have been cases of people who have not yet received the Medicare card from Medicare social services and do not apply. And for this reason, the months without coverage advance and they are fined. For this reason, we always recommend that you call the Social Security Department and verify your eligibility. Among the documentation required for Medicare in the United States are: Social Security, Medicare card; in addition, the date of birth, address, telephone number and email are required.

For more details on this important Medicare topic and much more, you can call the Medicare phone number ☎️ 786-910-9487, and one of our agents will assist you for free.

How much does Medicare cost? 

The Medicare price varies greatly. In 2025, beneficiaries of Medicare will pay higher premiums and deductibles for Part A and Part B coverage. Most users receive Medicare Part A for free after paying the required taxes for at least 10 years of work. The Part A deductible is set at $1,676 per hospitalization, although these costs may vary if the beneficiary is enrolled in a Medicare Advantage plan.

The cost of Medicare varies widely. In 2025, beneficiaries of Medicare.gov will pay higher premiums and deductibles for Parts A and B coverage. Most users receive Medicare Part A for free after paying the required taxes for at least 10 years of work. The Part A deductible is set at $1,676 per hospitalization, although these costs may vary if the beneficiary is enrolled in a Medicare Advantage plan. According to the official CMS (Centers for Medicare and Medicaid Services) website, the standard cost for Medicare Part B in 2025 will be $185, an increase of just over $10 compared to 2024. Meanwhile, the annual deductible for Part B will be $257, also rising (about $17) compared to the previous year.

For Part D (prescription drugs), prices are based on the individual's or their partner's income. If an individual earns less than $106,000 and their partner earns less than $212,000, the cost of Medicare Part D is $0 for 2025. However, beyond these income thresholds, payments begin. For example, if an individual earns more than $106,000 but less than $133,000, or if a couple earns more than $212,000 but less than $266,000, they will pay $13.70 for Part D.

⏭️ Read all the information here about: How Much does Medicare Cost

Can I get Medicare Part B for free?

There is a possibility of getting Medicare for free if the beneficiary also has Medicaid. To verify eligibility, simply call the state Medicaid number and check if your income qualifies for this financial assistance.

The Medicare price depends on the type of coverage acquired, the required medical care, and the doctor or hospital used. Additionally, whether Medicare isfree can also depend on factors such as whether the user has private insurance, among others.

Some people look for help paying for Medicare Part B by qualifying for Medicare Advantage plans that help reduce the Medicare Part B price. Known as Gift Back Plans or premium refund plans, they can be very useful in lowering costs. For this, we recommend contacting authorized Medicare brokers near me who can provide free guidance or calling Medicare customer service. At Dulcinea Insurance, we are happy to assist you if you call 786-910-9487.

The most important dates to sign up for Medicare in the US  

There are certain key dates to become a Medicare beneficiary without having to pay late penalties. These are the most important ones:

• To apply for Medicare: Three months before turning 65, the individual should apply for coverage to ensure they can take full advantage of the program's benefits as soon as they reach the required age.

• Initial Enrollment Period: During the three months before turning 65, the birthday month, and the three months after, individuals can enroll in Medicare Part A and/or Part B.

• Special Enrollment Period: If an individual did not enroll during the Initial Enrollment Period because they had group coverage through their employer (or their spouse’s or family member’s employer), they can enroll at any time while still covered by the group plan or within eight months after their employment or employer-sponsored coverage ends.

Individuals who missed the Initial Enrollment Period and do not qualify for a Special Enrollment Period can enroll in Medicare Parts A and B during the General Enrollment Period, from January 1 to March 31 each year. This would be considered a late enrollment, so they will most likely have to pay a penalty. 

However, if you recently lost your Medicaid coverage and did not enroll in Medicare when you were first eligible, you may now apply without paying the late enrollment penalty. You also have the opportunity to renew your Medicare cards or enroll in a Medicare Advantage plan by calling Medicare customer service at 786-910-9487.

What factors affect the Medicare price?

Some of the factors that Medicare insurance takes into account to determine the value of its policies are:

• The coverages we purchase.
• The type of doctor or hospital we use.
• What type of medical care do we need or will need?
• If we have any private insurance.
• Whether or not our doctors accept this type of coverage.

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What is the difference between Medicare and Medicaid? 

There are clear differences between Medicare and Medicaid, and at Dulcinea Insurance, we are here to explain them to you. Many people wonder if Medicaid and Medicare are the same, but in reality, they have distinct differences.

Medicare vs Medicaid:

Although both programs are created by the government and provide financial protection for healthcare in the United States, they are completely different from each other. This is due to their administration, coverage, costs, and type of funding. Some of the most notable differences between Medicare and Medicaid are:

• Medicare provides financial protection for seniors and individuals with terminal illnesses, while Medicaid is focused on low-income individuals.
• The state government directly controls everything related to Medicaid, unlike Medicare, which is handled by the federal government.
• Another difference between Medicare and Medicaid is that the value of these policies is determined in different ways. For example, Medicare is based on the amount of coverage you choose, while Medicaid looks at your income.
• Applying for Medicare is different from applying for Medicaid because each state has its own requirements. Applying for Medicaid in Spanish depends on each state, unlike Medicare, which automatically enrolls you when you turn 65 years old.
• Another answer to what is the difference between Medicare and Medicaid lies in cost: Medicaid is free and Medicare typically has a fee for Part B.

Can you have Medicare and Medicaid together?

If you have a low income and are granted Medicaid by the Department of Children and Families, you can have Medicaid and Medicare together. This is a great advantage, since the monthly Medicare premium will be covered by Medicaid and the client would not have to pay anything monthly for the cost of their health insurance (Part B of Medicare).

To apply for Medicaid we recommend going directly to the Department of Children and Families or calling Medicaid directly. These Medicaid Medicare policies are very effective, but they depend on each person's income.

✅ Do you want to get a quote and enroll on your own in the best Medicare plans in your state? 👉 Click HERE.

When should I sign up for Medicare in the US? 

If you're wondering how to apply for Medicare, Dulcinea Insurance is here to explain it to you. You should apply for this coverage three months before turning 65; this way, you can start enjoying all the benefits provided by this federal program as soon as you reach that age. At Dulcinea Insurance, we can help you access the best services offered by Medicare insurance.

Additionally, don’t overlook Medicare renewal. To learn all the details about this process, which ensures continued coverage under this government plan, read our post on how to renew Medicare cards.

Call us at the Medicare phone number ☎️ 786-910-9487 or send us a message through the following link, and one of our agents will personally review your case for Medicare Advantage. We will take care of finding the best medical policies for you and your family.

Can I delay enrollment in Part B without paying a penalty?

Yes, as long as you are insured through the Marketplace Shop. You can take advantage of this Medicare health insurance coverage offered by your employer through your job or your spouse's job.

Because SHOP Marketplace coverage is treated the same as employment-based health coverage, Secondary Payer rules are taken into account.

Also, be aware that there is a Special Enrollment Period for Medicare Part B. During this time, you can enroll without incurring a penalty, unless you lose employer coverage and fail to report it by the established deadline. Get more details from our Medicare Advantage insurance agents near me by calling ☎️ 786-910-9487.

Expanded Medicare Benefits

Thanks to the health care law, the Program expands its benefits for preventive care and prescription drug coverage. These include, for example, cancer screenings, free preventive services and a wellness visit each year.

Among the Medicare benefits, prescription drug coverage is considered an essential health benefit. Generally, Part D coverage tends to be more comprehensive and reliable than a plan from the Health Insurance Marketplace or the SHOP Marketplace.

Does Medicare cover dental​?

Purchasing a stand-alone dental plan is usually expensive for older people. Many insurance companies that work within Medicare insurance include preventive and basic dental benefits so that their clients have the minimum covered.

However, many Medicare Advantage plans include dental coverage as an additional benefit. Several insurance companies even cover dental implants as a way to attract more clients. Right now, you can consult with one of our Medicare Advantage insurance agents near me to learn about the health insurance plans that best incorporate dental coverage.

What Medicare Advantage plans are available?

Medicare advantage plans are available in all states of the country. It is notable with Medicare in Florida, or Medicare Texas and many more, that Latinos and Hispanics try to enroll in this option, abandoning the possibility of staying with open enrollment, without any company to cover them.

Without a doubt, Medicare Advantage is an excellent opportunity to have your healthcare organized and consolidated. Remember that Medicare Advantage, also known as Part C, is offered by private health insurance companies that follow federal regulations and combine coverage from Parts A, B, and D. These plans also include additional benefits that would be very costly under Original Medicare, such as podiatry, vision, dental, and transportation services. Learn more about Medicare Advantage plans here.

For more specific information about what Medicare is and whether you can apply at this time, consult one of our Medicare insurance agents at ☎️ 786-910-9487.

What is the best Medicare plan?

There is no doubt that there are excellent insurance companies offering Medicare USA plans. Among them are:

• United Healthcare
• Centene
• Aetna Medicare
• Simply Healthcare
• Anthem Medicare PPO
• Oscar Insurance
• Kaiser Permanente Medicare
• Medicare Molina Healthcare
• Humana Medicare
• Well Care
• Blur Cross Blue Shield
• Devoted

These different Medicare insurance options allow you to compare plans and prices, choose a company that covers your doctors, and benefit from the strong competition among providers, which leads to continuous improvements in additional benefits as they compete to offer the best Medicare plan.

Who qualifies for Medicare in Florida?

Medicare plans in Florida are among the most competitive in the country. This is because the Sunshine State is one of the largest in terms of population in the United States, with major cities like Miami, Orlando, Tampa, Jacksonville, and Fort Lauderdale, and a growing population of legal and undocumented Latino and Hispanic immigrants.

This is why, when applying for Medicare in Florida, you will find all the previously mentioned companies, as well as other local insurers that offer plans exclusively in certain cities, such as Health Sun or Solís. If you want to enroll in any of the available insurance plans in your city and state right now, visit Dulcinea Insurance to find one of the Medicare offices near me. Our authorized Medicare brokers near me will be happy to assist you at ☎️ 786-910-9487.

Can I purchase Medicare Advantage plans in my state?

Medicare Advantage plans are available in all states across the country and offer an excellent opportunity to keep your healthcare organized and consolidated. These plans combine Parts A, B, and D, while also including additional benefits that would otherwise be very costly, such as hearing, dental, vision, transportation, and more.

These Medicare Advantage plans in Spanish are highly effective for those who find it difficult to manage Original Medicare. At our Medicare agency near me, we are happy to help you completely free of charge in selecting the plan that best suits your needs.

What happens to Medicare if you move to another state?

People change addresses a lot, and people change states a lot. This, of course, has an impact. If you have Original Medicare, Part A and Part B are valid throughout the country and you are less affected.

However, if you have a Medicare Advantage plan, there is a greater impact, since most of the coverage here has local networks of doctors and it is most likely that you will have to change plans.

If you change state, the following actions must be taken, whether you have Original Medicare or Medicare Advantage:

• Notify Social Security of any change of address and status immediately.
• Urgently notify your Medicare Advantage insurance company of your move and take action to change your policy if necessary. Keep in mind that you may lose coverage under a specific Medicare plan if the company does not serve the new area.
• Be very careful with Part D, as these plans are administered by private insurers and not updating this plan in time can leave you without drug coverage.
• IMPORTANT: You have two months of Special Enrollment Period (SEP) to make the appropriate address and Medicare plan changes.

If you have questions or need assistance choosing the right plan once you've changed your address or moved out of state, one of our licensed Medicare brokers near me can guide you and help you make the best decision.

Medicare Advantage vs. Original Medicare

Many people approach our Medicare Advantage insurance agents looking for information about the differences between Medicare Advantage and original Medicare. We are now going to explain the pros and cons of each.

Remember that Original Medicare is the program covered by the Federal Government in its primary conception with Parts A and B each on its own. On the other hand, Medicare Advantage is run by a private insurance company that combines each of the Medicare parts into a single coverage and adds extra benefits such as dental, vision, hearing, etc. coverage.

It is worth remembering that with Original Medicare you have the advantage of being able to see virtually any doctor you want, as long as he or she works within the program. On the other hand, with Medicare Advantage you must go to a network of doctors, clinics and hospitals that are within the insurance company's network. In Open Medicare you can usually go to a specialist without needing a referral, while in Medicare Advantage you do need a referral in most cases.

Both forms of Medicare have lower monthly premiums and maximum out-of-pocket costs, but these may be lower in Advantage because it has stronger and stricter rules for its customers.

Finally, regarding medications, Original Medicare requires you to enroll in a Medicare Part D drug coverage plan, which may have an additional cost. Meanwhile, Medicare Advantage includes Part D in most of its plans at no additional cost.

The selection and comparison of Medicare Advantage vs. Original Medicare depend on all the factors mentioned above, as well as personal preferences. For better assistance and personalized attention, call the Medicare phone number at 786-910-9487.

¿What does Medicare Part D cover?

¿Is there Medicare for undocumented immigrants?

Many people who do not have legal documents are looking for ways to make tax contributions to social security in view of a possible immigration reform. And many have been filing taxes for more than 10 years. However, since this possible modification of the immigration laws in the United States has not yet been achieved, today there is no Medicare for immigrants.

So, if you're looking for a health insurance plan for undocumented immigrants in the USA, remember that you have several options available to take care of both your health and finances. Call us, and one of our certified agents will help you find the best health insurance for undocumented individuals in your city. We work with Medicare and much more, including all individual and family plans available in the marketplace.

Medicare Offices Near Me

Today more than ever, the question of how to apply for Medicare has a simple answer. At our Medicare office, we can help you completely free of charge to qualify for the best health insurance plans available.

We have all the possible options available for you—not just in terms of pricing, but also the best coverage. Call the number of our Medicare agency near me ☎️ 786-910-9487, and we’ll show you everything. Dulcinea Insurance is waiting for your call.