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Explore your healthcare options

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Understanding Medicare and Your Healthcare Options: A Simple Guide

Choosing the right healthcare coverage can feel overwhelming—especially when you’re navigating Medicare or comparing multiple insurance options for the first time. At Monarch InsuraRisk Agency, our goal is to make healthcare insurance simple, clear, and tailored to your needs.

Whether you’re approaching Medicare eligibility or looking for better healthcare coverage, this guide breaks down the basics and explains how we can help you make confident decisions.

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General Healthcare Insurance Options

In addition to Medicare, we also help individuals and families explore other healthcare options, including:

  • Individual and family health plans

  • Short-term medical insurance

  • Supplemental health plans

  • Dental, vision, and critical illness coverage

Every situation is different, and having the right coverage can make a meaningful difference in both care and cost.

Why Work With a Licensed Insurance Agent?

Healthcare decisions aren’t one-size-fits-all. When you work with Monarch InsuraRisk Agency, you get:

  • Personalized plan comparisons

  • Clear explanations with no pressure

  • Ongoing support after enrollment

  • Help during annual reviews and life changes

Our services are typically at no additional cost, and our focus is always on what’s best for you.

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Smart healthcare choices start with information.

What Is Medicare?

Medicare is a federal health insurance program primarily designed for:

  • Individuals age 65 and older

  • Certain people under 65 with qualifying disabilities

  • Individuals with End-Stage Renal Disease (ESRD)

Medicare is divided into different “parts,” each covering specific healthcare services.

Medicare Part A – Hospital Coverage

Part A helps cover:

  • Inpatient hospital stays

  • Skilled nursing facilities

  • Hospice care

  • Limited home healthcare

Most people qualify for Part A with no monthly premium.

Medicare Part B – Medical Coverage

Part B covers:

  • Doctor visits

  • Preventive services

  • Outpatient care

  • Medical equipment

Part B typically requires a monthly premium and is an essential part of complete Medicare coverage.

Medicare Advantage Plans (Plan C)

Medicare Advantage plans combine Parts A and B and often include:

  • Prescription drug coverage

  • Dental, vision, and hearing benefits

  • Fitness and wellness programs

These plans are offered by private insurance companies and may have network restrictions.

Medicare Supplement (Medigap) Plans

Medigap plans help cover out-of-pocket costs such as:

  • Copayments

  • Coinsurance

  • Deductibles

These plans work alongside Original Medicare and offer more flexibility in choosing healthcare providers.

Prescription Drug Coverage (Part D)

Medicare Part D helps cover the cost of prescription medications. Choosing the right drug plan is important, as costs and covered medications vary by plan. We help review your prescriptions to find coverage that fits your needs and budget.

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Carriers We Work With

  • BlueCross BlueShield logo featuring a blue shield with a caduceus symbol.

  • United Healthcare logo with a stylized U and waves in dark blue

  • Ambetter logo with pink and white colors

  • Molina Healthcare logo with three stylized human figures in teal and the company name in black

  • Humana logo in green text.

  • A purple heart symbol followed by the purple text 'aetna' with a trademark symbol.

  • Centene Corporation logo in blue and gray text

Frequently Asked Questions

  • You can enroll during Open Enrollment each year. You may also qualify for a Special Enrollment Period if you experience a life change like marriage, birth, or job loss.

  • A deductible is the amount you pay out of pocket before your insurance starts paying for covered services.

    A copay is a set amount you pay for certain services, like $25 for a doctor visit, while your insurance covers the rest.

    Coinsurance is the percentage of costs you share with your insurance after meeting your deductible.

  • Original Medicare usually does not cover these services. However, many Medicare Advantage plans offer dental, vision, and hearing benefits.

  • Medigap plans help pay costs that Original Medicare doesn’t fully cover, like copays and deductibles. These plans work alongside Original Medicare.

  • Most people enroll during their Initial Enrollment Period, which starts 3 months before they turn 65 and ends 3 months after. There are also yearly enrollment periods to make changes.

  • Yes. Most health insurance plans cover pre-existing conditions and cannot charge you more because of them.