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Agent Resources

Everything you need to
sell with confidence.

Guides, education, and tools to help you serve your clients at the highest level.

Guide
Medicare 101
A complete breakdown of Medicare Parts A, B, C, and D — enrollment periods, Medigap, and everything your clients need to know.
Read the guide →
Coming Soon
AHIP Certification Guide
Step-by-step walkthrough of the AHIP Medicare training and certification process required to sell Medicare Advantage plans.
Coming Soon
CMS Compliance Checklist
Stay ahead of CMS marketing guidelines, material filing deadlines, and annual certification requirements.
Medicare 101

Understanding Medicare,
part by part.

Medicare is the federal health insurance program for people 65 and older, and for certain individuals with disabilities or End-Stage Renal Disease (ESRD). Here's what every agent — and every client — should know.

Overview
What is Medicare?

Medicare is a federal health insurance program administered by the Centers for Medicare & Medicaid Services (CMS). It provides coverage for Americans who are 65 or older, people under 65 with certain disabilities, and individuals with End-Stage Renal Disease (ESRD) or ALS.

Medicare is divided into four parts — A, B, C, and D — each covering different types of care. Most beneficiaries are enrolled in Original Medicare (Parts A & B) and may add a Supplement or Part D plan, or instead choose an all-in-one Medicare Advantage plan (Part C).

Part A
Hospital Insurance

Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services.

  • Most people get Part A premium-free if they or their spouse paid Medicare taxes for at least 10 years
Part B
Medical Insurance

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and some home health services.

  • Standard 2026 premium: $202.90/month (higher for higher incomes via IRMAA)
  • Annual deductible: $283
  • Medicare covers 80% of approved costs; the beneficiary pays the remaining 20%
Part C
Medicare Advantage

Medicare Advantage (MA) plans are offered by private insurers approved by Medicare. They bundle Parts A and B — and often Part D — into a single plan.

  • May include extra benefits: dental, vision, hearing, fitness
  • Often have lower out-of-pocket costs than Original Medicare
  • Plans are network-based (HMO, PPO, PFFS, SNP)
  • Requires continued enrollment in Part B
Part D
Prescription Drug Coverage

Part D provides coverage for prescription drugs. It is offered through private insurers as either a standalone PDP (for Original Medicare enrollees) or bundled within a Medicare Advantage plan.

  • Premiums, deductibles, and formularies vary by plan
  • Late enrollment penalty applies if not enrolled when first eligible
  • Low Income Subsidy (LIS/Extra Help) available for qualifying beneficiaries
Medigap
Medicare Supplement Plans

Medigap plans (also called Medicare Supplement Insurance) are sold by private companies to fill the cost gaps left by Original Medicare — including copays, coinsurance, and deductibles.

  • Standardized plan types: A, B, D, G, K, L, M, N (Plans C & F closed to new enrollees as of 2020)
  • Plan G is the most comprehensive for new enrollees
  • Works with any Medicare-accepting provider nationwide — no networks
  • Cannot be combined with Medicare Advantage
Initial Enrollment Period
IEP — Turning 65
A 7-month window starting 3 months before the month you turn 65, including your birthday month, and ending 3 months after. Best time to enroll to avoid late penalties.
Annual Enrollment Period
AEP — Oct 15 to Dec 7
The main annual window to join, switch, or drop a Medicare Advantage or Part D plan. Changes take effect January 1 of the following year.
Special Enrollment Period
SEP — Qualifying Events
Triggered by qualifying life events such as losing employer coverage, moving out of a plan's service area, or qualifying for Medicaid. Timing varies by event.