ORIGINAL MEDICARE

Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). After you pay a deductible, Medicare pays its share of the Medicare approved amount, and you pay your share (coinsurance). Medicare pays 80% and you pay the remaining 20% in cost-sharing. Does not include prescription drug coverage, dental, vision, hearing, OTC benefits, etc. you want Medicare drug coverage (Part D), you can join a separate Medicare drug plan.

PART A: HOSPITAL

***You get this for “free” for working 40 quarters (10 years) in your lifetime where you paid taxes. You are automatically enrolled in Part A when you turn 65 years old.

PART B: MEDICAL

***You sign up for Part B through the Social Security office and start paying a premium. This is taken out of your social security before you receive it. This premium changes every year. Some years it goes up, some years it goes down. The Part B Premium for 2026 is $202.90/month.

***If you have Medicaid, depending on your level, Medicaid will pay this Part B Premium. There are also Medicare Advantage plans that will pay part of your Part B premium in the form of a “giveback”.

PART D: PRESCRIPTION DRUG COVERAGE

***This is an additional premium each month that you pay on top of your Part B premium. This only covers your prescription drug costs and should be paired with a medicare supplement plan. If you have a medicare advantage plan, you don’t need a Part D plan. If you do not have prescription drug coverage once your Initial Enrollment Period ends, you will be assessed a “Part D Late Enrollment Penalty.” See The Part D Late Enrollment Penalty.

SUPPLEMENT: MEDIGAP COVERAGE

***This is an additional premium each month. You pay a monthly premium to a private health insurance company to help pay/cover the 20% coinsurance and out-of-pocket costs in Original Medicare, like copayments, coinsurance, and deductibles. You can go to any doctor and use any network.

MEDICARE PART C: Medicare Advantage

A, B, D, + Dental, Vision, Hearing, + OTC $$ Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for health coverage. It combines Part A, Part B, and Part D coverage as well as dental, vision, and hearing coverage and extra benefits such as grocery, utility, OTC, or DME money benefits. These plans normally cost $0. You are not paying a monthly premium, but when you go to the doctor, you have copays.

AEP: “Annual Enrollment Period”: October 15th - December 7th: pick the plan you want to start on January 1st of the upcoming year. Example: Oct. 15 - Dec. 7, 2025 - Pick what plan you want to start on 1-1-2026. The plan you enroll in during this window, does not change the current coverage you have for 2025.

OEP: “Open Enrollment Period”: January 1st - March 31st; you can move once. You can go back to the plan you were on that you moved from, or pick a completely new plan. It is a safety net for if you switched your plan and you aren’t satisfied with it because prescriptions are not being covered, doctor is not in network, etc.; or you didn’t switch your plan and you wish that you had.

SEP: If you have a change in status such as your health, you move to a different county, you gain or lose medicaid status, etc. you receive a “Special Election Code” (SEP) where you can switch right away with coverage starting the month following your enrollment.

BEWARE TELEMARKETERS!

Do not talk to telemarketers on the phone and be very careful about giving out any information if you do. They are very tricky and will find ways to switch you or move you to the plan they are pushing. I am contracted with all the carriers for every type of plan. I will never push you in one direction, I will just put you where you want to go, it doesn’t matter to me what you pick!

If you are unhappy with your plan, if you hear of a different plan that sounds better than what you are on, please call me. Be weary of anyone on the phone trying to switch you or “add benefits” to your plan. You cannot “add” to a plan. If they do, they are switching your plan and you will lose me as your Agent of Record. The telemarketer becomes your Agent of Record and then I legally cannot assist you, and you never hear from that person again. If this ever happens, call me, and I can fix it for you.

What Scammers Are After

1. Your Medicare number, Social Security number, or bank information.

2. The ability to bill Medicare for fake services or equipment.

3. Access to your medical identity to commit health insurance fraud.

Common Medicare Scam Tactics

1. Fake Medicare Calls – Scammers claim your Medicare card is expiring or that you need a new one, asking for your Medicare number. Medicare will NEVER call you for this.

2. Free Medical Equipment Offers – Promises of free braces, creams, or genetic tests. Scammers bill Medicare for fake or unnecessary products.

3. Open Enrollment Scams – Fake representatives pressure you to change plans or pay fake fees during enrollment (Oct 15–Dec 7).

4. Vaccine Scams – Texts or calls offering home vaccines or COVID-19 tests in exchange for your Medicare number.

How to Protect Yourself

1. Hang up on unsolicited Medicare calls.

2. Guard your Medicare number like a credit card.

3. Never give personal information by phone, text, or email.

4. Check your Medicare Summary Notice (MSN) for unfamiliar charges.

5. Use trusted sources only, such as 1-800-MEDICARE or www.medicare.gov.

If You Suspect a Medicare Scam

1. Call the Indiana Senior Medicare Patrol (SMP): 1-800-986-3505

2. Call 1-800-MEDICARE (1-800-633-4227)

3. Contact the Indiana Attorney General’s Consumer Protection Division: (317) 232-6330 or visit www.in.gov/attorneygeneral

Remember

Medicare will never call, email, or text you to ask for your number or payment information. Stay cautious, stay informed, and protect your benefits.

Why Seniors Are Targeted

1. Seen as trusting and polite.

2. Often have retirement savings or steady income.

3. Some may be less familiar with new technology.

4. Over $3 billion is lost by seniors in scams each year (FBI, 2024).

Common Types of Scams

1. Phone Scams – Fake IRS, Social Security, or Medicare calls.

2. Email & Text Scams – Links for fake prizes or account issues.

3. Romance Scams – Online dating trickery.

4. Charity Scams – Fake causes asking for donations

5. Tech Support Scams – Pop-ups claiming your computer is infected.

Indiana-Specific Scams

1. Fake calls pretending to be from Indiana Department of Revenue.

2. Utility scams demanding payment (Duke Energy, Citizens Energy, etc.).

3. Medicare & Medicaid scams offering 'free' equipment.

4. Property deed & title scams targeting homeowners.

Red Flags of A Scam

1. Told to act immediately or you'll lose money.

2. Asked to pay by gift card, wire, or cryptocurrency.

3. Claims to be from government or police.

4. Requests personal info like SSN, Medicare, or bank details.

How To Protect Yourself

1. Hang up on suspicious calls.

2. Don’t click unknown links or attachments.

3. Verify organizations by calling official numbers.

4. Use strong passwords and enable two-factor authentication.

5. Shred sensitive mail before discarding it.

If You’re Targeted by a Scam

1. Stop communication immediately.

2. Report the scam to:

3. Indiana Attorney General’s Office: (317) 232-6330

4. Federal Trade Commission (FTC): reportfraud.ftc.gov

5. Local Police Department

6. Contact your bank or credit card company if you sent money.

Helpful Resources

1. Indiana Attorney General Consumer Protection Division: www.in.gov/attorneygeneral

2. Indiana Senior Medicare Patrol: 1-800-986-3505

3. AARP Fraud Watch Network: 1-877-908-3360

4. Better Business Bureau (BBB) Indiana: www.bbb.org/indiana

Remember

If it sounds too good to be true, it probably is. Stay informed and share what you learn with friends and family.

Open This PDF to view or download a full list of Social Security Office locations and phone numbers in Indiana.