Medicare Guidance In 38 States

Get help with Medicare today without sorting it out alone.

Turning 65, newly eligible, reviewing coverage, or helping a family member? Direct Insurance Solutions can explain Medicare basics now, then provide plan-specific help after the required Scope of Appointment.

Licensed agents 38-state health footprint SOA-first guidance
✓ Medicare Eligibility Checker
How old are you?

This checker is educational only. Medicare eligibility and enrollment timing depend on your specific situation.

Understanding Medicare

Medicare has parts. This makes them easier to see.

Parts A, B, C, and D each cover different needs. Medicare Supplement, dental, vision, hearing, and dual eligible support can add another layer. Start with the map, then speak with an agent when you are ready.

Original Medicare Advantage and Medigap Part D drug coverage
Tap a part to learn what it covers
Selected Medicare part
Part A - Hospital

Helps cover inpatient hospital care, skilled nursing facility care, hospice, and some home health services.

Plan-specific benefits, networks, costs, formularies, and comparisons require a completed Scope of Appointment.

Compliance Checkpoint

Before plan details, we complete the SOA.

A Scope of Appointment documents the Medicare product types you want to discuss. It must be completed before our agents explain plan benefits, compare plans, review costs, check networks or formularies, or assist with enrollment.

No enrollment obligation Clear product categories Compliant next step
What can happen before and after SOA?
Allowed first

General education, Medicare terms, enrollment windows, resources, and preparation checklist.

SOA required

Plan benefits, plan costs, plan comparisons, provider networks, drug formularies, and enrollment assistance.

SOA status
Before SOA: General Education

We can explain Medicare basics, coverage types, enrollment timing, official resources, and what information to prepare.

Completing a Scope of Appointment does not require you to enroll in a plan.

Enrollment Made Simple

Know your Medicare window before it sneaks up.

Initial Enrollment, Annual Enrollment, Medicare Advantage Open Enrollment, and Special Enrollment Periods each work differently. We help you understand timing and next steps without making the page feel like paperwork.

IEP timing AEP review SEP questions
Enrollment period guide
IEP
Initial EnrollmentSeven-month window around your 65th birthday. Often your first chance to enroll.
AEP
Annual EnrollmentOctober 15 through December 7. Review or change Medicare Advantage and Part D coverage.
OEP
MA Open EnrollmentJanuary 1 through March 31 for people already in a Medicare Advantage plan.
SEP
Special EnrollmentTriggered by qualifying events such as moving, losing coverage, or qualifying for Medicaid.

Enrollment rules depend on your current coverage, eligibility, and situation.

38
States for health coverage
4
Main Medicare parts
SOA
Before plan-specific help
$0
Cost for guidance

Medicare does not have to feel like a maze.

Direct Insurance Solutions helps people understand Medicare Advantage, Medicare Supplement, Part D, dental, vision, hearing, and dual eligible options across the 38 states where we offer health coverage. We start with education, complete the required Scope of Appointment, then move into plan-specific help when appropriate.

☎ Call 800-619-8959
Coverage Types
Understanding Medicare coverage options

Medicare is not one single plan. It is a set of coverage paths that can include Original Medicare, Medicare Advantage, prescription drug coverage, Medicare Supplement coverage, extra benefits, or Medicaid coordination.

A

Part A - Hospital Insurance

Original

Helps cover inpatient hospital care, skilled nursing facility care, hospice care, and some home health care.

  • Inpatient hospital care
  • Skilled nursing facility care
  • Hospice and some home health
B

Part B - Medical Insurance

Original

Helps cover doctor visits, outpatient care, preventive services, medical equipment, and medically necessary care.

  • Doctor and specialist visits
  • Outpatient care and lab tests
  • Preventive screenings
C

Part C - Medicare Advantage

Private Plans

Private Medicare plans that bundle Part A and Part B. Many include Part D and extra benefits depending on the plan and service area.

  • All-in-one private plan option
  • Networks and benefits vary
  • SOA required before plan comparison
D

Part D - Prescription Drugs

Drug Plans

Prescription drug coverage through stand-alone plans or some Medicare Advantage plans. Formularies and pharmacy networks vary.

  • Medication coverage
  • Plan formularies vary
  • Pharmacy costs can differ
M

Medicare Supplement

Medigap

Private coverage that works with Original Medicare to help pay certain deductibles, copays, and coinsurance.

  • Works with Original Medicare
  • Standardized plan letters
  • Separate from Advantage plans
+

Dual Plans — Medicare & Medicaid

(DSNP)

If you qualify for both Medicare and Medicaid, a Dual Special Needs Plan (DSNP) can coordinate both programs into one plan — often with $0 premiums, dental, vision, transportation, and grocery benefits.

  • Combines Medicare & Medicaid
  • Often $0 premium & copays
  • Extra benefits (food, transport)
Interactive Checklist
Build your Medicare prep list

Choose the situation that sounds closest to you. The checklist updates instantly so the next step feels less abstract.

Your prep list

I am new to Medicare

Start with eligibility, Initial Enrollment timing, whether you need Part A and Part B, and how any employer coverage affects your timing.

  • Confirm your Initial Enrollment Period.
  • Gather employer or retiree coverage details if you have them.
  • Prepare a medication list and preferred doctors.
Call 800-619-8959
This checklist is educational and is not a plan recommendation. Plan-specific discussion requires a Scope of Appointment.
Plan comparison
Original Medicare vs. Advantage vs. Medigap

Not sure which path is right for you? Here’s a plain-language side-by-side of the three main Medicare routes.

Feature
🏠
Original Medicare
Part A + Part B
Medicare Advantage
Part C
📋
Medicare Supplement
Medigap
Hospital & Doctor Coverage Part A & B only
80% after deductible
Part A, B & often D
All bundled
Original Medicare
+ fills gaps
Prescription Drugs ✕ Not included
Add Part D separately
✓ Usually included ✕ Not included
Add Part D separately
Dental / Vision / Hearing ✕ Not covered ✓ Often included ✕ Not covered
Doctor Network Any Medicare-accepting doctor In-network required
HMO or PPO
Any Medicare-accepting doctor
Nationwide
Out-of-Pocket Cap ✕ No cap
Unlimited exposure
✓ Yes (annual cap) ✓ Minimal exposure
Plan fills most gaps
Monthly Premium Part B: ~$185/mo Often $0 + Part B
Varies by plan
Part B + Medigap premium
Higher but predictable
Best For Those adding Medigap + Part D for full coverage Those wanting low premiums + extras in one plan Those wanting nationwide freedom & predictable costs
Scope of Appointment
The SOA is the checkpoint before plan-specific Medicare help

A Scope of Appointment documents which Medicare product categories you want to discuss. It does not obligate you to enroll, but it is required before plan-specific conversations.

Before SOA

General education can happen first. This helps you get oriented without jumping straight into plan details.

  • Medicare basics and coverage types
  • Enrollment periods and eligibility basics
  • Official resources and preparation checklist
  • Questions to ask before choosing coverage

After SOA

Once the required SOA is complete, an agent can move into plan-specific support for the product types selected.

  • Plan benefits and cost details
  • Plan comparisons and carrier availability
  • Provider network and drug formulary review
  • Enrollment assistance if you choose to apply
1. Ask for helpCall or send a question.
2. Get orientedReview Medicare basics and needs.
3. Complete SOASelect the product categories to discuss.
4. Review optionsMove into plan-specific help.
How to enroll
Medicare enrollment periods explained

Missing your enrollment window can mean permanent late-enrollment penalties. Here’s every period you need to know — and how DIS can help you navigate each one.

IEP — Initial Enrollment Period
7-month window around your 65th birthday

Starts 3 months before your birthday month and ends 3 months after. This is your first opportunity to sign up for Part A, Part B, and Part D. Enrolling on time avoids late penalties.

⚠ Miss this window and you may pay a 10% Part B penalty for life
AEP — Annual Enrollment Period
October 15 – December 7 (every year)

Every year during this window you can switch Medicare Advantage plans, switch from Original Medicare to Advantage (or back), or change your Part D drug plan. Changes take effect January 1.

OEP — Open Enrollment Period
January 1 – March 31 (every year)

If you enrolled in a Medicare Advantage plan during AEP and want to make a change, you have until March 31 to switch to a different MA plan or return to Original Medicare and add a Part D plan.

SEP — Special Enrollment Period
Triggered by qualifying life events

You can enroll outside normal windows if you lose employer-sponsored coverage, move to a new service area, qualify for Medicaid, or experience other qualifying events. Generally a 2–3 month window from the event.

GEP — General Enrollment Period
January 1 – March 31 (every year)

If you missed your IEP and don’t qualify for an SEP, you can enroll in Part A and B during the GEP. Coverage starts July 1. Late-enrollment penalties may apply depending on your situation.

Not sure which period applies to you?

One call clarifies everything

Our licensed agents review your situation — current coverage, retirement date, employment status — and tell you exactly when and how to enroll to avoid penalties and coverage gaps.

☎ Call 800-619-8959
Medicare eligibility requirements
Age 65 or older
U.S. citizen or permanent legal resident for 5+ years
Under 65 with qualifying disability
Received SSDI benefits for 24+ consecutive months
ESRD or ALS at any age
End-Stage Renal Disease or ALS qualifies immediately
Part A premium-free eligibility
You or spouse worked 40+ quarters (10 years) paying Medicare taxes
Medicare carriers we work with

Top Medicare carriers in Florida

We shop multiple top-rated carriers to find the plan that fits your needs and budget

Aetna
Humana
UnitedHealthcare
Blue Cross Blue Shield
Anthem
WellCare
Devoted Health
HealthSpring
Direct Insurance Solutions Medicare guidance
Serving clients
across 38 states
Why Direct Insurance Solutions
Medicare help should feel clear, calm, and compliant
1

Education without pressure

We can help you understand Medicare language before you make any coverage decision.

2

Plan-specific help after SOA

Once the required Scope of Appointment is complete, an agent can discuss plan-specific details.

3

English and Spanish service

Medicare questions deserve clear answers in the language you are most comfortable using.

4

No cost for guidance

There is no cost to you for speaking with our agents. Carrier compensation may apply if you enroll.

Resources
Helpful Medicare resources

Official tools and counseling resources can help you verify information while our team helps you prepare for the next step.

🏠

Medicare.gov

The official U.S. Medicare website. Compare plans, find doctors in network, review your coverage, and manage your account.

Visit Medicare.gov →
📍

Medicare Plan Finder

Search and compare Medicare Advantage and Part D plans available in your ZIP code, filtered by your specific prescriptions and preferred pharmacies.

Compare plans →
👤

Social Security Administration

Apply for Medicare through SSA, check your Social Security statement, and manage SSDI benefits that affect your Medicare eligibility.

Visit SSA.gov →
📞

Florida SHINE Program

Serving Health Insurance Needs of Elders — Florida’s free counseling program that provides unbiased Medicare assistance to Florida residents.

Visit SHINE →
💊

Extra Help (LIS)

The Low Income Subsidy program helps people with limited income pay for Medicare Part D prescription drug costs. Check if you qualify at SSA.gov.

Check eligibility →
📌

Still have questions?

Our licensed agents can walk you through any of these resources — or skip them entirely and just find you the right plan directly.

Call 800-619-8959 →
FAQ
Common Medicare questions

When can I first enroll in Medicare?

Many people first enroll during a seven-month Initial Enrollment Period around their 65th birthday month. Some people qualify earlier due to disability, ALS, or End-Stage Renal Disease. Your timing can depend on current employer coverage and other factors.

What is the difference between Medicare Advantage and Original Medicare?

Original Medicare is Part A and Part B through the federal Medicare program. Medicare Advantage, also called Part C, is offered by private insurance companies approved by Medicare and provides another way to receive Part A and Part B benefits. Costs, networks, drug coverage, and extra benefits vary by plan.

Do I need a Scope of Appointment?

General Medicare education can happen before a Scope of Appointment. A Scope of Appointment is required before an agent discusses plan-specific benefits, compares plans, reviews costs, checks networks or formularies, or assists with enrollment for Medicare insurance products.

Is Medicare Supplement the same as Medicare Advantage?

No. Medicare Supplement, or Medigap, works with Original Medicare to help pay certain out-of-pocket costs. Medicare Advantage is a private-plan alternative for receiving Part A and Part B benefits. They are different coverage paths.

Can I get dental, vision, or hearing benefits with Medicare?

Some Medicare Advantage plans may include extra benefits such as dental, vision, or hearing coverage. Benefits vary by plan, carrier, and service area. Original Medicare generally does not cover most routine dental, vision, or hearing services.

Does Direct Insurance Solutions help Medicare clients in multiple states?

Yes. Direct Insurance Solutions offers Medicare guidance across the 38 states where we also offer health coverage. Plan availability still depends on state, county, ZIP code, carrier, eligibility, and enrollment period.

Bring these to the Medicare conversation

A little prep makes the call much easier.

  • Medicare card if available
  • Doctors and specialists
  • Prescription list and pharmacy
  • Current plan or employer coverage
  • Medicaid status, if applicable
Call 800-619-8959
Get Help
Get help with Medicare today

Start with general Medicare guidance. When you are ready for plan-specific discussion, we will complete the required Scope of Appointment first.

Call a licensed agent

Speak directly with a licensed Medicare agent and ask where to begin.

800-619-8959
@

Send a message

Send your Medicare questions and a team member can follow up with next steps.

Send a message
SOA

Prepare for SOA

Bring your coverage questions, doctors, prescriptions, preferred pharmacy, and Medicaid status if applicable.

Review SOA

*Direct Insurance Solutions is not connected with or endorsed by the U.S. government or the federal Medicare program. This page is for general educational purposes only and is not a complete description of Medicare benefits, costs, eligibility, enrollment rules, plan availability, or carrier offerings. Plan availability, premiums, benefits, drug formularies, provider networks, pharmacies, cost sharing, and enrollment rules vary by plan, county, state, carrier, eligibility, and enrollment period. A Scope of Appointment is required before an agent can discuss plan-specific Medicare products, compare plans, explain plan benefits, review costs, check networks or formularies, or assist with enrollment.

Visit Medicare.gov →
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