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Medicare basics
Understanding Medicare
Learn how Medicare works, compare your options, and see how Clever Care supports your health and wellness journey.
Medicare 101
The four parts of Medicare
Medicare has four distinct parts. Each covers different services.
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Part A covers hospital care
Hospital stays, skilled nursing, hospice, and home health services.
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Part B covers medical services
Doctor visits, outpatient care, preventive services, and medical equipment.
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Part C is called Medicare Advantage
All-in-one coverage combining Parts A, B, supplemental benefits, and often Part D.
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Part D covers prescription drugs
Medications your doctor prescribes, covered through approved plans.
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Original Medicare versus Medicare Advantage
Original Medicare is managed by the federal government and covers hospital and medical services. Medicare Advantage bundles everything into one plan with supplemental benefits like dental and vision.
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Original Medicare
Government-run coverage for hospital and doctor visits.
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Medicare Advantage
All-in-one private plans with extra benefits included.
Enrollment periods
When to enroll in Medicare
Initial Enrollment Period
Initial Enrollment Period includes your 65th birthday month, the three months before, and the three months after—for a total of seven months to initially enroll.
Annual Enrollment Period
The Annual Enrollment Period runs from October 15 to December 7 every year. During this window, anyone with Medicare can join, switch, or drop a Medicare Advantage or Part D prescription drug plan—your new coverage starts January 1.
Special Enrollment Period
A Special Enrollment Period lets you enroll or change plans outside the usual windows after certain life events—like moving outside your plan's service area, losing other coverage, or qualifying for Medicaid or Extra Help. The timing depends on your situation, but it's often a two-month window.
Open Enrollment Period
California’s open enrollment period runs annually from November 1 through January 31. During this window, individuals can sign up for, change, or renew their health insurance marketplace plans for the upcoming year.
Your coverage
How Clever Care fits into your Medicare
Clever Care Medicare Advantage plans bring hospital, medical, and prescription coverage together in one plan. We add dental, vision, and hearing benefits, plus wellness programs rooted in both Western and Eastern medicine.
- Complete hospital and medical coverage
- Dental, vision, and hearing benefits
- Holistic wellness and community-centered service
Medicare terms explained
Five key terms that make Medicare costs and coverage clearer.
Monthly premium
The fixed amount you pay each month to keep your plan active — separate from any costs for actual care. Excludes copayments or coinsurance for care or prescription drugs.
Deductible
The amount you pay for covered services before your plan starts sharing costs. Most Clever Care plans have a $0 medical deductible — your coverage starts on day one.
Copay
A fixed dollar amount you pay for a specific service — for example, $0 for a primary care visit or $40 for an emergency room visit. Copays are predictable so you always know what to expect.
Out-of-pocket maximum
The most you’ll pay out of pocket for covered Part A and Part B services in a calendar year. Once you reach this cap, your plan pays 100% of covered care for the rest of the year. Original Medicare has no out-of-pocket maximum — Medicare Advantage plans do.
Provider network
The doctors, hospitals, pharmacies, and specialists your plan partners with. Using in-network providers usually means $0 or low copays. Clever Care’s network includes 2,700+ wellness providers across Southern California.
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