Medicare Planning

1. Know When to Enroll

  • Initial Enrollment Period (IEP): Starts 3 months before your 65th birthday, includes your birthday month, and continues for 3 months after (7 months total).

  • If you’re already receiving Social Security benefits, you’ll be enrolled automatically.

  • Missing your enrollment window could mean penalties (especially for Part B and Part D).

    unless you have “credible coverage” that is as good as medicare offers through an employer.

2. Understand the Parts of Medicare

  • Part A: Hospital insurance (usually premium-free).

  • Part B: Medical insurance (doctor visits, outpatient care — monthly premium required).

  • Part C (Medicare Advantage): All-in-one private plan that bundles A, B, often D, and extra benefits.

  • Part D: Prescription drug coverage (standalone or inside Part C).

3. Decide Between Original Medicare, Medicare Advantage or Medicare Supplement

  • Original Medicare (Parts A & B):

    • See any provider who accepts Medicare nationwide.

    • Doesn’t include drug coverage unless you add Part D.

    • Doesn’t include hearing, vision, dental

    • Consider adding a Medigap (Supplemental) policy to help with out-of-pocket costs.

  • Medicare Advantage (Part C):

    • Often includes drug coverage and extras like dental, vision, hearing, fitness.

    • Typically uses networks (HMO/PPO) for care.

      Annual out-of-pocket maximum (protection from unlimited costs).

  • Medicare Supplement (secondary) - Original Medicare remains primary

    • No doctor network as long as the doctor accepts Orginal Medicare

    • Has a monthly premium that increases each year

    • Drug coverage is not included and you need a stand along prescription drug plan to pair with it.

    • If medicare doesn’t coverage it, then it’s unlikely the supplement will either.

    • Doesn’t include hearing, vision, dental.

4. Check Prescription Coverage

  • List current medications and compare Part D or Advantage plan formularies.

  • Drug coverage is where costs can vary the most — choosing wisely can save thousands.

5. Factor in Costs Beyond Premiums

  • Look at deductibles, copays, coinsurance, and yearly out-of-pocket limits, not just the monthly premium.

  • Budget for supplemental coverage (Medigap or Advantage plan extras).