Medicare Made Simple

Your Initial Enrollment Period is a 7-month window. It starts 3 months before the month you turn 65 and ends 3 months after. If you miss it, you can make changes during Annual Enrollment (October 15 to December 7 each year), and Medicare Advantage plans have their own Open Enrollment Period from January 1 to March 31.

Medicare Advantage (Part C) bundles your hospital, medical, and usually drug coverage into one plan from a private insurer, often with extras like dental or vision. Medigap (Medicare Supplement) works alongside Original Medicare to help with the gaps, like deductibles, copays, and coinsurance. It's sold separately from drug coverage. Which one fits better depends on your doctors, your budget, and how you like to get your care.

Original Medicare (Parts A and B) doesn't cover most prescription drugs on its own. You'll need a stand-alone Part D plan, or a Medicare Advantage plan that includes drug coverage, to protect yourself from drug costs and the Part D late enrollment penalty.

Nothing. The insurance company pays me a commission, not you, so your premium is exactly the same whether you enroll through me, another agent, or directly with Medicare. There's no fee for a consultation, a plan review, or my ongoing service.

It depends on your employer's size and your current coverage. If your employer has 20 or more employees, you can often wait on Part B without a penalty. If it has fewer than 20, you likely need to sign up for Medicare right away. It's worth a quick, no-cost conversation before you make a mistake that's hard to undo.

Annual Enrollment runs October 15 through December 7 every year. During that time, anyone with Medicare can switch Medicare Advantage plans, switch Part D drug plans, or move between Original Medicare and Medicare Advantage. Changes start January 1.

Sometimes a carrier ends a Medicare Advantage plan or shrinks its service area for the next year. If that happens to yours, Medicare requires the carrier to tell you in writing, and you automatically qualify for a Special Enrollment Period to pick a new plan. You won't lose coverage in the gap, but you do need to choose a replacement yourself rather than waiting for one to be assigned.

This happens when a health plan and a hospital system or medical group can't agree on a new contract. In some cases it can affect your coverage even outside the usual enrollment windows. Depending on your plan and situation, you may qualify for a Special Enrollment Period to switch to a plan that keeps your doctors in-network. A quick, no-cost network check is worth it before you assume you have to change doctors.

Some carriers have been cutting back or ending PPO options in certain counties and shifting toward HMO plans. PPOs usually give you more flexibility to see out-of-network providers. If your PPO is affected, take a look at what's still available before you default to an HMO, and check it against your own doctors and needs.

That's your Annual Notice of Change, or a non-renewal notice. Plans have to send one every fall if your costs, benefits, network, or availability are changing for the next year, or if the plan won't be offered at all. Read it closely and look at your other options before the enrollment deadline. Staying with what you have isn't always the best choice, and sometimes it isn't even an option.