Medicare: Your Guide Through the Maze

Turning 65? Congratulations - you're about to enter the wonderful world of Medicare, where nothing is simple and everything has a different part number. Parts A, B, C, D, and don't forget about Medigap policies, which aren't actually called Part anything.

Confused yet? You're not alone. Medicare might be the most complicated government program ever created, and the decisions you make when you first sign up can affect you for years. So let's break this down into actual English.

Medicare Basics: What You're Actually Getting

Part A (Hospital Insurance): Covers hospital stays, skilled nursing facilities, hospice care, and some home health services. Most people get this free because they paid Medicare taxes while working.

Part B (Medical Insurance): Covers doctor visits, outpatient care, medical equipment, and preventive services. This one costs money - about $175 per month for most people in 2025, but it can be higher if you have a big income.

Together, Parts A and B are called "Original Medicare." It covers a lot, but not everything. No prescription drugs, limited dental or vision, and you'll pay 20% of most services with no cap on how much that could add up to.

Medicare Advantage (Part C): The Alternative Route

Instead of Original Medicare, you can choose a Medicare Advantage plan. These are private insurance plans that include everything Original Medicare covers, plus usually prescription drugs and sometimes dental, vision, or hearing benefits.

Sounds great, right? It can be, but there's a catch: you're locked into their network of doctors and hospitals. And the plan that looks amazing this year might change their benefits, doctors, or drug coverage next year.

Part D: Prescription Drug Coverage

If you stick with Original Medicare, you'll probably want to add a Part D prescription drug plan. These are sold by private companies and vary widely in what drugs they cover and how much they cost.

Here's the gotcha: if you don't sign up for Part D when you're first eligible and don't have other prescription coverage, you'll pay a penalty for the rest of your life when you finally do sign up.

Medigap: Filling the Gaps

Original Medicare leaves you responsible for deductibles, copays, and that 20% coinsurance with no limit. Medigap policies (also called Medicare Supplement insurance) help pay these costs.

There are different Medigap plans (named with letters like Plan G, Plan N), and they're standardized, so Plan G from one company covers the same things as Plan G from another company. But the prices can be very different.

When Do You Need to Make These Decisions?

Initial Enrollment Period: Three months before you turn 65, the month you turn 65, and three months after. This is your best shot at getting coverage without penalties or health questions.

Annual Open Enrollment (October 15 - December 7): You can switch Medicare Advantage plans or Part D plans. But you can't switch from Medicare Advantage back to Original Medicare plus Medigap without answering health questions.

Don't miss these deadlines. The penalties and restrictions can follow you for years.

The Choices That Really Matter

Medicare Advantage or Original Medicare plus Medigap? This is the big decision. Medicare Advantage often has lower upfront costs but restricts your doctor choices. Original Medicare plus Medigap costs more monthly but gives you more freedom and predictable costs.

Which Medigap plan? Plan G is the most popular because it covers almost everything except the Part B deductible. Plan N costs less but you pay small copays for doctor visits.

Which Part D plan? Look at your actual prescriptions and see which plan covers them at the lowest cost. Don't just look at the premium - the drug costs matter more.

What About If You're Still Working?

If you're 65 but still working with good employer insurance, you might be able to delay Medicare Part B without penalties. But the rules are tricky, and making the wrong choice can cost you thousands.

How I Can Help You Navigate This Mess

I've been helping people with Medicare decisions for years, and I can tell you that no two situations are exactly the same. Here's what we'll figure out together:

What your actual costs will be: Not just premiums, but total out-of-pocket costs based on your health and prescriptions.

Medicare Advantage vs. Original Medicare: Which approach makes sense for your situation, doctor preferences, and budget.

Plan comparisons: I can show you all your options and explain the real differences, not just the marketing fluff.

Timing: When to enroll, when to make changes, and how to avoid costly mistakes.