This guide will break down the steps and considerations for moving with Medicare, with specific sections on:

• Moving with Original Medicare and Medigap
• Moving with Medicare Advantage (Part C)
• Moving with Medicare Part D (Prescription Drug Plans)

Let’s look at each scenario in detail.

Moving with Original Medicare and Medigap

Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). It’s federally administered, which means it works the same way anywhere in the United States. However, if you also have a Medigap (Medicare Supplement) policy, moving may require a few additional steps.

How Moving Affects Original Medicare

Original Medicare travels with you. Since it’s a national program run by the federal government, you can see any doctor or healthcare provider in the U.S. who accepts Medicare, without worrying about network restrictions or needing a referral. (Read More: Medicare and Medigap – How Do They Work Together? | 65Medicare.org)

Key Points:

• No need to change your Part A or Part B enrollment if you move within the U.S.
• You should update your address with Social Security or the Railroad Retirement Board, depending on where you get your benefits. Updating your address with Social Security takes care of notifying Medicare of your new address.
• Make sure to find new healthcare providers in your new area that accept Medicare if you’re moving a significant distance.

How Moving Affects Medigap Policies

Medigap plans are sold by private insurance companies to help cover costs like copayments, coinsurance, and deductibles that Original Medicare doesn’t pay. The plans are Federally-standardized in most states, so it is easy to compare “apples to apples”. In other words, a Plan G, for example, is the exact same coverage regardless of the insurer.

When you move:

• If you stay within the same state, you should be able to keep your current Medigap policy.
• If you move to another state, especially one with different Medigap rules or pricing (community-rated vs. issue-age-rated vs. attained-age-rated plans), your plan options may change, and it is wise to check your options to ensure your current plan is still the right plan for you in your residence.

Possible Scenarios:

1. You can keep your Medigap policy:
   Some companies allow you to keep your current plan even if you move, although premiums might change to reflect the current premiums of your new location.
2. You may want to switch plans:
   If better or more affordable options are available in your new location, you might be able to switch, though depending on your situation, you could be subject to medical underwriting (health questions). An independent broker can help you evaluate whether a move to a new state would call for a corresponding move to a new insurer. Get Medigap rates for your new state delivered by email.
3. Special Rights:
   If you’re moving out of the service area of a Medicare SELECT policy (a type of Medigap policy that requires using specific hospitals and doctors), you have a guaranteed right to buy a standard Medigap policy without medical underwriting.

Action Steps:

• Notify your Medigap insurer of your move. You can do this by calling the number on your Medigap insurance card or contacting your Medigap broker.
• Review plan options and premiums in your new area. This can be done online through an independent broker or, in some states, through the state department of insurance.
• Consider enrolling in a different Medigap plan if it offers better coverage or lower premiums. (Medigap Premium Increases – Does Your Premium Change When You Move?)

Moving with Medicare Advantage

Medicare Advantage (Part C) plans are offered by private insurance companies and must cover at least what Original Medicare covers, but often include extra benefits like dental, vision, or hearing. These plans are regional, network-based, and they have specific service areas.

How Moving Affects Medicare Advantage Plans

Because Medicare Advantage plans depend on local networks of doctors, hospitals, and pharmacies, moving outside your current plan’s service area usually requires changing your plan.

Key Points:

• If you move outside your plan’s service area, you must switch plans.
• If you move within your plan’s service area but to a different county or ZIP code, you might still be allowed (or even encouraged) to change plans because different options may be available.
• You will get a Special Enrollment Period (SEP) to choose a new plan, as a result of a move outside of your plan’s service area.

Special Enrollment Period (SEP) Details

• You can switch to a new Medicare Advantage plan or return to Original Medicare (and enroll in a Part D plan separately).
• The SEP starts the month before your move and continues for two full months after you move.
• If you notify your current plan after you move, your SEP begins the month you notify them and lasts two additional months.
• If you have previously been “stuck” in Medicare Advantage due to medical conditions, a move outside of your Advantage plan’s service area represents an opportunity to move back to original Medicare and add a Medigap plan on a guaranteed issue basis.

Action Steps:

• Notify your current Medicare Advantage plan about your upcoming move.
• Research plans in your new area ahead of time.
• Choose a new Medicare Advantage plan or switch to Original Medicare with optional Part D and Medigap coverage.
• Be sure to avoid gaps in coverage by making timely decisions.

Moving with Medicare Part D (Prescription Drug Plans)

Medicare Part D offers prescription drug coverage through private plans that operate within specific regions. Like Medicare Advantage, Part D plans have networks, so moving could require a change depending on your destination.

How Moving Affects Medicare Part D Plans

Each Part D plan has a designated service area, and moving outside that area means you need to enroll in a new plan.

Key Points:

• You must be enrolled in a Part D plan that operates in your new location.
• Moving gives you a Special Enrollment Period (SEP) to join a new Part D plan.

Special Enrollment Period (SEP) Details

• SEP begins the month before you move and lasts two full months after you move.
• If you notify your plan after you move, the SEP begins the month you notify your plan and lasts for two months.
• If you don’t choose a new plan during the SEP, you could face a gap in coverage and a potential late enrollment penalty if you go without prescription drug coverage for 63 days or more.

Action Steps:

• Notify your current Part D plan provider. If your new location is outside the plan’s service area, you will be disenrolled as of the 1^st day of the next month.
• Compare available Part D plans in your new area using the Medicare Plan Finder tool or by working with a licensed broker.
• Check that your medications are covered under your new plan’s formulary.
• Enroll promptly to maintain continuous coverage.

Important Things to Remember When Moving with Medicare

• Update Your Address: Contact Social Security (1-800-772-1213) or update your information online at ssa.gov.
• Keep Documentation: Save any notices and correspondence from your Medicare plan and Social Security Administration.
• Evaluate Your Options Carefully: Moving gives you a unique opportunity to reassess your healthcare needs and possibly find a plan that better fits your situation or reduces your monthly premiums.
• Timing Matters: Acting quickly ensures you don’t experience a lapse in healthcare or prescription drug coverage.

Moving with Medicare: The Bottom Line

Moving, in general, can be stressful, but staying informed about how Medicare is affected helps simplify the transition.

• If you have Original Medicare, it’s mostly just updating your address — but if you have a Medigap policy, you’ll want to review it closely and possibly make a change to a plan that offers a lower premium in your new location.
• If you have Medicare Advantage or Part D, you’ll need to use your Special Enrollment Period to pick a new plan.
• Always act within your Special Enrollment timelines to prevent interruptions in your health or prescription coverage.

By staying proactive and organized, you can ensure that your move is smooth not only for your personal life but for your healthcare coverage as well.

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65Medicare.org is a leading, independent Medicare insurance 

agency for people turning 65 and going on Medicare. We have worked with 10,000+ Medicare-eligible individuals over the last 10+ years, assisting with understanding and comparing the plans. You can get a list of Medigap quotes in your area. Or, if you have any questions about this information, you can contact us online or call us at 877.506.3378.

The post Medicare and Moving to Another State – What You Need to Do appeared first on 65Medicare.org.

First and foremost, we should clarify that the technical name for this period is the “Annual Election Period” (AEP). It runs from October 15, 2023 to December 7, 2023. Even Medicare itself sometimes mistakenly and confusingly calls it the “open enrollment period”. Open enrollment for Medicare is actually when you turn 65. And open enrollment for Medicare Supplement plans is when you start on Medicare Part B for the first time (either due to turning 65 or starting on it later than that). But since most people call it open enrollment and so as not to get to hung up on jargon, we’ll use both terms interchangeably – annual election period and Medicare open enrollment.

What Changes Can You Make During Medicare Open Enrollment?

So, what changes can you make during the annual election period? This period is all about changing your Medicare Advantage plan or your Medicare Part D prescription drug plan. With either of those two types of plans, you have the opportunity to switch to another plan within your same insurance company or a different insurance company. Any changes that you make to your coverage will take effect on January 1 of the following calendar year.

If you are already on a Medicare Advantage plan or a Medicare Part D plan, you should receive something from your plan, by mail, in late September/early October detailing the plan’s changes for next year. This is called the annual notice of changes (ANOC), and it is a requirement that plans send this out and do so in a timely manner.

The plan coverage for the next calendar year will be available on Medicare.gov on or around October 1. So you would be able to log in and compare your current plan to what else is available after that date. But you cannot make any changes or enroll in a new plan until October 15.

Comparing all aspects of your plan is crucial to do if you are on Medicare Part D or Medicare Advantage. Both types of plans can change each year in terms of premiums, coverage levels, deductibles, and networks.

Can You Change Medicare Supplements During Medicare Open Enrollment?

The types of plans that are not in any way connected with the Annual Election Period are Medicare Supplement plans, also called Medigap. Medigap plans are plans from private companies that fill in the gaps in Medicare Parts A and B.

Open enrollment for Medigap is a 6-month period that begins on the first day you are in Medicare Part B, whether that is the month of your 65th birthday or later than that if you delay Part B enrollment. During that time period, you do not have to answer medical questions or qualify to get a Medigap plan. You can choose any plan from any company on an open enrollment basis.

After that initial 6 month window, regardless of the time of year that it is, you DO have to answer medical questions to get a Medigap plan (with a few exceptions of some states that prohibit underwriting in certain situations or at all).

So, yes, you can change your Medicare Supplement during the annual election period. However, you cannot do so an “open enrollment” basis – you will have to answer medical questions and get approved by the new insurance company in order to change your plan.

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. If you have any questions about this information or would like to see if there is a mutual fit to work together, you can contact us online or call us at 877.506.3378.

The post When Does Medicare Open Enrollment Start? appeared first on 65Medicare.org.

You can sign up for Medicare Part D during:

• Your IEP (Initial Enrollment Period)
• When you are about to turn 65, you have a seven-month period in which you can enroll in Medicare Parts A and B. This includes three months before you turn 65, your birthday month and three months after your 65th birthday.

• The AEP (Annual Enrollment Period)
• From October 15^th to December 7^th each year. You can change your prescription drug plan during this time frame. However, it will not go into effect until January 1^st.
• If your birthday falls on the 1^st of the month, the your seven-month period would start the month before your birth month. Let’s say your birthday is on May 1^st. Then your IEP will be from January 1 to July 31.

• Special Enrollment Periods such as:
• Losing credible drug coverage
• Losing drug coverage from an employer or union
• You are eligible for Extra Help

Note: If you get Extra Help, or live in a nursing home, you may change your Part D plan once a month.

It is a good idea to sign up for Part D early to make sure your new plan begins when it should. If you do not sign up in a timely fashion, as indicated above, you will have to pay a late penalty, which may also delay the effective date of your Part D plan. This penalty is calculated at 1% of the “national base beneficiary premium” ($32.74 in 2020) multiplied by the number of months in which you were not covered.

Are there any requirements to be eligible for a Part D prescription drug plan?

In order to enroll in a drug plan, you are required to:

• Have Part A and/or Part B
• Reside in the service area of the plan, i.e. zip code or county

You can sign up for a Part D plan by:

• Calling Medicare at 1- 800-MEDICARE (800-633-4227); TTY: 877-486-2048;
• Call the plan of your choice or go to their online website and enroll directly.
• By using Medicare’s Plan Finder tool (see below)

If you take any medications, particularly if you take any that are expensive, it is very prudent that you use the Medicare.gov comparison tool (or have a broker do it for you) to compare the plans. The co-pays and lists of covered drugs can vary tremendously from company to company.

Here are the steps for using the plan finder tool:

• Go to medicare.gov/plan-compare – you can either create a login or continue without logging in. If you create a login, you will be able to see drug prices based on any help you get, compare plans, create and save your drug list, and other helpful features;

• Next you will be asked what type of drug plan you are looking for. Click on Drug Plan (Part D). You will then be asked to enter your zip code. If there is more than one county in your zip code, then it will bring up those counties and ask you to choose one.

• You will be asked if you get help from certain programs

• Do you want to see your drug costs?

• It will then ask how you pay for your drug costs: Retail pharmacy, mail order or both.

• If you have drugs to enter, you will be prompted to add those drugs. Once you are done adding drugs you will indicate your preferred pharmacy if that’s how you get your medications. A list of various pharmacies will come up in your zip code and neighboring ones.

• You will then see a list of plans which can be sorted by going to the dropdown box at the top right of the page. The choices are – a) lowest monthly premium; b) lowest yearly drug deductible; c) lowest drug + premium cost. Note: If you did not enter any drugs, then the last option will not be available.

• You can compare up to 3 plans at a time. You also can save and print the plan comparison(s).

As stated above, you may enroll directly on the plan-finder tool by clicking on the “enroll” button or by clicking on the plan to get the plan provider details.

How Do I Pay for My Part D Prescription Drug Plan?

The monthly premium will be deducted from your Social Security benefits every month in most cases. However, you also have the option to pay the plan directly via bank draft or have them bill you instead.

What Else Do You Need Besides Part D?

If you have Medicare Part A and Part B and you add Part D, you also have the option of getting a Medigap plan to fill in the gaps in Medicare A & B. Medigap plans pay the unlimited 20% that Medicare does not cover as well as, on some plans, covering the deductibles in Medicare. To compare the Medigap plans for your area, you can go here: Medigap quotes by email.

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. If you have any questions about this information, you can contact us online or call us at 877.506.3378.

The post When and How To Sign Up for a Part D Plan? appeared first on 65Medicare.org.

Once you are enrolled in Medicare Parts A and B, you never have to renew them.  You can “stop” Medicare Part B if you wish to do so (i.e. if you get a job that offers group insurance and want to disenroll from Medicare).  But if you do nothing, Medicare will always continue without a need for annual, or periodic, renewal.

Medicare Advantage and Part D:

These plans renew their contract with Medicare each year – Medicare must approve the plan design each year.  If it is approved by CMS (Medicare), and you want to keep the plan, you do not have to do anything.  But the plan contract with Medicare IS renewed annually.  You will receive a notice each year around late September/early October about the plan’s status for the following calendar year. This also contains information about how the plan is changing (premiums, coverage, etc) for the following year. See below for more information about what happens if/when your plan is not renewed for the following year. What are the differences in Medigap and Medicare Advantage

Medicare Supplement (Medigap) Plans:

Medigap plans renew each time the premium is paid.  If you pay monthly, they are renewed monthly. You do not have to do anything annually to renew them, and there is no annual open enrollment period for Medicare Supplement plans. They have the benefit of being “guaranteed renewable”.  It will continue indefinitely unless you don’t pay the premium. However, if your policy does lapse, you will generally have a grace period and/or a reinstatement period. It is very easy for this to occur if for instance, you are traveling for an extended period, you are moving to a new location, you are experiencing a long illness, or changing your autopay source. Your Medigap carrier cannot drop you from your plan or make changes to your plan (i.e. downgrade your benefits) because of any changes in health.

IMPORTANT: Just because Medigap plans have the benefit of renewing indefinitely, does NOT mean that you should put them on auto-pilot and never check pricing. In fact, the opposite is true. Rates go up on Medigap, considerably so with some companies, and it is always prudent to check pricing annually or bi-annually. You can request 2020 Medigap rates here.

What Happens If My Medicare Advantage Plan or Medicare Part D Plan Are Not Renewed?

If your Medicare Part C (Medicare Advantage) or Prescription Drug Plan (Part D) plans are not renewed (in other words, they are no longer approved/offered in your area), you will have a Special Election Period (SEP). During a SEP for a Medicare Advantage non-renewal, you can sign up for a Medicare Supplement plan or change your Medicare coverage to a new Medicare Advantage plan. If your Part D plan non-renews for the next year, you can choose a new Part D plan – if you don’t do so, you may be without drug coverage for the following year. Besides the SEP granted to people in a non-renewing plan, there are also different SEPs applied to different circumstances.  Listed below are a few SEP scenarios and their corresponding time frame:

• You moved and your plan is not offered in your new service area – if you notify your plan prior to your move, you can switch the month before the month you move; it continues for 2 full months after you move. But, if you tell your plan after you have moved, you will be able to switch plans beginning the month you tell your plan, plus 2 more full months.

• The Medicare contract for your plan is not renewed for the upcoming year – December 8 to the end of February.

• Your plan leaves the Medicare program in mid-year – your SEP begins the month in which you are notified and continues for two more months.

• Medicare terminates its contractual agreement with your plan – you have two months before and one full month following the end of the contract.

In addition to the above situations, there are life changing events that would allow for SEPs. Each qualifying life event has a different SEP.  For more information about SEPs, call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048, or go to www.Medicare.gov.

Even if you do not need to renew your Medicare coverage, it is prudent to review your coverage every year.  Your plan benefits may change. In addition, provider and pharmacy networks may be added or taken off your list.  Drug formularies may change too. This especially may have a big impact on the cost effectiveness of your plan along with cost sharing. These can all change from year-to-year and affect your out-of-pocket costs.  Comparing plans on an annual basis is an excellent idea to ensure that your coverage continues to be in alignment with your budget and your health needs.

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. We have worked with 10,000+ Medicare-eligible individuals over the last 10+ years, assisting with understanding and comparing the plans. You can get a list of Medigap quotes in your area. Or, if you have any questions about this information, you can contact us online or call us at 877.506.3378.

The post Is Medicare Renewed Automatically Each Year? appeared first on 65Medicare.org.

 Who Gets Part A and Part B Automatically?

• If you are already receiving Social Security benefits (starting the first day of the month you reach age 65; unless your birthday is on the 1^st of the month, in which case they will start on the 1^st of the prior month;
• If you are already getting Railroad Retirement Board (RRB) benefits;
• If you have ALS (Amyotrophic Lateral Sclerosis, Lou Gehrig’s disease)(starting the month your Social Security benefits begin);
• If you are disabled and under 65 or receive certain disability benefits from the RRB. These benefits must have been received for a period of at least 24 months.  You will get your Medicare card three months prior to your 25^th month of getting disability benefits;

Your red, white and blue Medicare card will indicate whether you have Part A (hospital insurance) or Part B (medical insurance), and the effective date.  You will receive it three months prior to your 65^th birthday or on the 25^th month of disability benefits (see above).  If you want to keep Part B, you do not have to do anything.  However, if you choose to waive your right to Part B, you may have to wait to enroll at a later date, and in addition, pay a late penalty for the duration of time you have

Part B (see below).

Who needs to sign up for Part A and Part B?

• If you are not presently collecting Social Security benefits or Railroad Retirement Board benefits. –  You will need to sign up for Medicare three months prior to your 65^th birthday.
• If you have end-stage renal disease (ESRD)
  • Contact Social Security for more information, or online at Medicare.gov/publications and search for the booklet entitled, “Medicare Coverage of Kidney Dialysis & Kidney Transplant Services.”

Note:  If you live in Puerto Rico, you are not automatically enrolled in Part B.  You will have to complete form CMS-40B to enroll.  Contact Social Security or RRB for more information.

When can I enroll in Part A and Part B?

• Initial Enrollment Period – during the 7-month period that begins 3 months prior to the month you turn 65, including the month you turn 65, and ending 3 months after the month in which you turn 65; If your birthday falls on the 1^st day of the month, your coverage will begin on the 1^st day of the prior month.
• Special Enrollment Period – if you are still working and covered under a group plan (your own, your spouse’s or a family member’s)
  • Anytime you are still covered by a group health plan
  • During the 8-month period starting the month following the end of employment or coverage, whichever occurs first

Note:  If you are disabled, your employer must have 100 or more employees to get a Special Enrollment Period.

               Also, if you are on Cobra, there is no Special Enrollment Period when it ends.

• General Enrollment Period: If you did not enroll during your Initial Enrollment Period, and you do not qualify for a Special Enrollment Period, you can sign up from January 1 – March 31 each year.  In that case, your coverage will begin on July 1 of that year.  Please see below for late enrollment penalties.

What are the Medicare late enrollment penalties for not getting Medicare Part B?

It is very important that you enroll in Medicare Part B when you first become eligible, otherwise you will incur a penalty.  The penalty is 10% for each 12-month period that you didn’t sign up for Part B, but could have done so (excluding a Special Enrollment Period).

Example:

Mr. Banks Initial Enrollment Period ended October 25, 2014.  He waited to enroll in Part B until April 2017, during the General Enrollment Period.  In this case, Mr. Banks waited a total of 30 months to sign up.  This included two full 12-month periods).

What are the Medicare late enrollment penalties for not getting Medicare Part D?

A late enrollment penalty is incurred any time there is a lapse of 63 or more consecutive days when you do not have Part D, or other creditable drug coverage.  Creditable drug coverage can include drug coverage from your current or former employer or union, TRICARE, Indian Health Service, the Dept. of Veterans Affairs, or health coverage.  Your plan is obligated to tell you each year whether your drug coverage is creditable.

Note:  You will not have to pay a late enrollment penalty if you get Extra Help.

This late penalty is 1% of the “national base beneficiary premium” ($34.10 in 2016), then multiplying that by the number of months that you were eligible but did not sign up for Medicare Part D, and you were without other creditable prescription drug coverage.  This amount, which is rounded to the nearest $.10, is added to your monthly premium.

Note:  This amount may increase each year, since it is based upon the “national base beneficiary premium,” which may increase yearly.

Example:

Mrs. Johnson was eligible to enroll in Medicare Part D by June 2013.  She does not have prescription drug coverage from another source.  She enrolled in a Medicare prescription drug plan during the Open Enrollment Period in 2015.  Her coverage started on January 1, 2016.  Since Mrs. Johnson did not have creditable prescription drug coverage from July 2013 to December 2015, her penalty in 2016 is 30% (30 months x 1%) of $34.10 (the national base beneficiary premium for 2016), which is $10.23.  As mentioned, the monthly penalty is rounded to the nearest $.10, which will result in a penalty of $10.20.  This amount will be added to her plan’s monthly premium as long as she has Part D, and this amount may increase each year.

Can Medicare late enrollment penalties be disputed if I don’t agree?

Yes.  You may request reconsideration or a review of your Medicare late enrollment penalties.  To do this, you must complete a reconsideration request (your drug plan will send it to you) by the date indicated in the letter.  You will then be able to provide information, i.e. creditable prescription drug coverage, that will support your case.

As you can see, there may be monetary consequences to not signing up during the appropriate enrollment periods.  In addition, these penalties are for the entire duration that you have Medicare Part B or Part D, not only a one-time charge.  So, it is very important that you know when you are eligible and how much time you have to sign up in your particular situation.  For further information about enrollment periods and late penalties, call 1-800-MEDICARE (1-800-633-4227).  TTY users can call 1-877-486-2048.

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. We have worked with 10,000+ Medicare-eligible individuals over the last 10+ years, assisting with understanding and comparing the plans. You can get a list of Medigap quotes in your area. Or, if you have any questions about this information, you can contact us online or call us at 877.506.3378.

The post Medicare Late Enrollment Penalties: The Importance of Enrolling on Time appeared first on 65Medicare.org.

You may be retiring or thinking about retiring soon, and you’re probably getting hounded with emails and mail about Medicare and what you should do about it.

If you’re trying to figure it all out on your own… well… you don’t have to.

Our agents are ready to give you a hand at absolutely no cost to you whenever you’re ready.

But, if you’re just starting to get a feel for your new responsibilities, here are 5 things that all 65ers need to know.

5. Enroll in Medicare Part A and Part B.

When you turn 65, Medicare is officially available to you. You’ve been paying into it for long enough, so why not reap its benefits?

Part A cover inpatient care, and it’s completely free. No monthly premium for you.

Part B covers outpatient care, and it’s monthly premium, as of 2017, is $134. Note: that cost is higher if you make more than $85,000 per year (or $170,000 per year as a household).

If you’re on group coverage, and you’re still working, you need to weigh your options. You can read more about that here: https://65medicare.org/should-you-keep-your-group-insurance-when-you-turn-65.

Here’s what your timeline looks like:

→ 3 months before you turn 65, your birthday month, and 3 months after you turn 65.

If you miss this 7-month window, you’re going to be hit with some late enrollment penalties.

Here’s how to sign up, straight from Medicare.gov:

• Apply online at Social Security. If you started your online application and have your re-entry number, you can go back to Social Security to finish your application.
• Visit your local Social Security office.
• Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
• If you worked for a railroad, call the RRB at 1-877-772-5772.
• Complete an Application for Enrollment in Part B (CMS-40B). Get this form and instructions in Spanish. Remember, you must already have Part A to apply for Part B.

You can choose to opt out of Medicare Part B if you want, but you should discuss it with your agent first.

4. Look into Medicare Part C (Medicare Advantage).

Medicare Advantage is an alternative to Medicare and Medigap plans. It often has a very low monthly premium, but it also comes with its downsides.

The first problem is the limited network. There are a lot of doctors that don’t accept Medicare Advantage. It could leave you with either no doctors in your area, or a doctor that’s not your favorite.

Also, the premium may look like a good sticker price, but there’s still hefty deductibles and co-pays. We’ve seen those range anywhere from $3,000-$7,000.

Medicare Advantage can be a good option for those in large cities. Large cities often have more doctors to choose from.

If you’re in a smaller city, you may not have any doctors, meaning you’ll have to drive a distance to see a doctor.

It’s always best to weigh your options  (Read our Medicare Advantage vs. Medigap article), so don’t rule anything out until you check out your own situation and your own network of coverage.

3. Sign up for Medicare Part D.

Medicare Part D, also called a prescription drug plan, or PDP for short, helps a lot of people save money on drug costs.

The dilemma here is that many turning 65 aren’t on any prescriptions yet. Why then would you pay a monthly premium for drug coverage that you don’t need?

Great question, and here’s the answer: For every month you delay signing up for Part D, you receive a 1% penalty on the premium.

We realize that may sound a little confusing, so here’s an example.

If you had signed up for Part D when you turned 65, let’s say your monthly premium would’ve been $50.

For each month you delay signing up, your monthly premium goes up by $0.50. So, by the end of the year — 12 months later — your premium has gone up to $56. Now, you’re not paying that premium yet, but when you do sign up for Part D, that penalty will go into effect.

If you had signed up for Part D, your premium would’ve stayed at $50.

It’s often a choice that takes time to make. If you end up needing prescriptions and you don’t have a Part D plan in place… well, we all know how expensive prescriptions are. It’s a gamble — are you willing to take the risk? And the penalty?

2. Choose a Medigap plan.

Medicare does cover a good portion of your medical expenses, but you’re still left behind with a nice chunk of risk.

To put things simply, Medicare covers about 80% of your medical expenses. A Medigap plan picks up that other 20%. That’s a generalization, and it’s more complicated than that, but that’s the simple way of putting it.

To “fill in the gaps of Medicare,” many will buy a Medigap plan. This is also called a Medicare Supplement.

You can buy a policy of your choice up to 6 months after you enroll in Medicare Part B. After that — you guessed it — penalties.

One of our agents can help you choose a plan that fits your budget.

1. Consider long-term care insurance.

Long-term care insurance is a big decision to make, and it definitely shouldn’t be made in haste. However, as time goes on, your ability to even purchase it starts to decrease.

Long-term care is only available to  those that can pass the rigorous health questions. As we get older, that becomes less likely, and some carriers even cap off the age you can apply right around 65.

Also, the other you get, the more expensive it gets. After the age of 65 or so, long-term care insurance starts to become very pricey, often more than many are willing to pay.

Long-term care itself is extremely expensive — it can be around $100,000 a year in many cases — so if you’re interested in getting some insurance coverage, you ought to start thinking about it now.

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65Medicare.org is a leading, independent Medicare insurance agency for people turning 65 and going on Medicare. We have worked with 10,000+ Medicare-eligible individuals over the last 10+ years, assisting with understanding and comparing the plans. You can get a list of Medigap quotes in your area. Or, if you have any questions about this information, you can contact us online or call us at 877.506.3378.

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