Understand your coverage options, important enrollment dates, and how healthcare fits into your retirement plan.
Approaching Medicare eligibility brings new decisions about healthcare and retirement. Start with the basics, understand your options, and bring your questions into a conversation with Raj Atwal.
Consider your doctors, prescriptions, travel, current coverage, and budget together. The right questions can help you compare your choices with greater confidence.
Each part plays a different role. Understanding those roles helps you compare coverage.
Helps cover inpatient hospital care, skilled nursing facility care, hospice, and some home healthcare.
Helps cover doctors’ services, outpatient care, preventive services, and certain medical equipment.
A private plan alternative that provides your Part A and Part B benefits. Most plans include prescription drug coverage; networks and costs vary.
Helps cover prescription drug costs. Coverage is offered through private plans, either separately or within many Medicare Advantage plans.
Original Medicare includes Part A and Part B. You may add a separate Part D plan and, if eligible, a Medicare Supplement Insurance (Medigap) policy. Medigap helps pay certain out-of-pocket costs; it is separate from Medicare Advantage.
Medicare Advantage bundles your Part A and Part B benefits through a private plan. Most plans include Part D. Review provider networks, referrals, prior authorization, benefits, and out-of-pocket costs for the specific plan.
Original Medicare generally does not cover long-term custodial care, most routine dental care, hearing aids, or routine eye exams for glasses. Premiums, deductibles, and coinsurance also matter. Specific benefits depend on your coverage.
Medicare generally starts at age 65 for people who meet citizenship or residency requirements. Some people qualify earlier because of disability, End-Stage Renal Disease (ESRD), or ALS. Check your own eligibility and enrollment steps with Social Security or Medicare.
Different enrollment windows serve different purposes. Review the dates that apply to your situation before making a change.
Usually seven months: the three months before your 65th birthday month, your birthday month, and the three months after. Your sign-up date affects when coverage begins; special birthday rules can apply.
A chance to sign up for Part A and/or Part B if you missed your initial opportunity and do not qualify for a Special Enrollment Period. Late penalties may apply. Coverage generally starts the month after you sign up.
Certain circumstances, such as leaving qualifying job-based health coverage or moving, may create a special opportunity to enroll or change plans. The rules and deadlines depend on the circumstance and type of coverage.
Your federal six-month window begins the first month you are 65 or older and enrolled in Part B. During this window, medical underwriting generally cannot be used to deny a policy. Additional protections and state rules may apply.
If you already have Medicare Advantage, you can generally make one change to another Medicare Advantage plan or return to Original Medicare and join a separate drug plan. This period is not for first joining Medicare Advantage from Original Medicare.
Review and change Medicare Advantage or Part D coverage for the following year. Changes generally take effect January 1. This is different from signing up for Part A or Part B for the first time.
Understand how hospital, medical, and prescription coverage fit together.
Explore this topic ↗Review common coverage gaps before you compare plans.
Explore this topic ↗Find the enrollment window that matches your situation.
Explore this topic ↗Compare Original Medicare and Medicare Advantage.
Explore this topic ↗Consider networks, benefits, and costs together.
Explore this topic ↗Learn how Medigap can work with Original Medicare.
Explore this topic ↗Check how your medicines are covered by a plan.
Explore this topic ↗Bring your current coverage details and a list of your doctors and prescriptions. Raj can discuss how healthcare decisions connect with your broader retirement priorities.
This page provides general education. Plan benefits, costs, availability, and enrollment rights depend on your circumstances. For complete information about Medicare and available coverage, visit Medicare.gov, call 1-800-MEDICARE (1-800-633-4227), or contact your State Health Insurance Assistance Program (SHIP).
