Do I need to take Medicare?

The majority of people need to take Medicare at 65 in order to avoid penalties later.  If you have private insurance, a medishare plan, COBRA, or no coverage at all, you will need to enroll in Medicare Parts A and B.  The question of requirement relies on two factors:  If you have employer group health insurance (through active employment by you or a spouse) that is considered "creditable" AND the employer has 20 or more employees, then you may not need to take Medicare until you lose that coverage.  There is a process for enrolling later without penalty, which is something we can assist you with when the time comes.  It is important to answer this question when turning 65, and we are here to help.

How much will Medicare cost?

There are two Parts of Medicare that come directly from the government.  Part A hospital coverage is premium-free for most people because of their work history.  It has essentially been pre-paid by years of Medicare payroll taxes.  Part B has a standard monthly premium for 2025 of $185.00 per month up to a certain income level.  People with higher incomes pay more per month-- up to nearly $600 for the highest earners.  Social Security looks at income from two years prior, so if you join in 2025, they will base your premium on your 2023 taxes.  Many people retire at 65 and experience a drop in income.  For these clients, we assist with an appeals process that may lower the amount you are required to pay.

Should I take Social Security?

The question of when to take Social Security can be a complicated one.  If you are already enrolled in Social Security, you will automatically be enrolled in Medicare Parts A and B at 65 without any additional action from you, but there are still important decisions to make about your coverage.  If you are waiting to take Social Security, you can visit their website to get an estimate of your benefits via your account.

Can I keep my doctors?

Doctor choice is one of the most important considerations when choosing secondary coverage.  Medigap policies do not have doctor or hospital networks, and every plan of the same letter offers identical medical coverage, so doctor choice is less restrictive.  Medicare Advantage Plans all have some type of PPO or HMO restrictions. HMO plans typically do not cover any care received out of network, and require you to choose a primary care physician.  If you need to see a specialist, they require referrals.  Carriers of HMO and PPO managed care plans also require prior authorization for surgeries and diagnostic procedures.  Our specialty is guiding you through the process of deciding which route works for your particular situation.

How are your services free?

We are contracted with most of the major Medigap, Medicare Advantage, and Part D insurance carriers.  When we assist you in enrolling in a particular plan, that company pays us a commission.  Our services are never at any cost to you, and the plan premiums do not vary based on agent assistance.