Don't Let Medicare's
20% Gap Drain Your Savings

Most people should sign up for Medicare during their Initial Enrollment Period (IEP), which is the 7-month period that begins 3 months before the month you turn 65, includes your birth month, and extends 3 months after. If you're still working and have employer coverage, you may qualify for a Special Enrollment Period later.

Medicare Advantage (Part C) replaces Original Medicare (Parts A & B) and often includes prescription drug coverage and extra benefits like dental and vision. Medicare Supplement (Medigap) works alongside Original Medicare to help cover out-of-pocket costs like deductibles and coinsurance. You cannot have both Medicare Advantage and Medicare Supplement at the same time.

It depends on your situation. If you work for a company with fewer than 20 employees, Medicare is typically primary, so you should enroll when first eligible. If you work for a larger employer, you may be able to delay Medicare enrollment without penalty. Either way, it's generally recommended to at least enroll in premium-free Medicare Part A when you're first eligible.

Medicare Part D provides prescription drug coverage. Each Part D plan has its own formulary (list of covered drugs) categorized into tiers that determine your cost-sharing amount. Plans typically cover most commonly prescribed medications, but coverage and costs vary between plans. It's important to check if your specific medications are covered when comparing Part D plans.

Medicare costs vary by part. Most people get Part A premium-free if they've worked and paid Medicare taxes for at least 10 years. Part B has a standard monthly premium ($170.10 in 2023 for most people), which may be higher based on income. Part D and Medicare Advantage premiums vary by plan. There are also deductibles, copayments, and coinsurance for services used.

To choose the right Medicare plan, consider your healthcare needs, budget, preferred doctors and hospitals, prescription medications, and additional benefits you may want. Compare Original Medicare plus a Supplement and Part D plan versus Medicare Advantage plans available in your area. Consulting with a Medicare specialist can help you evaluate your options and find the best fit.

The Medicare donut hole, or coverage gap, is a temporary limit on what most Part D plans cover for drugs. In 2023, once you and your plan have spent $4,660 on covered drugs, you're in the coverage gap. While in the gap, you pay no more than 25% of the cost for covered brand-name and generic drugs. You exit the gap when your out-of-pocket costs reach $7,400, after which catastrophic coverage begins.

Yes, you can change your Medicare plan during specific enrollment periods. The Annual Enrollment Period (October 15-December 7) allows you to change between Original Medicare and Medicare Advantage or switch Part D plans. Medicare Advantage enrollees can also make one change during the Medicare Advantage Open Enrollment Period (January 1-March 31). Special Enrollment Periods may apply in certain circumstances like moving or losing other coverage.