Part A is hospital insurance. It covers inpatient hospital stays, skilled nursing after a hospital stay, hospice, and some home health care. Most people pay no premium for Part A because they paid Medicare taxes while working. There is a deductible for each hospital benefit period and daily coinsurance for long stays.

Part B is medical insurance. It covers doctor visits, outpatient care, preventive services, lab work, and durable medical equipment. Everyone pays a monthly Part B premium, deducted from Social Security for most people, plus a yearly deductible. After the deductible, Original Medicare pays 80 percent of the approved amount and you pay 20 percent with no yearly limit. Doctor access is broad: any doctor in the country who accepts Medicare.

When to sign up: your Initial Enrollment Period is seven months long, the three months before your 65th birthday month, your birthday month, and the three months after. If you are already collecting Social Security, you are enrolled in A and B automatically. If you are still working with employer coverage, you can delay Part B without penalty and sign up later during a Special Enrollment Period.

Where to sign up: online at ssa.gov/medicare, by phone with Social Security, or at a Social Security office.

Why it matters: Part A and Part B are the foundation. A Medicare Advantage plan, a Medigap plan, and a drug plan all require you to have them first.

Current premium and deductible amounts change each January: https://www.medicare.gov/basics/costs/medicare-costs. Signing up: https://www.ssa.gov/medicare

These are the two ways to fill the gaps in Original Medicare, and you choose one path, not both.

Medigap (Medicare Supplement) plus a standalone Part D drug plan: you keep Original Medicare and buy a supplement that pays most of what Medicare does not, plus a separate drug plan. Any doctor who accepts Medicare, no networks, no referrals. Higher monthly premiums, but very predictable costs. Outside of certain guaranteed windows, the Medigap company can ask health questions and decline you.

Medicare Advantage (Part C): a private plan approved by Medicare that replaces how you receive your Part A and B benefits. Usually lower premiums, most include drug coverage, and many add dental, vision, hearing, and other extras. In exchange, you use the plan's network of doctors and hospitals, and you pay copays as you go up to a yearly out-of-pocket maximum.

Neither is right for everyone. The honest way to choose is by your doctors, your prescriptions, your budget, and how much you travel. That is exactly what the Plan Recommendation Report looks at. We work primarily with Medicare Advantage plans and can tell you plainly when a supplement is the better fit.

Source: Medicare.gov, "Your coverage options": https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options

HMO: you choose a primary care doctor, you see specialists inside the plan's network, and in many HMOs you need a referral. Out-of-network care is not covered except emergencies and urgent care. Premiums and copays are usually lower.

PPO: you can see doctors in and out of the network. In-network costs less; out-of-network costs more but is still covered. No referrals. Premiums and copays are usually a little higher.

Which one fits depends on whether your doctors are in the plan's network and whether you want the freedom to go outside it. If every doctor you see is in the HMO network, the HMO is often the better value. If you have a specialist outside the network, or you split time between two states, the PPO earns its cost. We check your doctors against the network before recommending either.

Source: Medicare.gov, "Your health plan options": https://www.medicare.gov/health-drug-plans/health-plans/your-health-plan-options

There are four windows most people use.

Initial Enrollment Period (IEP): the seven months around your 65th birthday. Your first chance to sign up for Part A and B and to join a plan.

Annual Enrollment Period (AEP): October 15 to December 7 every year. Anyone can join, switch, or drop a Medicare Advantage or drug plan. Changes take effect January 1.

Medicare Advantage Open Enrollment Period (OEP): January 1 to March 31. If you are already in a Medicare Advantage plan, you can switch to another one or go back to Original Medicare, once. New Medicare Advantage members also get a similar 90-day window after they first join.

Special Enrollment Periods (SEP): windows that open because of a life event, such as moving to a new service area, losing employer coverage, your plan leaving the area, a change in Medicaid or Extra Help status, or a declared disaster. Each one has its own rules and time limit.

If you are not sure which window you are in, tell us your situation and we will tell you which applies and when your coverage could start.

Source: Medicare.gov, "Joining a plan": https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan

Every Medicare Advantage plan has a service area, the counties where it is sold. To stay on the plan, you have to live in that area. If you are away from it for more than six months in a row, the plan is required to disenroll you, and you go back to Original Medicare on the first of the following month until you join another plan.

This catches two kinds of people. Snowbirds who spend more than half the year in another state, and people who move permanently but keep the old plan running. Some plans have a visitor or traveler program that extends the window to twelve months for members who tell the plan in advance, but not every plan does.

Being disenrolled this way opens a Special Enrollment Period, so you can join a plan in your new area without waiting for the fall. The mistake is not telling anyone: a plan that drops you without a new one in place leaves you on Original Medicare with no drug coverage and no out-of-pocket cap.

If you are going to be away for more than a few months, or you are moving, tell us before you go. We will check whether your plan has a travel program and, if not, line up the switch so there is no gap.

Source: Medicare.gov, "Joining a plan" (moving out of a plan's service area): https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan

Medicare charges a permanent penalty if you go without coverage when you were supposed to have it.

Part B penalty: if you do not sign up for Part B when you are first eligible and you did not have coverage from a current employer, your Part B premium goes up by 10 percent for each full 12-month period you could have had Part B but did not. You pay that higher premium for as long as you have Part B.

Part D penalty: if you go 63 days or more in a row without creditable drug coverage after your Initial Enrollment Period ends, Medicare adds a penalty to your drug plan premium. It is calculated as 1 percent of a national base premium for each month you went without coverage, rounded to the nearest ten cents, and it is added every month for as long as you have drug coverage.

This is why the "drugs or no drugs" question matters so much. Choosing a plan without drug coverage when you have no creditable coverage elsewhere starts the Part D penalty clock. Employer coverage, VA benefits, and TRICARE for Life usually count as creditable. If you are unsure, ask before you choose.

Sources: Medicare.gov, "Costs" (Part B penalty): https://www.medicare.gov/basics/costs/medicare-costs and "Avoid late enrollment penalties" (Part D penalty): https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties

Most Medicare Advantage plans include prescription drug coverage. Some do not, and for some people a plan without drug coverage is the better choice. Here is why, and when.

What is good about a plan that does not cover drugs? Two things. First, the giveback: many of these plans pay back part of your Part B premium every month. Second, the late enrollment penalty. If you have already gone a stretch of time without drug coverage since you were first eligible, the moment you join a plan that covers drugs, Medicare adds a monthly penalty to your premium. A plan without drug coverage does not trigger that penalty.

How the penalty works: Medicare counts every full month you went without creditable drug coverage after your Initial Enrollment Period, once you have been without it for 63 days in a row. The penalty is that number of months, times 1 percent of a national base premium, added to your drug plan premium every month for as long as you have drug coverage. So a long gap means a penalty that follows you.

The catch: those months keep counting while you go without coverage. A plan without drugs does not erase the penalty; it postpones it, and the number grows. And you have no coverage for prescriptions in the meantime, and you generally cannot add a separate drug plan to a Medicare Advantage HMO or PPO.

Who it fits: people with creditable drug coverage from somewhere else, such as VA benefits, TRICARE for Life, or a current employer or union plan. For them there is no gap, no penalty, and the giveback is money back every month.

Bottom line: if the giveback and postponing the penalty outweigh the cost of going without drug coverage, a plan without drugs can be right for you. If not, choose a plan that includes drugs. We check this for every client before we recommend a plan, and the report tells you which kind it is. If you receive a report for a plan without drugs and would rather have one that covers them, reply to the email and we will prepare that report instead.

Source: Medicare.gov, "What's Medicare drug coverage (Part D)?": https://www.medicare.gov/health-drug-plans/part-d and "Avoid late enrollment penalties": https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties

Four steps, and most clients never need a phone call.

1. Intake form and Scope of Appointment. You fill out our form at apply.magnifymed.com with your doctors, prescriptions, pharmacy, and current coverage, and you sign a Scope of Appointment electronically. Medicare requires that signature before any agent can discuss Medicare Advantage or drug plans with you. About ten minutes.
2. Consultation, if you want one. We do our research first. If you would rather talk before deciding, the report email includes a link to put time on our calendar.
3. Plan Recommendation Report. We check your doctors, check your prescriptions, and compare the plans we offer in your area. Then we email you a report that says which plan we recommend, why, and what it costs. You read it on your own time and approve it with one click if it looks right.
4. Enrollment link. After you approve, we prepare the application and email you a secure link with a personal code. You review and e-sign. The carrier confirms, and we send you what to expect next.

No cost to you, and no obligation at any step.

Source: CMS, "Managed Care Marketing": https://www.cms.gov/medicare/health-drug-plans/managed-care-marketing

Before the call: fill out the form at apply.magnifymed.com if you have not. Ten minutes. Your doctors, your prescriptions, your pharmacy. Then the call is about you, not about us reading a list back to you.

On the call: we go through what you need and what you are worried about, we look at the plans we offer in your area against your doctors and medications, and we tell you which plan fits and why. If you already have a report from us, we walk through it together. Forty-five minutes is set aside; most calls are shorter.

Medicare requires the call to be recorded, and the Scope of Appointment you signed on the form covers what we are allowed to discuss.

After the call: nothing to decide on the spot. You get the recommendation in writing, and you enroll when you are ready.

To book: https://calendar.app.google/W3dvQzLUqXZJPY4b8

Source: CMS, "Managed Care Marketing": https://www.cms.gov/medicare/health-drug-plans/managed-care-marketing

The application is only the start. Here is the short version of what we walk every new member through.

1. Watch for the carrier. Approval usually takes about a week. Your welcome packet and ID card arrive by mail within a few weeks of approval.
2. Create your online account. Every carrier has a member website. Register as soon as you have your member ID; you can print a digital ID card there before the plastic one arrives.
3. Handle your old coverage the right way. A Medicare Advantage or drug plan you already had ends on its own when the new one starts. A Medigap plan, an employer plan, or a Marketplace plan does not; you must cancel it, with the right effective date, so you are not double billed and not left with a gap. We tell you exactly what to do for your situation.
4. Check the network before your first visit. Confirm your doctors and pharmacy are in network with the new plan, even if we already checked, because networks change.
5. Expect solicitation calls and mail. Your age is public record and marketing companies buy the list. Nothing you gave us goes anywhere. Tell callers "take me off your list" and hang up. Open mail from Medicare and from your plan; the rest is advertising.
6. Call us, not the 1-800 number. Billing questions, a claim denied, a doctor who says you are not covered: we know your situation and can usually solve it faster.

Source: Medicare.gov, "Medicare Advantage & other health plans": https://www.medicare.gov/health-drug-plans/health-plans

• UnitedHealthcare (UHC)
• Aetna
• Humana
• Cigna
• Devoted
• Blue Cross Blue Shield
• Anthem

• UnitedHealthcare (UHC)
• Aetna
• Humana
• Anthem
• Cigna
• Blue Cross Blue Shield (BCBS)
• Devoted
• Wellcare

Yes, during certain windows each year, or sooner if you qualify for a Special Enrollment Period. See When can I enroll or change plans? for the dates, or book a call and we'll walk you through your options.

Yes. Two, actually.

• Already on Medicare and wondering whether to change plans this fall: Your Annual Enrollment Period guide
• New to Medicare and figuring out where to start: Your guide to starting Medicare

I wrote these for people like me. I like to understand how everything works before I trust someone with something important. If that's you, read them. There's nothing to download, and nobody will ask for your email.

But here's my honest take: most people don't need another guide. This time of year, letters, ads, and offers come from every direction, and one more thing to read usually just adds to the pile.

What most people need is someone who knows what they're doing, does the work, and explains it plainly. That's why I built my process the way I did. After ten years and more than 20,000 conversations, this is what works:

1. You fill out one short form. It takes about ten minutes: your doctors, prescriptions, pharmacy, and the hospitals you like. Those ten minutes save us an hour or two on the phone.
2. I make the plans compete for you. I compare the options in your area against what matters to you.
3. You get my recommendation in a Plan Recommendation Report, at no cost to you, and read it on your own time.
4. If you want to talk, my calendar link is inside. By then the homework is done, so our conversation is short and about you.
5. You decide from there. No pressure.

Get my Plan Recommendation Report

It is a form Medicare requires before an agent can talk with you about Medicare Advantage or drug plans. You check the types of coverage you want to discuss and sign it. It does not commit you to anything. It exists so that no agent can steer a conversation toward products you did not ask about, and so there is a record that you requested the meeting. I keep a copy on file for every client, as required.

Most people sign it as the last step of the intake form, and that's still the way I'd suggest. Ten minutes on the form can save us both an hour or two, because by the time we talk, I've already checked your doctors and your prescriptions. The call becomes about you, not about me reading a list back to you.

If you'd still rather skip the form and just talk, you can sign the Scope of Appointment on its own here. Then book a consultation call and we'll go from there.

Sometimes, and only for emergencies.

Some Medicare Advantage plans include coverage for emergency and urgent care outside the United States. Not all plans do, and the ones that do vary in what they pay and how you file a claim. It is not coverage for routine care, prescriptions, or planned treatment abroad.

Two rules apply no matter which plan you have. First, your plan is tied to where you actually live. The address on your enrollment has to be your permanent home, and you need to spend most of the year there. Second, if you are outside your plan's service area for more than six consecutive months, the plan will disenroll you.

If you travel for long stretches, or you are thinking about living part of the year somewhere else, tell me before you enroll. The right answer depends on where you live, how long you are gone, and which plans in your area include the benefit. Some people are better served by a Medicare Supplement plan with foreign travel emergency coverage, or by separate travel medical insurance for the time they are away.

The Annual Enrollment Period runs October 15 to December 7. It's the one time of year anyone on Medicare can change their Medicare Advantage or prescription drug plan, and whatever you choose starts January 1.

Start with the Annual Notice of Change letter your plan mailed in September. It lists what's changing next year. Most of the time, your plan is still the right fit, and you don't need to do anything.

If you want to check it yourself, we wrote two guides: Your Annual Enrollment Period guide if you're already on Medicare, and Your guide to starting Medicare if you're new to it.

Or let us do it. Fill out one short form, and we'll compare the plans in your area against your doctors, prescriptions, and budget, and send you a Plan Recommendation Report: apply.magnifymed.com

Two letters are worth a call.

Your plan is ending. Insurance companies sometimes stop offering a plan for the next year. If you get this letter, book time with us and we'll find you a new one.

Your doctor is leaving your plan. Doctors' offices and medical groups sometimes send a letter saying they won't take your insurance next year. Many of these groups belong to what's called an accountable care organization, so the letter may use that term. Book a call, or resubmit the form on our website and mention the letter. We'll look for a plan that keeps your doctors, or help you weigh whether switching doctors makes sense for you.

Most of it is sales. Here's how to sort it.

• Mail: Open anything from Medicare, Social Security, your insurance company, or us. Toss the rest.
• Email: Medicare doesn't email you out of the blue asking for your Medicare number or personal information. Unless you asked Medicare to send you something, delete it and don't click the links. Emails from your insurance company and from us are fine. We'll send one check-in during enrollment season.
• Phone calls: Say "take me off your list," then hang up.
• The grapevine: A friend or neighbor may have a plan with the same name as yours and different benefits. Plans vary by county and by plan. If you hear something, ask us.

We're still your agents. When you have a Medicare question, start with us.