Medicare plans and enrollment

If you or your spouse are actively employed and covered by that employer's group plan, you can usually delay Part B and Part D without a penalty and enroll later under a special enrollment period when the job or the coverage ends. Whether the employer plan is primary or secondary to Medicare depends on the employer's size, and a small employer's plan can become secondary, which makes delaying Part B costly. Many people take Part A when first eligible because it carries no premium for them, but doing so ends eligibility to contribute to a health savings account, so the timing is worth working out in advance.

Start from your doctors and your travel. Advantage plans are network products with lower up-front premiums and costs that rise when you use care, capped at the plan's annual maximum. Medigap plus Part D costs more every month and very little at the point of care, with no network. Someone healthy today who values a low premium and stays near home often chooses Advantage; someone with ongoing conditions, out-of-state family or a preferred specialist often chooses Medigap. Switching from Advantage back to Medigap later can require medical underwriting, so the first choice carries more weight than it appears to.

A permanent addition to your Part D premium, calculated from the number of full months you went without Part D or other creditable drug coverage after first becoming eligible. It is paid for as long as you have Part D. Employer, union, VA and some retiree plans count as creditable if they say so in writing, and keeping that letter is what avoids the penalty later.

Original Medicare pays anywhere in the United States and its territories but almost nothing outside them. Some Medigap letters include a foreign travel emergency benefit with its own deductible and lifetime limit. Advantage plans cover emergencies nationwide but route routine care through their network, and a long stay outside the service area can end enrollment. For extended travel abroad, a separate travel medical policy is the usual answer.

Nothing beyond what you would pay enrolling directly: the premium for a plan is the same whether you enroll through us, through the carrier or through Medicare.gov, and the carrier pays us a commission set within federal limits for Advantage and Part D. We are paid only on plans we place, and we do not offer every plan in your area, which is why we also point you to Medicare.gov and 1-800-MEDICARE for the full list.

Within the enrollment windows, yes. The annual election period allows changes to Advantage and Part D for the following year, and the Advantage open enrollment period allows one change for people already in an Advantage plan. Medigap can be applied for at any time, but outside your one-time open enrollment window or a guaranteed issue right, the insurer can underwrite and decline. A special enrollment period also opens after certain events, such as a move or a plan leaving your county.