If you’re turning 65 soon, congratulations are in order—not just for the milestone, but for becoming newly eligible for Medicare. With that eligibility comes an important set of decisions regarding your health coverage.
Whether you’ve already begun exploring your options or are just starting to think about them, now is the time to consider how Medicare fits into your overall healthcare and financial planning strategy.
Traditional Medicare or Medicare Advantage?
When enrolling in Medicare, one of the first choices you’ll face is whether to go with Original Medicare (Part A and Part B) or a Medicare Advantage plan (Part C).
Here’s a quick breakdown:
Original Medicare (Parts A & B)
This is the traditional government-provided coverage, which includes:
Part A: Hospital insurance
Part B: Medical insurance (doctor visits, outpatient care)
However, Original Medicare doesn’t cover everything. You’ll typically be responsible for deductibles, coinsurance, and prescription drug coverage (unless you add a separate Part D plan).
Medigap (Medicare Supplement Insurance)
To help fill in the "gaps" of Original Medicare, you might consider a Medigap policy. This type of private insurance helps cover out-of-pocket costs like copayments, coinsurance, and deductibles.
Medicare Advantage (Part C)
Alternatively, you can choose a Medicare Advantage plan through a private insurer. These plans often bundle hospital, medical, and prescription drug coverage, and may even include extras like vision, hearing, or dental.
The trade-off? These plans typically have network restrictions—you may need to see doctors and hospitals within the plan’s network to receive full benefits.
What If You Change Your Mind?
One helpful feature of Medicare is the Annual Open Enrollment Period (October 15 – December 7). During this time, you can:
Switch from Original Medicare to a Medicare Advantage plan (or vice versa)
Join or switch a Medicare Part D prescription plan
Change from one Medicare Advantage plan to another
This gives you the flexibility to adjust your coverage as your health needs or financial situation evolves.
The Next Step Is Yours
You may have already thought through some of these choices, but now that you’re eligible, it’s time to make them official. Medicare decisions can impact your healthcare access, out-of-pocket expenses, and even your financial wellbeing in retirement.
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This content is for informational purposes only and should not be considered tax or legal advice. Please consult a qualified professional regarding your individual situation. Content developed in collaboration with FMG Suite and not affiliated with the named advisor or firm.