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Medicare can be confusing. A licensed Medicare broker helps simplify the process and guide you through your options.

Benefits of Working With a Broker

• Personalized plan comparisons
• Help understanding Medicare rules and timelines
• Assistance with enrollment paperwork
• Access to multiple insurance carriers
• Annual plan reviews as your needs change
• Ongoing support after enrollment

A broker can help you avoid common mistakes such as:

• Missing enrollment deadlines
• Choosing the wrong drug coverage
• Selecting a plan that doesn’t include your doctors or prescriptions

Best of all, there is typically no additional cost to use a Medicare broker.

Medicare is divided into different parts that each cover different healthcare services.

Medicare Part A
Part A helps cover:

• Hospital stays
• Skilled nursing facility care
• Hospice care
• Some home health services

Many people receive Part A premium-free if they paid Medicare taxes while working.

Medicare Part B
Part B helps cover:

• Doctor visits
• Outpatient care
• Preventive services
• Lab work
• Durable medical equipment

Part B has a monthly premium that most beneficiaries pay.

Medicare Part D
Part D provides prescription drug coverage through private insurance companies approved by Medicare.

Part D plans help cover:

• Generic medications
• Brand-name prescriptions
• Many common retail pharmacy drugs

Each Part D plan has its own:

• Drug formulary
• Pharmacy network
• Premiums and copays

Reviewing drug coverage annually is important because formularies and costs can change each year.

Medicare Advantage and Medicare Supplement plans are two very different ways to receive your Medicare benefits.

Medicare Advantage (Part C)
Medicare Advantage plans are offered by private insurance companies approved by Medicare. These plans combine your hospital and medical coverage into one plan and often include prescription drug coverage, dental, vision, hearing, fitness benefits, and more.

Key features:

• Usually lower monthly premiums
• Copays and networks typically apply
• May require referrals for specialists
• Often includes extra benefits not covered by Original Medicare
• Annual out-of-pocket maximum protection

Medicare Advantage may be a good fit for people who:

• Prefer lower upfront costs
• Want bundled coverage
• Are comfortable using provider networks

Medicare Supplement (Medigap)
Medicare Supplement plans work alongside Original Medicare and help pay many of the out-of-pocket costs that Medicare does not cover, such as deductibles, copays, and coinsurance.

Key features:

• Generally higher monthly premiums
• Very little out-of-pocket cost when receiving care
• Freedom to see any doctor nationwide that accepts Medicare
• Prescription drug coverage is purchased separately through a Part D plan

Medicare Supplement plans may be a good fit for people who:

• Travel frequently
• Want predictable medical costs
• Prefer maximum provider flexibility

There is no one-size-fits-all answer. The best option depends on your health needs, budget, travel habits, and personal preferences.

Most people become eligible for Medicare when they turn 65.

You can start the process during your Initial Enrollment Period, which begins:

• 3 months before your 65th birthday month
• Includes your birthday month
• Ends 3 months after your birthday month

If You Are Already Receiving Social Security
In many cases, you may be automatically enrolled in:

• Medicare Part A
• Medicare Part B

You’ll typically receive your Medicare card by mail.

If You Are Not Receiving Social Security
You will usually need to enroll yourself through the Social Security Administration.

After enrolling in Medicare, you can then choose:

• A Medicare Advantage plan, or
• A Medicare Supplement plan with a Part D prescription drug plan

Working with a licensed Medicare broker can help simplify this process and ensure you understand your options.

It depends on the size of your employer and the type of coverage you have.

If You Work for a Large Employer (20+ Employees)
You may be able to delay Medicare Part B without penalty while keeping your employer coverage.

Many people in this situation:

• Take Part A at 65
• Delay Part B
• Stay on their group health plan

However, if you contribute to a Health Savings Account (HSA), enrolling in any part of Medicare can affect your HSA eligibility.

If You Work for a Small Employer (Fewer Than 20 Employees)
Medicare may become your primary insurance at age 65. In many cases, delaying Medicare could create coverage gaps or penalties.

Important: Every employer plan is different. Before making a decision, it’s important to:

• Verify how your group plan coordinates with Medicare
• Confirm prescription coverage creditability
• Understand any HSA implications

A Medicare consultation can help prevent costly enrollment mistakes.

Once you enroll in any part of Medicare, you generally can no longer contribute to a Health Savings Account (HSA).

This includes enrollment in:

• Medicare Part A
• Medicare Part B

Important HSA Rules

• You may continue using existing HSA funds after enrolling in Medicare
• HSA money can still be used tax-free for qualified medical expenses

HSA funds can help pay for:

• Medicare premiums
• Copays
• Deductibles
• Prescription costs

Important Timing Issue
If you enroll in Medicare after age 65, Medicare Part A may be backdated up to 6 months. Because of this:

• Many people stop HSA contributions at least 6 months before enrolling in Medicare

Improper HSA contributions after Medicare enrollment can create IRS tax penalties.

IRMAA stands for Income-Related Monthly Adjustment Amount. It is an additional premium some higher-income Medicare beneficiaries pay for:

• Medicare Part B
• Medicare Part D

IRMAA is based on your income from approximately two years prior.

Common Life Events That May Reduce IRMAA
You may be able to request a reconsideration if your income dropped due to:

• Retirement
• Marriage
• Divorce
• Death of a spouse
• Loss of pension income
• Reduction in work hours

How to Appeal IRMAA
You can file:

• Form SSA-44 through the Social Security Administration.

Supporting documentation is often required. Many people successfully reduce or eliminate IRMAA after retirement or other qualifying life events.