Medicare planning
You will leave knowing which plan covers your doctors, what your prescriptions cost, and why you picked it.
Medicare arrives on a schedule. You turn 65, or you set a retirement date, and the mailbox fills with envelopes that all look official and all say something different. None of them knows anything about your health.
Medicare planning turns that pile into one decision you understand. Which arrangement covers the doctors you see, the hospital you would want to be taken to, and the prescriptions you take, at a cost you can live with in the year you actually get sick.
David Schaeffer founded 123EasyMedicare so this decision gets made clearly, before it turns urgent. I have sat in on hundreds of these meetings. People come in asking which plan is good, and leave understanding how the whole thing works.
What medicare planning actually means
There are two roads, and both are legitimate. Keep Original Medicare, add a Medicare Supplement policy, a Medigap, and add a separate Part D drug plan. Or enroll in a Medicare Advantage plan, which delivers your benefits through a private plan and usually carries drug coverage on the same card.
David Schaeffer describes the trade-off in one line: pay whether you use the plan or not, or pay when you use it. With a supplement you pay a premium in the months nothing happens, and you can see any doctor or hospital in the country that takes Medicare. With an Advantage plan you pay less most months and more at the point of care, inside the plan's network.
Unless you have other coverage, such as retiree, VA, or TRICARE benefits, stopping at Original Medicare alone is where people get hurt. It usually leaves you 20% of the cost of each covered service, with no yearly limit on what you pay out of pocket unless you add a supplement or join an Advantage plan.
Supplements are the simpler shop. Medigap policies are federally standardized, so a policy with the same letter offers the same basic benefits no matter which company sells it. David Edge says it plainly: Plan G is Plan G. Price is the only difference, so the job is finding the price, not the logo.
Advantage is the harder shop, and it lives in the details. Every plan has a network, a drug list, and copays set one year at a time. The extras are real, and they belong to the plan rather than to Medicare, so they can change next year. Marc's rule covers most of the trouble: check the network before the appointment, not after.
Sound familiar?
- “I turn 65 in March and the mail on my counter is out of hand. Every envelope says I am missing something.”
- “I retire in February and my employer coverage ends that month. Nobody told me what happens next.”
- “The doctor's office said they take my plan. The bill said otherwise.”
- “My plan cut a benefit and raised my copays, and I never changed a thing.”
- “A dozen calls a day tell me I am owed benefits, and I cannot tell who is honest.”
What happens when you sit down with us
or call any office
What to bring
- Your red, white and blue Medicare card, if you have one yet.
- The real names of every doctor you want to keep, and the hospital you would choose.
- Your prescriptions, with the doses, and the pharmacy you use.
- Your retirement date, or the date your employer coverage ends.
Your Discovery Day
Takes about a minute. Adam from our office calls you back to set the time with the right advisor, in the office nearest you or on Zoom, whichever you prefer.
- About an hour with an advisor.
- Bring whatever is keeping you up at night. That is the agenda.
- Discovery Day, not decision day. You decide when you are ready.
Rather talk now? (602) 281-3898
Request your Discovery Day
We will call you to set the time.
Got it. Adam will call you.
Usually within one business day, to set up your Discovery Day with the right advisor. Would you rather pick a time yourself right now?
Choose a time on the calendarStraight answers
Should I take a supplement or a Medicare Advantage plan?
There is no universal answer, and anyone who gives you one before seeing your doctors and your drug list is guessing. A supplement buys freedom of choice for a premium you pay whether you use it or not. An Advantage plan buys a lower monthly cost and asks you to stay in a network. You see both, and you choose.
When can I sign up, and what if I miss it?
Your Initial Enrollment Period lasts 7 months, starting 3 months before you turn 65 and ending 3 months after the month you turn 65. Your Medigap Open Enrollment Period is separate: a one time 6 month window starting the first day of the month you are 65 or older and signed up for Part B. It does not come back, and after it there is no federal guarantee that a company will sell you a supplement.
Can I change my mind later?
Some of it, yes. Medicare Open Enrollment runs October 15 through December 7 each year, and Medicare Advantage Open Enrollment runs January 1 through March 31. Moving from a supplement to an Advantage plan is usually straightforward. Moving back generally means health questions. Nevada adds a birthday rule: state law gives supplement policyholders an open enrollment period starting the first day of their birthday month and running at least 60 days after, to move to a plan with the same or lesser benefits, at any company, without underwriting. Marc Frye runs that check for our Las Vegas clients every year.
I take no prescriptions. Do I still need a drug plan?
Almost always, and Kyle's reason is the right one: drug coverage is not about the now, it is about the future. If you go 63 days or more without creditable drug coverage, Medicare adds a late enrollment penalty, and it stays added for as long as you have Medicare drug coverage.
What if I do nothing this year?
Your coverage keeps going, and it will not be the same coverage. Plans mail an Annual Notice of Change each fall listing what takes effect in January. Clients tell our advisors every year that they did not change anything. They did not. The plan did.
Kyle Jacobs
David Edge
Marc Frye
David Schaeffer