FAQ
When should I start talking to someone about Medicare?
Ideally, you should start 6–3 months before you’ll need coverage:
- If you plan to retire and go on Medicare at 65, start learning and talking to an advisor during that window.
- If you’re working past 65 with employer coverage, start 6–3 months before your planned retirement date.
That gives you time to understand options, avoid penalties, and make sure there’s no gap in coverage.
What’s the difference between Medicare Advantage and a Medicare Supplement?
At a high level:
- Medicare Advantage (Part C):
- Offered by private insurers (HMO, PPO, HMO-POS)
- Wraps Parts A & B (and often Part D) into one plan
- Uses provider networks and often requires referrals
- Usually has lower premiums but more cost-sharing and managed care
- Medicare Supplement (Medigap):
- Works alongside Original Medicare (Parts A & B)
- Helps cover deductibles and coinsurance
- Often combined with a standalone Part D drug plan
- Generally higher premiums but broader provider access and simpler cost-sharing
The “right” option depends on your budget, provider preferences, health needs, and travel patterns.
Why should I use an independent Medicare agent instead of calling an 800 number?
Independent agents like Tom:
- Represent multiple carriers and plan types, not just one company
- Can help you compare options side-by-side based on your doctors, medications, and budget
- Provide ongoing support when you have billing issues, access problems, or want to change plans
- Often know the local provider landscapes and can suggest practical solutions
800 numbers may connect you with someone who doesn’t know your area, your doctors, or your history.
Can I stay on my employer plan after 65, or do I have to sign up for Medicare?
It depends on:
- The size of your employer
- The cost and quality of the employer plan
- Whether you (or your spouse) are still actively working
In many cases, you can delay some parts of Medicare without penalty if you have qualifying employer coverage. But the rules are nuanced. It’s wise to talk with:
- Your HR/benefits department
- A qualified Medicare broker
- Possibly your financial advisor
before deciding.
How do Medicare agents get paid? Will I be charged a fee?
Typically, Medicare agents are paid by the insurance carriers when you enroll in a plan. Most individuals do not pay a separate fee to the agent. That said:
- Compensation is usually similar across carriers, which helps reduce bias toward any single plan.
- The key is to work with someone who focuses on fit and long-term relationships, not just one-time commissions.
What if I choose the wrong plan can I change later?
Often, yes, but it depends on timing and circumstances:
- Annual Enrollment Period (Oct 15–Dec 7): You can typically switch Medicare Advantage and Part D plans for the following year.
- Special Enrollment Periods: Certain life events (moving, losing coverage, qualifying for assistance) may allow changes outside the annual window.
- Changing from Advantage to Supplement can be more complex and sometimes requires underwriting.
That’s why Tom emphasizes making a well-informed choice up front and reviewing annually.