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Medicare Help: Your Complete Resource Guide

Medicare Help: Your Complete Resource Guide

Get clear, practical medicare help with this complete guide. Learn about coverage, enrollment, cost-saving tips, and where to find trusted support.

A supportive hand holding an older person's hand, offering help with Medicare.

For many people, one of the biggest concerns about healthcare is the cost. Between monthly premiums, deductibles, and the price of prescriptions, it’s easy to worry about how it will all fit into your budget. Thankfully, your Medicare plan doesn’t have to be a source of financial stress. There are several programs and strategies specifically designed to make your healthcare more affordable, but many people simply don’t know they exist. This article will shine a light on these valuable resources. We’ll cover everything from state-run savings programs to federal assistance for medications, giving you a clear guide to finding the Medicare help that can lower your out-of-pocket expenses.

Key Takeaways

  • Know your enrollment deadlines to avoid penalties: Medicare isn't a sign-up-anytime service. Your Initial Enrollment Period around your 65th birthday is the most important window. Missing it can result in permanent late fees, so be sure to mark your calendar and act on time.
  • Look beyond the basics to manage your costs: Original Medicare doesn't cover everything, and it comes with out-of-pocket expenses. You can reduce these costs by exploring Medicare Savings Programs, applying for "Extra Help" with prescriptions, and carefully comparing plans to find one that fits your budget.
  • Lean on expert support for clear guidance: The healthcare system is complex, but you don't have to figure it out by yourself. A patient advocate offers personalized help to choose the right plan, coordinate with your doctors, and explain your benefits, removing the guesswork from your healthcare decisions.

What Is Medicare and Who Qualifies?

Medicare can feel like a puzzle with a lot of moving pieces, but once you understand the basics, it all starts to make sense. Think of it as the federal health insurance program primarily for people aged 65 or older, as well as some younger individuals with specific disabilities or medical conditions. It’s not a single, one-size-fits-all plan. Instead, it’s broken down into different "parts," each covering distinct healthcare services.

Understanding these parts is the first step to making sure you have the right coverage for your needs. Whether you're approaching your 65th birthday or helping a loved one with their healthcare, getting a handle on what each part offers is essential. Let's walk through what Medicare Parts A, B, C, and D cover and who is eligible to enroll.

Part A: Hospital Insurance

Often called hospital insurance, Part A is your coverage for inpatient care. This is the part of Medicare that steps in when you're admitted to a hospital or a skilled nursing facility. It also helps cover hospice care and some home health care services if you meet certain conditions. For most people, Part A is premium-free. If you or your spouse worked and paid Medicare taxes for at least 10 years, you've already paid for it. Think of it as the foundational coverage for more serious medical situations that require an overnight stay. You can always check your Original Medicare (Part A and B) Eligibility to be sure.

Part B: Medical Insurance

While Part A covers hospital stays, Part B covers your day-to-day medical needs. This includes things like doctor's visits, outpatient care, preventive services (like flu shots and cancer screenings), ambulance services, and durable medical equipment. Unlike Part A, most people pay a monthly premium for Part B. Together, Parts A and B are known as "Original Medicare," and they form the basis of federal healthcare coverage for millions of Americans. This is the coverage you’ll use for regular check-ups and managing your health outside of a hospital setting. It’s designed to keep you healthy and address medical issues before they become more serious.

Part C: Medicare Advantage

Medicare Advantage, or Part C, is an alternative way to get your Medicare benefits. These are all-in-one plans offered by private insurance companies that are approved by Medicare. A Medicare Advantage plan bundles your Part A (hospital) and Part B (medical) coverage into a single plan. Most of these plans also include Part D prescription drug coverage. A key appeal of Part C is that many plans offer extra benefits that Original Medicare doesn't cover, such as routine dental, vision, and hearing care. If you prefer having all your coverage under one roof, a Medicare Advantage plan might be a good fit for you.

Part D: Prescription Drugs

Medicare Part D is all about helping you pay for your prescription medications. This coverage is optional and is offered through private insurance companies, either as a standalone plan that works alongside Original Medicare or as part of a Medicare Advantage (Part C) plan. Since Original Medicare doesn't cover most prescription drugs you take at home, enrolling in a Part D plan is crucial if you want help with medication costs. Each plan has its own list of covered drugs, called a formulary, so it’s important to choose one that includes the specific medications you need.

Eligibility Requirements

So, who qualifies for Medicare? The main requirement is being a U.S. citizen or a legal resident who has lived in the United States for at least five consecutive years. Most people become eligible when they turn 65. However, you might also qualify before 65 if you have a disability and have received Social Security disability benefits for 24 months, or if you have End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). According to the Center for Medicare Advocacy, even if you're not receiving Social Security benefits yet, you can still apply for Medicare when you turn 65.

Where Can You Find Medicare Help?

Figuring out Medicare can feel like a full-time job, but you don’t have to do it alone. Whether you’re just starting or need to adjust your coverage, there are several fantastic resources available to provide clear, reliable guidance. From local counselors to personalized advocates and official online tools, here are some of the best places to turn for support.

State Health Insurance Assistance Programs (SHIPs)

Think of your local State Health Insurance Assistance Program (SHIP) as your community connection for Medicare guidance. SHIP is a free counseling service available in every state, designed to give you personalized help from trained volunteers. These counselors can sit down with you and explain the nuts and bolts of your coverage. They’re great for walking you through enrollment, helping you understand what Medicare covers, explaining costs, and comparing the different plan choices available to you. It’s an excellent, unbiased resource right in your backyard.

Patient Advocacy Services like Pairtu

If you’re managing a new diagnosis or complex health needs, a patient advocate can be a true partner in your healthcare. Services like Pairtu connect you with a dedicated patient advocate—often a doctor, nurse, or another healthcare expert—who works for you. They listen to your concerns, help you find the right specialists, and make sure you’re receiving the care you need. This one-on-one support is invaluable for making sense of a complicated system, and for many Medicare members, this service is available at no extra cost.

Medicare.gov Plan Finder Tools

For those who feel comfortable doing their own research online, the official Medicare website is a powerful resource. It has helpful tools that let you find and compare different Medicare plans in your area, including Medicare Advantage (Part C) and prescription drug plans (Part D). You can see a side-by-side breakdown of their costs, what services they offer, and their quality ratings. This is a great way to get a clear picture of your options and see how they stack up against each other before making a decision.

Social Security Administration Support

It’s easy to get the roles of Medicare and Social Security mixed up, but the Social Security Administration (SSA) handles a few key tasks. If you need to sign up for Medicare for the first time or simply update your address, you’ll need to contact the Social Security Administration. The SSA is also the place to go if you need to apply for the Extra Help program, which assists with the costs of prescription drugs. For these specific administrative needs, the SSA is your go-to resource.

Common Medicare Myths, Busted

Medicare can feel like a puzzle with a lot of moving parts, and it’s easy to get tripped up by misinformation. When you’re making decisions about your health coverage, you need clear, accurate facts. Believing common myths can lead to missed deadlines, unexpected costs, or gaps in your coverage. Let’s clear the air and tackle some of the most common myths about Medicare. Getting these straight will help you make confident choices about your healthcare and find the plan that truly works for you. Understanding the reality behind these myths is the first step toward getting the most out of your benefits.

Myth: Medicare covers everything, including dental and vision.

This is one of the biggest misconceptions out there. While Medicare is fantastic for hospital and medical care, Original Medicare (Part A and Part B) doesn’t cover most routine services for your teeth, eyes, or ears. That means things like regular check-ups, cleanings, fillings, eyeglasses, and hearing aids typically aren't included. Some Medicare Advantage plans (Part C), which are offered by private companies, do bundle these benefits into their coverage. It’s important to look at the details of any plan to see exactly what is and isn’t covered before you enroll.

Myth: Everyone is automatically enrolled at 65.

This is only true for some people. You’ll be automatically enrolled in Medicare Part A and Part B if you’re already receiving benefits from Social Security or the Railroad Retirement Board when you turn 65. If you aren't, you will need to sign up for Medicare yourself. This usually happens during your Initial Enrollment Period, which is a seven-month window around your 65th birthday. Waiting too long to enroll can lead to gaps in your coverage and even late enrollment penalties, so it’s crucial to know when your specific window opens.

Myth: Medicare is completely free.

While Part A is premium-free for most people who have worked and paid Medicare taxes for at least 10 years, Medicare is not free. Most beneficiaries have to pay a monthly premium for Part B. Beyond premiums, you’ll also be responsible for deductibles, copayments, and coinsurance when you receive care. These out-of-pocket costs can add up, which is why it’s so important to understand the full financial picture of your plan. Some programs can help lower these expenses if you meet certain income requirements.

Myth: You can enroll in Medicare anytime you want.

Signing up for Medicare is time-sensitive. You can’t just enroll whenever you feel like it. There are specific Medicare enrollment periods you need to follow. Your first chance is your Initial Enrollment Period when you first become eligible. If you miss it, you may have to wait for the General Enrollment Period (from January 1 to March 31) and could face lifelong late enrollment penalties for Part B. There are also Special Enrollment Periods for certain life events, like losing other health coverage, but relying on those can be risky. Planning ahead is key.

Know Your Medicare Enrollment Deadlines

One of the most confusing parts of Medicare is figuring out when you’re supposed to sign up. Missing a deadline can lead to gaps in your coverage and even lifelong penalties, which is the last thing you need when managing your health. Think of these enrollment periods as specific windows of opportunity. Knowing when your window opens and closes is the first step to getting the coverage you need without any extra stress.

There are four main enrollment periods to be aware of. Each one serves a different purpose, whether you're signing up for the first time, missed your initial chance, are going through a major life change, or want to switch your current plan. Let's walk through what each one means for you so you can mark your calendar and feel prepared. If you ever feel lost, remember that a patient advocate can help you sort through these dates and find the right path.

Your Initial Enrollment Period

This is your first and best chance to sign up for Medicare. The Initial Enrollment Period (IEP) is a seven-month window that starts three months before the month you turn 65, includes your birthday month, and ends three months after. For example, if your birthday is in May, your IEP runs from February 1 to August 31. If you’re already receiving Social Security or Railroad Retirement Board benefits, you’ll likely be enrolled in Parts A and B automatically. But if not, it’s up to you to sign up during this time. Taking action during your IEP helps you avoid coverage gaps and potential late enrollment penalties down the road.

The General Enrollment Period

If you missed your Initial Enrollment Period and don't qualify for a Special Enrollment Period, the General Enrollment Period (GEP) is your next opportunity to sign up for Medicare Part A and Part B. This window runs from January 1 to March 31 each year, with coverage starting on July 1. It’s important to know that if you enroll during the GEP, you may have to pay a late enrollment penalty for Part B for as long as you have it. This period is a crucial safety net, but aiming for your IEP is always the most straightforward and cost-effective approach to getting your Medicare coverage started.

Special Enrollment Periods for Life Changes

Life happens, and Medicare has built-in flexibility for certain situations. Special Enrollment Periods (SEPs) allow you to sign up for Medicare outside of the usual windows if you experience a qualifying life event. A common example is leaving a job where you had health insurance, which gives you an eight-month period to enroll in Part B without a penalty. Other events, like moving to a new area with different plan options or even performing volunteer service abroad, can also trigger an SEP. These periods ensure you can get Original Medicare coverage when your circumstances change unexpectedly, without having to wait for the next General Enrollment Period.

Annual Open Enrollment for Plan Changes

The Annual Open Enrollment Period is for people who are already enrolled in Medicare. It runs from October 15 to December 7 every year. During this time, you can review your current coverage and make changes for the upcoming year. This is your chance to switch from Original Medicare to a Medicare Advantage plan (or vice versa), change your Medicare Advantage plan, or join, drop, or switch a Medicare Part D prescription drug plan. Your health needs can change from year to year, so this period is the perfect time to make sure your plan still fits your life and your budget.

Overcome Common Enrollment Challenges

Getting through the Medicare enrollment process can feel like a major project, but it doesn't have to be overwhelming. The key is to break it down into manageable steps so you can feel confident you’re making the right choices for your health and budget. By focusing on deadlines, comparing your options, and getting your documents ready, you can handle enrollment smoothly. And remember, if you hit a snag, support is available. A patient advocate can help you sort through the details and find a clear path forward.

Meet Deadlines and Avoid Penalties

Timing is everything when it comes to Medicare. To avoid a lifetime penalty, you generally need to enroll in Medicare Part A and Part B when you first become eligible, which for most people is during the three months before their 65th birthday. Missing this window can lead to late enrollment penalties that are added to your monthly premium for as long as you have coverage. Understanding Medicare's enrollment rules is the best way to avoid signing up too early and paying for coverage you don’t need, or signing up too late and facing unnecessary costs.

Compare Your Coverage Options

Many people believe Medicare plans are only available through the federal government, but that’s not the case. You can also choose private plans, known as Medicare Advantage (Part C), which often bundle hospital, medical, and prescription drug coverage. If you already receive Social Security benefits, you might be automatically enrolled in Original Medicare (Parts A and B), but it’s still wise to actively compare your options. Every person’s health needs and budget are different, so what works for a friend or neighbor might not be the best fit for you. Taking the time to review all available plans ensures you get the coverage you truly need.

Get Your Paperwork in Order

Before you can enroll, you’ll need to have a few key documents ready, like your birth certificate and Social Security information. Gathering everything ahead of time makes the application process much simpler. It’s also helpful to create a checklist of what you need to submit and by when. If you’re feeling stuck or unsure about what’s required, a patient advocate can help you understand exactly what you need to do. The team at Pairtu can walk you through the process to ensure everything is submitted correctly and on time, giving you one less thing to worry about.

Coordinate with Other Insurance

If you have other health insurance, like from an employer or a spouse’s plan, you’ll need to figure out how it works with Medicare. In some cases, you may be able to delay enrolling in Part B without a penalty. It’s also important to know that if you’re happy with your current Medicare plan, you don’t have to make a change during the Annual Enrollment Period. You can simply let your coverage continue as is. Because these situations can be complex, it’s a good idea to talk to an advocate who can help you understand your specific circumstances and avoid any coverage gaps.

How to Lower Your Medicare Costs

Managing your budget while getting the care you need is a top priority, and thankfully, there are several ways to reduce your out-of-pocket Medicare expenses. From federal programs that assist with prescription costs to state-run initiatives that help with premiums, these resources are designed to make healthcare more affordable. Taking a proactive approach by exploring these options and choosing the right coverage can make a significant difference in your monthly and yearly spending. It’s all about knowing where to look and what you’re eligible for. Let’s walk through some of the most effective strategies to keep your healthcare costs down.

Get "Extra Help" with Prescriptions

If you find that your prescription drug costs are a major strain on your budget, you may qualify for the "Extra Help" program. This federal program is run by the Social Security Administration and is specifically designed to help people with limited income pay for their Medicare Part D (prescription drug coverage) costs. This assistance can cover expenses like your monthly premiums, annual deductibles, and copayments at the pharmacy. The best part is that you can apply for Extra Help at any time of year—you don’t have to wait for an enrollment period. It’s a valuable resource that can provide significant financial relief.

Use Medicare Savings Programs

Beyond prescriptions, you can also get assistance with your other Medicare costs through Medicare Savings Programs (MSPs). These are state-run programs that help eligible individuals pay for their Medicare Part A and/or Part B premiums, deductibles, and other out-of-pocket expenses. Because each state manages its own program, the eligibility requirements and application process can vary. These programs can dramatically reduce your healthcare spending, sometimes covering your entire Part B premium. You can learn more about the different types of MSPs and see if you qualify by checking the official Medicare website.

Choose a Cost-Effective Plan

One of the most direct ways to manage your costs is to ensure you’re enrolled in the right plan for your specific needs. It’s worth taking the time to explore various Medicare coverage options, including different Medicare Advantage (Part C) and Medicare drug plans (Part D) available in your area. When comparing plans, look beyond the monthly premium. Consider the deductibles, copayments, and the plan’s network of doctors and hospitals. A plan with a low premium might have a high deductible, which could cost you more in the long run. Finding the right balance is key to keeping your healthcare affordable and predictable.

Take Advantage of Preventive Services

Staying on top of your health is one of the best ways to avoid costly medical treatments down the road. Medicare makes this easier by covering a wide range of preventive services, often at no cost to you. These services include your annual wellness visit, flu shots, cancer screenings, and counseling to stop smoking. By using these benefits, you can catch potential health issues early when they are easier and less expensive to treat. Be sure to talk to your doctor about which preventive screenings and services are recommended for you and schedule them regularly. It’s a simple step that protects both your health and your finances.

A Closer Look at Medicare Savings Programs

If you’re worried about the costs that come with Medicare, you’re not alone. The good news is that there are programs designed specifically to help. Medicare Savings Programs (MSPs) can assist with expenses like premiums, deductibles, and coinsurance, making your healthcare much more manageable. These state-run programs are based on your income and resources, and qualifying can make a significant difference in your monthly budget.

Understanding which program you might be eligible for is the first step. The two most common programs are the Qualified Medicare Beneficiary (QMB) Program and the Specified Low-Income Medicare Beneficiary (SLMB) Program. Each one offers a different level of support based on specific eligibility guidelines. Let's break down what each program does and how you can apply for this valuable assistance. Having a patient advocate can also simplify this process, ensuring you find and apply for all the aid you're entitled to.

The Qualified Medicare Beneficiary (QMB) Program

Think of the QMB program as the most comprehensive level of assistance among the Medicare Savings Programs. If you qualify, it helps pay for your Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments. This means that when you see a doctor or receive a service covered by Medicare, you won't have to pay out-of-pocket for those costs. To be eligible for the QMB program, you must meet certain income and resource limits that are set by the federal government and can vary slightly by state. It’s designed to provide significant financial relief for those with limited means.

The Specified Low-Income Medicare Beneficiary (SLMB) Program

The SLMB program is for individuals whose income is slightly too high to qualify for the QMB program but who still need some financial assistance. If you're eligible for SLMB, the program will help by paying for your Medicare Part B premium. While it doesn't cover deductibles or coinsurance like the QMB program does, having your monthly Part B premium covered can free up a notable amount in your budget. It’s a crucial stepping stone that provides support for many beneficiaries who fall just outside the QMB income brackets, ensuring they can still afford their essential medical coverage.

Income and Asset Requirements

Eligibility for these programs hinges on your income and financial resources. To qualify, your income generally needs to be at or below specific percentages of the Federal Poverty Level. For the QMB program, your income must be at or below 100%, while the SLMB program is for those with incomes between 100% and 120%. There are also limits on your resources, such as money in checking or savings accounts and stocks. You can find detailed information on how to get help with costs directly from the official source, as these limits can be updated and may vary by state.

How to Apply

Ready to see if you qualify? The application process for all Medicare Savings Programs is handled through your state's Medicaid office. You’ll need to fill out an application and provide documentation about your income and resources. Because each state manages its own program, the specific steps and forms can differ depending on where you live. The best way to start is by contacting your local Medicaid office to get the correct application and a clear list of what you need to provide. They can guide you through the process from start to finish.

How a Patient Advocate Can Help

Trying to make sense of the healthcare system can feel like a full-time job, especially when you’re managing your health. A patient advocate is a professional who acts as your personal guide through it all. Think of them as a knowledgeable partner who is entirely on your side, helping you get the care you need without the confusion and stress.

Many advocates are experienced doctors, nurses, and healthcare experts who know the system inside and out. Their job is to listen to your concerns, answer your questions, and make sure your voice is heard. They can help with a wide range of challenges, from understanding a new diagnosis to coordinating with your medical team. For those on Medicare, services like Pairtu can connect you with a dedicated advocate to help you with your healthcare needs, and this support is often covered by your plan. It’s about having an expert in your corner so you can focus on what matters most: your health.

Get Help Choosing the Right Plan

Medicare comes with a lot of choices—Part A, Part B, Advantage plans, Medigap, Part D—and the details can be overwhelming. A patient advocate can help you sort through the noise. They’ll take the time to understand your specific health situation, the medications you take, and the doctors you want to see. With that information, they can help you compare plans and find the one that truly fits your life. Instead of just looking at monthly premiums, they help you see the bigger picture, ensuring you have the coverage you need without any unwelcome surprises down the road.

Manage Complex Health Needs

Receiving a new diagnosis or managing a chronic illness often means juggling multiple doctors, specialists, and treatments. A patient advocate steps in to streamline this process. They help coordinate communication between your different providers to ensure everyone is on the same page about your care plan. They can also help you and your family understand treatment options and prepare for what’s next. This support is invaluable for caregivers, too, as it provides a central point of contact and a clear path forward. If you’re feeling overwhelmed, you can talk to an advocate to get personalized support.

Understand Your Benefits and Coverage

One of the most confusing parts of any health plan is figuring out what’s actually covered. A patient advocate can review your Medicare plan with you and explain your benefits in plain English. They’ll help you understand your co-pays, deductibles, and what you can expect to pay out-of-pocket. An advocate can also help you make the most of your plan by identifying covered preventive services and other benefits you might not be aware of. They handle the fine print and the follow-up, so you can feel confident that you’re using your coverage correctly.

Find the Right Doctors and Specialists

Finding a new doctor who is in-network, accepting new patients, and a good fit for your personality can be a frustrating search. A patient advocate takes on that work for you. They can research providers in your area, check if they’re covered by your plan, and even help you schedule your first appointment. If you need to see a specialist for a specific condition, they can find experts with the right experience to handle your care. The goal is to get help connecting you with a medical team that listens to you and makes you feel supported every step of the way.

Find Reliable Medicare Support

When you’re trying to make sense of your Medicare plan, you don’t have to go it alone. Knowing where to turn for clear, accurate information can make all the difference. Whether you have a quick question or need in-depth guidance for a complex health situation, there are several fantastic resources available to help you get the answers and support you need. From official government channels to personalized, professional advocates, here’s a look at some of the most reliable places to find help.

Official Medicare Resources

Your first stop for questions should be the source itself. Medicare provides a direct line of support to help you understand your healthcare options. You can talk or live chat with a real person 24 hours a day, seven days a week, with the exception of some federal holidays. For quick questions about coverage or claims, you can call 1-800-MEDICARE (1-800-633-4227) or use the live chat feature on the Medicare website. This is a great way to get immediate answers straight from the organization that runs the program and feel confident in the information you receive.

Professional Patient Advocacy Services

Sometimes, you need more than just a quick answer—you need a dedicated expert in your corner. Patient advocacy services can be a game-changer for anyone feeling overwhelmed by the complexities of Medicare. When you get paired with a dedicated patient advocate, you have someone to help you with your specific healthcare needs, and this service is often covered by Medicare. The advocates at Pairtu include experienced doctors and nurses who take the time to listen, speak up on your behalf, and make sure you receive the care you deserve. They act as your personal guide through the healthcare system.

Local Community Assistance Programs

If you prefer in-person, local support, you’re in luck. State Health Insurance Assistance Programs (SHIPs) offer free, unbiased, and personalized help right in your community. These counselors are trained to assist you with a wide range of issues, from choosing the right plan and understanding your costs to reviewing your coverage. They can also help you apply for programs like "Extra Help" if you need assistance with prescription drug costs or even guide you on how to file a complaint if something goes wrong. It’s a valuable local resource that provides one-on-one attention.

Trusted Healthcare Coordination Organizations

Managing healthcare isn’t just about you—it often involves your family and loved ones. Healthcare coordination organizations specialize in supporting the entire family unit. For instance, Pairtu care advocates guide families through each stage of healthcare, and this support is covered by Medicare. They provide the tools and resources needed to keep your family connected and actively involved in your care journey. This ensures everyone is on the same page and that you have a strong support system every step of the way, which can be incredibly reassuring during challenging times.

Frequently Asked Questions

What’s the main difference between Original Medicare and a Medicare Advantage plan? Think of it this way: Original Medicare (Parts A and B) is the health plan run by the federal government. You can see any doctor or go to any hospital in the U.S. that accepts Medicare. A Medicare Advantage plan (Part C) is an all-in-one alternative offered by a private insurance company. It bundles your Part A and B benefits and usually includes prescription drug coverage and extra perks like dental or vision, but you'll typically need to use doctors and hospitals within the plan's network.

I think I missed my Initial Enrollment Period. What should I do? First, don't panic. If you missed your first seven-month window to sign up, your next chance is usually the General Enrollment Period, which runs from January 1 to March 31 each year. Just be aware that signing up late can result in a penalty that gets added to your monthly Part B premium for as long as you have it. Because every situation is a little different, this is a great time to talk with a patient advocate who can help you understand your specific options and next steps.

How do I know if I really need a patient advocate? A patient advocate is most helpful when you feel overwhelmed or unsure about your healthcare. You might consider one if you're managing a new or complex diagnosis, need help coordinating care between multiple specialists, or simply want an expert to help you find the right doctors and understand your plan's benefits. They step in to handle the logistical and administrative details so you can focus entirely on your health.

I have health insurance through my job. Do I still have to sign up for Medicare when I turn 65? This is a common question, and the answer is: it depends. If you work for a company with fewer than 20 employees, you'll likely need to sign up for Medicare Parts A and B when you turn 65. If your employer is larger, you may be able to delay enrolling without facing a penalty. The rules can be tricky, so it's best to talk with your company's HR department to understand how your current insurance works with Medicare.

With so many options, what's the most important thing to consider when choosing a plan? While the monthly premium is important, it's not the whole story. The best plan for you is one that fits your specific health needs and budget. Look closely at the total out-of-pocket costs, including deductibles and copayments. You should also make sure your regular doctors are in the plan's network and that your prescription medications are on its list of covered drugs. Taking the time to check these details will help you find a plan that truly works for you in the long run.

Smiling young man with short hair and a light beard wearing a white shirt against a blurred blue sky background.
Arian Razzaghi-Fernandez
CEO & Co-founder, Pairtu

Arian Razzaghi-Fernandez is the CEO and co-founder of Pairtu, a healthcare platform dedicated to helping Medicare beneficiaries and their families understand healthcare benefits, access patient advocacy, and navigate care coordination. His work is informed by real-world experience helping family members manage complex healthcare decisions.

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