Who we help
Turning 65
The seven-month window, the Part B decision if you are still working, and the one Medigap period you cannot get back.
The question
“Do I have to do anything, and when?”
Turning 65 is the only benefits decision in most people's lives with a hard clock on it. Miss the windows and the consequences are permanent: a Part B late enrollment penalty for life, a Part D penalty for life, and the loss of the one period where a Medicare Supplement carrier cannot ask you a single health question.
The good news is that the calendar is simple once someone lays it out. Your Initial Enrollment Period runs seven months: the three months before your birthday month, the birthday month itself, and the three months after. Enrolling in the first three avoids a gap.
Whether you should enroll at all depends on one thing: do you have creditable coverage from active employment, yours or a spouse's? If you do, delaying Part B is usually correct and carries no penalty. If what you have is retiree coverage, COBRA or a Marketplace plan, it is not creditable for this purpose and delaying will cost you.
The path
What we do, in order
- 7 months out
Check your coverage type
Active employer coverage is creditable. Retiree coverage, COBRA and Marketplace plans are not.
- 3 months out
Enroll or defer
Enroll in Part A and, if appropriate, Part B. If you are deferring, get the employer letter that proves creditable coverage.
- Birthday month
Choose the path
Medicare Advantage, or Original Medicare with a Supplement and a Part D plan. We check your doctors and prescriptions against each.
- Part B month 1
Medigap window opens
Six months of guaranteed issue for any Medicare Supplement, with no health questions. This does not come back.
- Each October
Annual review
Formularies and networks change for January. So does your medication list.
Avoid these
Four mistakes we see every single season
Assuming COBRA counts
COBRA is not active employment coverage. Relying on it past 65 is the most expensive mistake we see, because the Part B penalty is permanent.
Letting the Medigap window lapse
Six months from your Part B start date. After that, in Ohio, carriers may underwrite, and a single condition can close the door.
Choosing on premium alone
A zero-premium Advantage plan that excludes your oncologist is not cheap. Providers and prescriptions decide this, not the premium.
Skipping Part D because you take nothing
The penalty accrues for every month without creditable drug coverage, and it never goes away. A low-premium plan is the cheap insurance.
Before you decide
Turning 65 questions we hear most
If your question is not here, call the desk. Nobody will put you on a list for asking.
If your employer plan is creditable coverage from active employment, you can usually take premium-free Part A and delay Part B without penalty. Keep the employer's creditable coverage letter. When you retire, an eight-month Special Enrollment Period opens for Part B.
For most people who have enough work credits, yes. Part B carries a monthly premium set by Medicare, and higher earners pay an income-related adjustment on top.
Not necessarily. You are each enrolled individually, and different doctors or prescriptions often point to different plans. Several Supplement carriers offer a household discount when both adults hold a policy.
Nothing. We are compensated by the carrier you choose, at a rate set by federal rule for Medicare products, so there is no financial reason for us to prefer one plan over another.
Bring us the file. We will bring the market.
Send a census or ask one question. Either way it costs you nothing and nobody will chase you.
Independent and multi-carrier. $0 cost to work with us. No pressure scripts.