Medicare at 65: the four decisions that will follow you for life

Medicare looks like a single program. It is actually four interlocking decisions, and the choices you make during your initial enrollment window can be very difficult and expensive to change later.

Decision one is Original Medicare vs. Medicare Advantage. Decision two is your prescription drug coverage (Part D). Decision three, only available with Original Medicare, is which Medigap policy fills the gaps. Decision four, ongoing, is managing your income to avoid IRMAA surcharges.

The biggest mistake we see: choosing Medicare Advantage at 65 because the premium is low, then trying to switch to Original Medicare later when health needs change. By then, Medigap underwriting can deny you, lock you in, or price you out.

We are not insurance brokers. We coordinate with the Medicare specialists our clients use, and we make sure the income side, IRMAA, conversions, withdrawal timing, lines up with the coverage side.