Demystify Medicare

When you turn 65, you get a 7-month Initial Enrollment Period to sign up for Medicare — it begins 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. Enrolling in the first three months helps ensure your coverage starts the month you turn 65 with no gap. During this window you enroll in Part A (hospital) and Part B (medical), then add either a Medicare Advantage plan or a Medicare Supplement plus a Part D drug plan. If you miss it and don't have other qualifying coverage, you may face lifelong late-enrollment penalties, so we help Arizona clients plan this well before their 65th birthday.

A Medicare Supplement (Medigap) works alongside Original Medicare to fill its out-of-pocket gaps and lets you see any provider nationwide that accepts Medicare, while a Medicare Advantage plan is an all-in-one alternative that uses a local network and often bundles extra benefits. Medigap has a higher monthly premium but very low costs at the point of care, no networks, and no referrals, and it pairs with a standalone Part D drug plan — ideal for travelers and snowbirds. Medicare Advantage has a low or $0 monthly premium, uses a network of local Phoenix-area providers, usually includes drug, dental, vision, and hearing coverage, and has a yearly out-of-pocket maximum. Neither is universally better — the right choice depends on your doctors, budget, travel habits, and health, and we compare both for you.

Medicare's Annual Enrollment Period runs from October 15 to December 7 every year, and any changes you make take effect January 1. During AEP you can join, switch, or drop a Medicare Advantage or Part D prescription drug plan — and because plans change their networks, drug formularies, and costs every year, this is the time to review your coverage. There's also a separate Medicare Advantage Open Enrollment Period from January 1 to March 31 for people already on an Advantage plan. We proactively review our Arizona clients' plans each fall so they never get caught by a surprise change.

It depends on the specific plan — each Medicare Advantage plan in the Phoenix area uses its own provider network, so coverage of your doctors varies plan by plan and can change annually. In Maricopa County, plans contract with different combinations of systems like Banner Health, HonorHealth, Abrazo, and Dignity Health, and a doctor in one Advantage plan may be out-of-network in another. Rather than guess, tell us the doctors and specialists you want to keep and the prescriptions you take, and we'll confirm which Phoenix-area Advantage plans include them — or point you toward a Medicare Supplement if you'd rather not deal with networks at all.

Most people pay nothing for Medicare Part A, but everyone pays a standard monthly premium for Part B (set federally and adjusted each year), plus the cost of whatever coverage they add. Many Arizona Medicare Advantage plans have a $0 monthly premium (you still pay your Part B premium), with copays as you use services and a yearly out-of-pocket cap; a Medicare Supplement charges a monthly premium that varies by plan letter, age, and area, plus a separate Part D premium, in exchange for very low costs at the point of care. Higher earners may pay an income-related surcharge (IRMAA) on Part B and Part D. Because the exact figures change every year, we'll give you real, current numbers for your specific options — for free.

Yes — if you're enrolled in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period (January 1 to March 31) lets you switch to a different Advantage plan or return to Original Medicare once during that window, and you can also make changes during the Annual Enrollment Period. One important caution: if you leave Medicare Advantage for Original Medicare and want to add a Medicare Supplement, you may have to pass medical underwriting and could be denied, because guaranteed-issue rights for Medigap are limited after your initial window. That's exactly the kind of timing trap a local Medicare specialist helps you avoid.

Original Medicare (Parts A and B) does not include routine prescription drug, dental, vision, or hearing coverage — but you can add those benefits. For prescriptions you add a standalone Part D plan or choose a Medicare Advantage plan that includes drug coverage; for dental, vision, and hearing, most Medicare Advantage plans bundle these extras in, while with Original Medicare or a Supplement you'd add a standalone dental and vision plan. Because drug formularies differ by plan and change yearly, we match your Part D or Advantage plan to the exact medications you take so you're not overpaying — a small mismatch can cost hundreds of dollars a year.

If you keep working past 65 and have qualifying health coverage through a current employer, you can usually delay Medicare Part B without penalty and enroll later through a Special Enrollment Period — this generally applies when your (or your spouse's) employer has 20 or more employees. When that employment or coverage ends, you typically get an 8-month Special Enrollment Period to sign up for Part B without a late penalty. The rules depend on your employer's size and the type of coverage, and getting the timing wrong can create lifelong penalties or coverage gaps, so it's worth a quick free conversation before you decide to delay.