What we do
Turning 65 consultations
The mail starts arriving around your 64th birthday and does not stop. Here is how to sort the useful envelopes from the noise, and what to do in what order.
What you get
Concrete things, not a conversation about a conversation.
Every one of these is included, and none of it is billed to you. Our compensation comes from the carrier you eventually choose — or from nowhere at all, if the right answer is to leave your coverage exactly as it is.
- Your personal enrollment calendar, with every date that applies to you
- A creditable-coverage assessment if you are still working or on a spouse’s plan
- A plain-English comparison of Medicare Advantage versus Medigap for your situation
- A network check for every doctor and facility you want to keep
- A formulary check for every prescription you take, at your pharmacy
- A written summary you can think about, discuss at home, and come back to
How it runs
Step by step.
- 01
Six months out
We map your seven-month Initial Enrollment Period and confirm whether you should take Part B now or delay it because of employer coverage. Everything else depends on this answer.
- 02
Four months out
The structural decision. Original Medicare plus a supplement plus Part D, or a Medicare Advantage plan. We show you what each costs in a normal year and in a bad year, using your own doctors and drugs.
- 03
Three months out
File for Part A and Part B. Then narrow the plan shortlist and check every network and formulary detail. If you are going the Medigap route, this is when the underwriting-free window is at its most valuable.
- 04
Enroll and confirm
Applications submitted, effective dates confirmed with the carrier, cards tracked. Then we put your annual review in the calendar so the plan gets re-checked every autumn.
The two deadlines that are genuinely hard to undo
Most Medicare decisions can be revisited during a future enrollment period. Two cannot, and they both land in the same few months around your 65th birthday.
The first is your Part B enrollment. Miss the Initial Enrollment Period without creditable employer coverage and you pick up a lifetime premium penalty that compounds for every twelve months you were eligible and not enrolled.
The second is your Medigap Open Enrollment Period — six months from your Part B effective date — during which a supplement carrier must issue you a policy regardless of health. After it closes, in most states they can underwrite you and decline. If a Medigap plan is right for you, this is the window in which to buy one.
What to bring to the conversation
- A list of your doctors and the hospital you would want to use
- Your prescriptions — names, strengths and doses, from the bottles
- Your current insurance card and, if you have it, the summary of benefits
- Whether you are still working, and the size of your employer
- Whether you travel, spend part of the year elsewhere, or split time between states
- Roughly what you can comfortably spend each month, and in a bad year
The creditable coverage test, if you are still working
If you are employed at 65, whether you can safely delay Part B turns on one fact: how many people your employer has. At 20 or more employees with creditable group coverage, delaying is generally safe and a Special Enrollment Period opens when the employment ends. Below 20 employees, Medicare usually becomes the primary payer and delaying can leave you responsible for most of your costs.
| 20 or more employees | Fewer than 20 employees | |
|---|---|---|
| Who pays first | The group plan | Medicare |
| Safe to delay Part B? | Generally yes, if creditable | Usually no |
| Special Enrollment Period later | Yes — 8 months from separation | Not a substitute for enrolling on time |
| What to request from HR | Written creditable-coverage statement | Written creditable-coverage statement |
What Medicare will not cover, whichever route you take
This list surprises people every year, and it is better to plan for it at 64 than to discover it in a dentist’s chair at 67.
- Routine dental — cleanings, fillings, extractions, crowns, dentures
- Routine vision — eye exams for glasses, and the glasses themselves
- Hearing exams and hearing aids
- Long-term custodial care, as distinct from short-term skilled nursing
- Most care received outside the United States
Frequently asked questions
When exactly is my Initial Enrollment Period?
Seven months long: the three months before your 65th birthday month, your birthday month itself, and the three months after. Enrolling in the three months before your birthday month gives you coverage starting the first day of your birthday month; enrolling later delays the start date.
I am still working at 65. Should I take Part B?
If your employer has 20 or more employees and the coverage is creditable, delaying Part B is often reasonable and does not create a penalty, because you will get a Special Enrollment Period when the employment ends. If your employer is smaller, Medicare usually becomes primary and delaying can be a costly mistake. Confirm before you decide.
Is this consultation really free?
Yes. Carriers pay licensed brokers a commission on enrollment and that cost is already inside the premium. If you take our advice and stay exactly where you are, we get nothing and you still got the advice.
Coverage involved
The products this service touches.
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Medicare Advantage (Part C)
Medicare Advantage (Part C) is a private plan that replaces how you receive your Part A and Part B benefits. Plans usually bundle prescription drug coverage and extras like dental and vision, often carry a $0 monthly premium, and cap your annual out-of-pocket costs — but you use a provider network and pay copays at the point of care.
About this coverage -
Medicare Supplement (Medigap)
A Medicare Supplement, or Medigap, is a private policy that pays the deductibles, copayments and coinsurance Original Medicare does not. You keep Original Medicare, see any provider in the country who accepts Medicare, need no referrals, and pay a monthly premium. Prescription drug coverage is bought separately as a Part D plan.
About this coverage -
Part D prescription drug plans
Medicare Part D is prescription drug coverage sold by private carriers, either as a standalone plan alongside Original Medicare and a Medigap policy or bundled inside a Medicare Advantage plan. Each plan has its own formulary, tiers and pharmacy network, and an annual cap on what you pay out of pocket for covered drugs.
About this coverage
Related services
Often needed at the same time.
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Medicare enrollment assistance
Step-by-step help getting enrolled in the right Medicare arrangement, at no cost to you.
How it works -
Insurance plan comparison
Every realistic option in your county, compared against your own doctors and drugs.
How it works -
Prescription drug cost review
Your actual drug list, run against every plan in your county, at your pharmacy.
How it works