Services
The Medicare topics I walk people through, in plain words, measured against the details that decide which one suits you.
Six Pieces of Medicare I Explain Before Anything Else
Each one below catches people out for its own reason. Start with whichever sits closest to the question you brought me.
Original Medicare
The government runs this one, any provider who accepts Medicare will take it, and I never have to check a network before you book. Part A picks up hospital stays, skilled nursing that follows one of those stays and hospice care. Part B handles office visits, preventive screenings, lab work and equipment you use at home. It sets no ceiling on what you spend in a year, which is why I usually pair it with something more.
Medicare Advantage
A private insurer delivers your Parts A and B on one card, and drug coverage is usually baked in. Dental, vision or hearing benefits often come along for the ride. In exchange you accept a network and, in plenty of plans, a referral before you can see a specialist. Whether one of these earns your signature comes down almost entirely to whether your current clinics sit inside that network.
Drug Coverage
Separate drug coverage you buy to sit beside Original Medicare. Each plan writes its own drug list and files medicines into tiers, so one prescription can cost you wildly different amounts depending on the card in your wallet. Pharmacy networks, quantity caps and approval rules all go into my comparison, never just the monthly premium.
Medigap Policies
Standardized policies that pick up the portion Original Medicare hands back to you, from copays and coinsurance through to deductibles. Any given plan letter buys the same benefits from every insurer, so I compare them on price and on how they treat you afterward. You cannot hold one of these and an Advantage plan at the same time.
Signing Up on Time
Your first window opens around your sixty fifth birthday, the yearly switch period lands late every fall, and special windows swing open after a move, a job change or the end of coverage from work. Each window lets you make different moves, and letting one pass can bolt a permanent surcharge onto your premium.
What You Will Actually Pay
Premiums, deductibles, your share of each service and the yearly ceiling that some plans set and others never do. A higher income on an older tax return can also push your premium up through an adjustment nobody warned you about. I add every piece of it across twelve months, because a monthly figure flatters plans that do not deserve it.
Start With Your Details, Then Weigh the Plans
Tell me which doctors you see, what you take each month and roughly what you can spend. I hold that against the plans open to you and show where each one fits or falls short.
Before you enroll
- Your doctors, checked
- Your prescriptions, priced
- Yearly costs, added up
After you enroll
- Yearly notices, decoded
- Confusing bills, looked into
- Moves and new doctors
Everything I Check on Every Plan
I run the same list against each plan you are considering, so you can lay the results side by side without guessing at the gaps.
Getting care
- I match your doctors to each network
- I check the hospitals within driving distance
- I flag every referral and approval step
- I test how it covers you away from home
Your medicines
- I price each medicine on its own tier
- I compare preferred and standard pharmacies
- I list the quantity caps and therapy rules
- I flag mail order where it saves you money
Money and timing
- I total the premiums, deductibles and shares
- I note the yearly ceiling where one exists
- I check for income based premium add ons
- I confirm which window you can use now
My Job Is Not Finished When the Card Arrives
The plan that suits you in January can slip by December, and the letter warning you about it looks like junk mail.
Drug lists get shuffled, a clinic drops out of a network, and your share of the bill creeps upward. The yearly notice of change spells all of it out, and if I read it with you early there is still time to move.
When a bill looks wrong to you, I would far rather question it than watch you pay it on faith. I trace the statement back to your plan documents and check whether the charge matches the coverage you actually bought.
Your life counts too. Crossing a county line, picking up a new specialist, changing what you take each morning or losing coverage from work can each open a window and change what I would recommend from that day forward.
Find Out Which of These Six Even Applies to You
Give me your doctors, your medicines and your budget, and I will clear away the topics that were never yours to worry about.
Start Your Check