Hospital Insurance
Inpatient hospital stays, skilled nursing after a hospital stay, hospice, some home health care.
Usually $0 (you paid via payroll taxes)
Medicare 101
Medicare, explained like a neighbor would.
No jargon, no sales pitch — just the facts you need to make one of retirement’s biggest decisions well.
The Building Blocks
Four parts, one system.
Original Medicare is Parts A and B. You can add D for drugs — or replace both with an Advantage plan (Part C) and add a Supplement when you want fewer surprises.
Medical Insurance
Doctor visits, outpatient care, preventive screenings, durable medical equipment, some home health.
Standard premium — $185/mo in 2025*
Medicare Advantage
A private plan that bundles A & B — usually with drug coverage, dental, vision and hearing built in.
Often $0 beyond Part B
Prescription Drugs
Retail and mail-order prescription drugs. Standalone with Original Medicare, or bundled into most Advantage plans.
Varies by plan & medications
*Standard Part B premium shown for reference; premium-free Part A assumes sufficient work history. Figures change annually.
Timing Is Everything
The four windows that matter.
Missing a window is the most expensive Medicare mistake there is. Here’s when each one opens.
Initial Enrollment
7 months around your 65th birthday
Three months before the month you turn 65, your birthday month, and three months after. Enroll late here and Parts B & D penalties can follow you for life.
Annual Enrollment (AEP)
October 15 — December 7
Switch or drop Medicare Advantage plans, switch drug plans, or move from Original Medicare to an Advantage plan. Changes start January 1.
Open Enrollment (OEP)
January 1 — March 31
Existing Advantage holders can switch to a different Advantage plan or return to Original Medicare. One switch per quarter.
Special Enrollment
When life happens
Losing employer coverage, moving, Medicaid eligibility, and other qualifying events open 6- or 12-month windows outside the standard periods.
Myths vs. Reality
Four expensive things people believe.
I hear these every week. Correcting them early is often worth more than any plan recommendation I’ll ever make.
“Medicare covers everything.”
Medicare covers about 80% of approved costs — with no cap. The remaining 20% (plus hospital deductibles) is exactly what Supplements and Advantage plans exist to handle.
“I can enroll whenever I want.”
Miss your window and late-enrollment penalties for Parts B and D can increase your premiums permanently. Timing is the single most expensive mistake in Medicare.
“My employer plan makes Medicare unnecessary.”
If your employer has 20+ employees, you can often delay. Smaller employers may require Medicare first. Also, HSA contributions must stop six months before Part A — a detail worth planning around.
“The plan with the lowest premium wins.”
Total cost = premium + your drugs + your doctors + your expected care. The cheapest premium often produces the highest annual bill.
Getting Started
Three steps from confused to covered.
Mark your window
Put your 65th birthday month on the calendar three years out — and check whether your employer coverage changes the plan.
Build your list
Your prescriptions, dosages, and doctors — the three facts every plan comparison needs to be honest.
Compare before you commit
Call me (or any independent agent) and run the full market. Twenty minutes now, thousands saved later.
Let’s Talk
Still have a question? Good — ask it.
Medicare questions are free to ask and expensive to get wrong. Call (415) 891-9797 or grab a time on my calendar.
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