How to Choose a Medicare Plan at 65

Learn the four types of Medicare coverage and how to pick the right plan when you turn 65.

1. Know your enrollment deadline. You get a 7-month Initial Enrollment Period: 3 months before your 65th birthday, your birthday month, and 3 months after. If you're still working with employer health insurance, you may qualify for Special Enrollment later. Missing this window means paying late penalties forever.
2. Understand the four parts of Medicare. Part A covers hospital stays (free for most people). Part B covers doctor visits and outpatient care (monthly premium required). Part C is Medicare Advantage (private plans that replace A and B). Part D covers prescription drugs (separate premium).
3. Choose Original Medicare or Medicare Advantage. Original Medicare (Parts A + B) lets you see any doctor who accepts Medicare but covers about 80% of costs. Medicare Advantage (Part C) works like employer insurance with networks and copays, often includes prescription coverage, but limits your doctor choices.
4. Add prescription drug coverage. If you choose Original Medicare, buy a separate Part D plan for prescriptions or face lifelong penalties. Medicare Advantage plans usually include drug coverage. Compare plans based on your specific medications and preferred pharmacies.
5. Consider Medigap insurance. Medigap policies cover the gaps in Original Medicare (like the 20% you pay for doctor visits). You can only buy Medigap during your 6-month window starting when you enroll in Part B. Popular plans include G and N.
6. Compare costs beyond premiums. Look at total annual costs including premiums, deductibles, copays, and out-of-pocket maximums. Use Medicare.gov's plan finder tool to compare options in your area. The cheapest premium doesn't always mean the lowest total cost.