Medicare Guidance

How do I sign up for Medicare? The whole process is complicated and confusing.

You're not alone. Medicare enrollment can feel overwhelming, with multiple parts, deadlines, and decisions that impact your healthcare coverage and costs for years to come.

Common Medicare questions we help answer:

"When should I sign up for Medicare?"
"What's the difference between Medicare Part A, B, C, and D?"
"Do I need a Medicare Supplement (Medigap) plan?"
"Should I choose Original Medicare or Medicare Advantage?"
"What happens if I miss my enrollment window?"
"How does Medicare work with my employer coverage?"
"What does Medicare actually cover, and what doesn't it cover?"
"How much will Medicare cost me each month?"

We simplify the Medicare maze.

Whether you're approaching 65, retiring before 65, or helping aging parents navigate their options, we guide you through the enrollment process, explain your choices clearly, and help you select coverage that fits your health needs and budget.

Medicare is a critical part of your retirement plan. Let's make sure you get it right from the start.

Who pays a higher Part B premium because of income?

You’ll pay the higher premium if your modified adjusted gross income, as reported on your IRS tax return from 2 years ago, is more than:

$106,000 in 2025, if you file an individual tax return or are married and file separately
$212,000 in 2025, if you are married and file a joint tax return

Social Security will tell you if you have to pay a higher premium because of your income. If you've had a life-changing event that reduced your household income, you can ask Social Security to lower the additional amount you'll pay.

Find out if you'll pay a higher Part B premium in 2025:

Chart from Medicare.gov. Lists what your premium for Medicare Part B would be based on your yearly income for 2023. Links to the source

Download our Medicare 101 Presentation

Medicare Enrollment & Coverage:
Your Quick-Reference FAQ

Medicare can often feel complex. With the right information and a team in your corner, we’ll provide you with the tools and knowledge you need to make confident decisions.

Here are answers to the most common questions.

General Information

Q: I’m turning 65 soon. When do I actually sign up for Medicare?

A: Your Initial Enrollment Period (IEP) is a 7-month window:

It starts 3 months before the month you turn 65.
It includes the month you turn 65.
It ends 3 months after the month you turn 65.

To have coverage start the month you turn 65, you must enroll in the first three months of your IEP.

Q: I heard that if I make a mistake enrolling, I could face a permanent penalty. Is that true, and how do I avoid it?

A: This is one of the biggest fears, and it’s valid but avoidable! Penalties are most common with Part B (Medical Insurance) and Part D (Prescription Drug) if you delay enrollment and don't have "creditable coverage" from an employer or union.

The solution: Know your enrollment periods and verify your current or future coverage is "creditable." If you're in doubt, consult with us or the plan's administrator before your enrollment window closes.

Q: I'm 65 and own a small business, but I haven't signed up for Social Security yet. Do I have to enroll in Part B?

A: This is a common and critical point of confusion, especially for small business owners.

The critical factor is the number of employees in your group health plan.
- If your company has 20 or more employees: You can typically delay Part B enrollment without penalty as long as you (or your spouse) remain actively working and covered under the group plan. This employer coverage is considered primary.
- If your company has fewer than 20 employees: Medicare becomes your primary coverage once you turn 65. You must enroll in Part B during your IEP to avoid potential claims issues, gaps in coverage, and the permanent late enrollment penalty.

Always check with your employer plan administrator and us to confirm your small business status and to avoid costly coverage gaps.

Key Changes from the Inflation Reduction Act (IRA)

Q: I take expensive medication. Are my Part D prescription drug costs changing?

A: Yes. The Inflation Reduction Act (IRA) is changing how much people with Medicare Part D pay out-of-pocket for medications.

New Annual Cap (Starting 2025): The biggest change is a new annual cap on your out-of-pocket spending for covered Part D drugs. For 2025, this cap is set at $2,000. Once you hit this limit, you will pay $0 for covered Part D prescriptions for the rest of the calendar year.
Insulin Cap: Your cost for a month's supply of covered insulin is capped at $35.
Good-bye "Donut Hole": The coverage gap (or "Donut Hole") is effectively eliminated as of 2025, simplifying your year-round drug costs until you hit the $2,000 cap.

Q: Will the new Part D changes affect my current plan and premium?

A: These cost limits are excellent news for people with high drug costs, but the rules are causing some private insurance companies to adjust their plans.

Potential Plan Changes: Some plans have shifted from copayments (a flat fee) to coinsurance (a percentage) for drugs during the initial coverage phase. It is essential to re-review your Part D coverage every fall during the Annual Enrollment Period (AEP) to ensure your total estimated costs are still the lowest option for your specific list of prescriptions.

Costs and Premiums

Q: I got a letter about IRMAA. What is this, and do I have to pay it?

A: IRMAA stands for Income-Related Monthly Adjustment Amount. It is an extra amount you must pay on top of your standard monthly Part B and Part D premiums if your Modified Adjusted Gross Income (MAGI) from two years ago exceeds a certain threshold.

Do you have to pay it? Yes, if the Social Security Administration determines you fall into a higher-income bracket based on your last tax return.
Can you appeal? Yes. If your income has significantly dropped due to a life-changing event (like retirement, divorce, or the death of a spouse) since that tax year, you can file an appeal with Social Security using Form SSA-44.

Q: I heard Medicare Part B premiums and deductibles are changing for next year. What are the new amounts?

A: Medicare costs are adjusted annually. For 2025:

Standard Part B Premium: $185.00 per month (up from $174.70 in 2024).
Part B Annual Deductible: $257 (up from $240 in 2024).

These numbers do not include IRMAA or any late enrollment penalties.

Ready to Dive Deeper?

The details of your personal situation, including prescriptions, desired doctors, and current health status, should drive your Medicare choices.

Schedule a call today!