Your Road Map to Medicare

What is Medicare?

Car Analogy: Medicare is the national interstate system for health care when you hit age 65 (earlier for some disabilities). To “get on the road” you will need Medicare Part A & Part B. Your “big” decision will be selecting how you want to travel. You will have two options.

 

Pre-Trip Checklist

  •  Confirm you’re road-ready: Turning 65 (or qualifying earlier).
  •  Mark your booking window (IEP): A 7-month window—3 months before your birthday month, your birthday month, and 3 months after.
  • Pack your glovebox: Social Security details, your doctor “destinations,” medication list, and any current insurance.
  • 🔎 If you have employer/retiree coverage: Check how that “current car” merges with Medicare so you don’t double-pay or lose coverage.

Original Medicare (Parts A & B) —  Your Car

Analogy: Original Medicare is your reliable car that can drive on roads almost anywhere in the United States.

Part A — “Major repairs & garage time” (Hospital Insurance)

  • Inpatient hospital stays (the big repairs)
  • Short-term skilled nursing facility (post-repair tune-ups)
  • Hospice
  • Some home health services

Part B — “Everyday driving & maintenance” (Medical Insurance)

  • Doctor visits and outpatient services (routine trips)
  • Ambulance (emergency tow)
  • Durable medical equipment (adaptive gear/accessories)

 

Costs — Your Car Expenses

  • Premiums = the car payment (Part B monthly premium; Part A may be $0 for most).
  • Deductibles & coinsurance = pay-per-repair/visit costs. Typically Medicare pays ~80%, you pay ~20%.
  • No annual out-of-pocket max = in a bad year, repair bills can keep adding up.
  • Purchasing a Medicare Supplement (Car Warranty) will cover most if not all of those bills that can add up.
  • Not included in this car: Most prescription drugs, routine dental/vision/hearing, and long-term custodial care.

Action steps

  • Enroll in Part A & Part B during your IEP (or a Special Enrollment Period if you’re still working with qualifying coverage).
  •  Note your effective dates—your ignition-on moment.

Choose Your Car For Travel – Car 1 or Car 2

  • Car 1: Original Medicare + Medicare Supplement + Part D → Keep your car, add a repair-cost shield (Medicare Supplement) and a fuel card (Part D).    Car 1 is Medicare Part A and Medicare Part B plus a Prescription Plan (Part D) and Supplemental Plan.

 

  • Car 2: Medicare Advantage (Part C) → Trade Car 1 in and drive Car 2. This is an all-in-one lease with a defined service locations (networks) and extras. Car 2 replaces Car 1.  Car 2 is Medicare Part C.  This vehicle will have certain gas stations and mechanics you will use.  As a bonus, you lease of Car 2 will provide you will some additional features.  Features will include items such as dental and vision. Some of your maintenance may require you to get authorization in order for the service to be provided.

 

Car 1: Medigap + Part D — Keep Your Car, Add Protection

Medicare Supplement (Medigap Plan) = Extended warranty + roadside help (from private insurers)

  • Helps cover your share of A/B costs (deductibles, copays, coinsurance).
  • Separate monthly premium; benefits standardized by letter (e.g., Plan G, N).

Part D = Prescription “fuel card”

  • Covers medications with its own premium, deductible, and per-fill costs.
  • Formularies (drug lists) and preferred pharmacies vary—like which gas stations give the discount.

Action steps

  • Compare Medigap letters & premiums (and any health underwriting if you miss your no-questions-asked window).
  • Enroll during your 6-month Medigap Open Enrollment (starts the month your Part B begins) for guaranteed issue in most states.
  • Pick a Part D plan whose formulary and pharmacies match your med “fuel stops.”

Ongoing maintenance

  • 🔄 Re-shop Part D each Oct 15–Dec 7 (menus and prices change yearly).

 

Car 2: Medicare Advantage (Part C) —

All-In-One Lease

Analogy: You swap into a managed lease that bundles Parts A & B, usually Part D, and often extras (dental/vision/hearing). In return, you drive within the plan’s service network and follow its rules.

Plan types

  • HMO: Stay on marked roads—in-network only (PCP “crew chief,” referrals often needed).
  • PPO: More road freedom—out-of-network allowed at higher cost; referrals usually not required.

Costs

  • Often a low or $0 monthly plan premium (you still pay Part B).
  • Copays/deductibles per service, with an annual out-of-pocket maximum for A/B services—your yearly repair-bill cap.

Action steps

  • Network check: Are your doctors/hospitals approved service centers?
  • Drug check: Are your meds on the plan’s list? Any prior auths (special permits)?
  • Compare premiums, copays, deductibles, OOP max, and extras; enroll during your IEP or Oct 15–Dec 7.

Ongoing maintenance

  • Already leased? You can switch plans or return to Original Medicare Jan 1–Mar 31 (Medicare Advantage Open Enrollment).

 

Quick Tips on your Car Purchase

  • Prefer any mechanic, predictable costs, nationwide flexibility?
    Keep Cart 1 (Original Medicare) + add Medigap + Part D.
  • Prefer a simpler monthly setup with extras and a cost cap—and your doctors are in the network?
    Consider a Medicare Advantage and lease Car 2.