Your Medicare Starter Guide

What Medicare is, in plain words

Medicare is the federal government's health insurance for people 65 or older — and for some people under 65 with certain disabilities. It has four parts, and each one covers something different.

When you need to sign up

This is the part that confuses people the most — and the part that costs the most if you get it wrong. Your first chance to sign up lasts seven months: the three months before your birthday month, your birthday month, and the three months after.

Agent tip: sign up in the first three months, not the last. If you wait until the end, your coverage can start later and you're left a few weeks without insurance.

And there's another date to write down: every fall, from October 15 to December 7, anyone with Medicare can review their plan and change it for the coming year. Plans change every year, so it's worth reviewing even if you're happy.

How to apply — free and online

Here's what almost nobody explains: applying for Medicare costs nothing. You do it directly with Social Security, online, and it takes about fifteen minutes. No one should charge you to fill out that application.

1. First, check if you're already enrolled automatically. If you already receive your Social Security check before turning 65, your Medicare card arrives in the mail on its own. You don't have to do anything.

2. If you're not getting a check yet, you do need to apply. The application is on the Social Security website, ssa.gov, or by calling 1-800-772-1213.

3. Have this ready before you start. They'll ask for basic information about you and your work history.

4. Save your confirmation number. When you finish, you get a receipt. Keep it until your card arrives.

• Your Social Security number
• Your date and place of birth
• If you were born outside the U.S., your residency or citizenship information
• The name of your current employer, if you still work
• If you have health insurance through your job or your spouse's job, that information

Don't speak English well, don't read well, or not comfortable with computers? That's where I come in. I read you the questions, translate, and fill out the application with you right beside me. You answer and you confirm. That doesn't cost you anything either.

If you'll keep working past 65

Many people keep working past 65, and here the answer is no longer the same for everyone. If you have health insurance through your job — or through your spouse's job — in many cases you can wait to enroll in Part B without a penalty.

But that depends on the size of the company and on what kind of coverage you have. A small company doesn't work the same as a large one, and a retiree's insurance doesn't count the same as an active employee's.

The two paths: Original or Advantage

Once you have Medicare, the big decision comes: stay with Original Medicare or choose a Medicare Advantage plan. There isn't one that's best for everyone. There's one that's best for you.

That's why I'll never tell you over the phone which plan is best without first checking three things: your doctors, your medications, and your ZIP code. Without those three, any recommendation is a shot in the dark.

Three mistakes that cost money

The 5 questions to ask your agent

Before you sign anything, ask whoever is helping you these five questions. A good agent answers all of them, calmly and without rushing.

1. Are my doctors in this plan's network?

   Have them verify it in front of you, by the name of each doctor.

2. Are my medications covered, and how much would I pay for each?

   Bring the full list, with the doses.

3. What's the most I could pay in a bad year?

   Don't just ask about the premium. Ask about your out-of-pocket maximum.

4. What happens if I get sick while traveling?

   Important if you travel to another state or spend time away.

5. Will you take care of me after I enroll?

   The most important one of all. A real agent answers the phone in January, not just in December.