Turning 65 in the United States triggers one of the most confusing decisions in adult life. The mailers start showing up six months early, the TV ads featuring celebrities never stop, and most people end up either over-paying or under-covered for the next 20 years.

The four parts (and what each one does)

  • Part A — Hospital insurance. Covers inpatient hospital stays, skilled nursing, hospice. Free for most people if you or your spouse paid Medicare taxes for 10+ years.
  • Part B — Medical insurance. Covers doctor visits, outpatient care, preventive services. About $185/month in 2026 (more if your income is high).
  • Part C — Medicare Advantage. A bundled alternative to Original Medicare, sold by private insurers. Includes A and B, usually D, often vision/dental/hearing.
  • Part D — Prescription drug coverage. Stand-alone if you have Original Medicare; usually included in Advantage plans.

The big choice: Original Medicare + Supplement, or Advantage?

Path 1: Original Medicare + Medigap + Part D. Original Medicare (Parts A and B) plus a Medigap supplement (Plan G is most popular) plus a stand-alone Part D plan. Higher monthly premium (~$200–300 total), but no network restrictions and predictable out-of-pocket costs. You can see any doctor that accepts Medicare.

Path 2: Medicare Advantage. A single plan that bundles everything. Often $0 monthly premium beyond Part B. Network restrictions like an HMO or PPO. Potentially higher out-of-pocket if you use a lot of care, but capped by an annual maximum.

Roughly half of Medicare beneficiaries pick each path. Neither is universally better — it depends on your doctors, prescriptions, travel patterns, and budget.

The deadlines that matter (miss these, pay forever)

  • Initial Enrollment Period. 7 months — 3 months before your 65th birthday, your birthday month, 3 months after. Enroll in Part B during this window or you'll pay a 10%-per-year-late penalty for the rest of your life.
  • Annual Enrollment Period (AEP). Oct 15 – Dec 7 every year. Switch Advantage or Part D plans for next year.
  • Medicare Advantage Open Enrollment. Jan 1 – Mar 31. One chance to change Advantage plans or drop back to Original Medicare.
  • Special Enrollment Periods. Triggered by life events (moving, losing employer coverage). Don't assume — ask.

The Part D penalty trap

If you don't enroll in Part D when first eligible and don't have "creditable" drug coverage from another source, you'll pay a permanent late penalty: roughly 1% of the national base premium for every uncovered month. Wait 36 months, pay 36% extra forever.

How we help

For every client turning 65, we run a no-cost comparison: every Advantage and Supplement plan available in your zip code, with your specific doctors and prescriptions plugged in. The differences add up to thousands of dollars over a few years. Quotes and consultations are always free.