A common question GHPIA receives from clients approaching age 65 is when they should sign up for Medicare and how to get started. While every situation is different, GHPIA has helped many clients navigate the Medicare enrollment process and understand the coverage options available to them. With multiple enrollment deadlines, plan choices, and potential penalties to consider, Medicare can feel overwhelming. GHPIA is here to help.
As new technology emerges and the financial world becomes more complex, seniors and their families must take the necessary steps to protect their financial health. Seniors tend to be one of the most targeted groups for financial fraud and exploitation, due to the possibility of greater diminished capacity and a stronger likelihood to be dependent on other individuals. Seniors who are not able to maintain their own finances due to cognitive or physical decline have the highest risk. Fraudsters target the elderly because they are more likely to have savings, own their own homes, have good credit, and tend to be more polite, allowing fraudsters an opportunity to present their scam.
Visit ssa.gov/medicare and select “Sign up for Medicare”, then “Apply Online.”
Sign in to your “my Social Security Account.” If you do not have an account, create one at ssa.gov before beginning the application.
Continue and complete the requested personal information.
When asked if you wish to apply for Medicare ONLY, but not for monthly retirement cash benefits, select “Yes” if you are NOT applying for Social Security benefits.
Save your re-entry number in case you need to return and complete the application later.
Complete the remaining Medicare Part B and health insurance questions. Note: If you already have health insurance through work or your spouse, you might not need to sign up for Medicare Part B.
Save your confirmation number after submitting the application and monitor your application status through your Social Security account.
(Note: Even if you are not applying for Medicare or close to age 65, it is a great idea to open your own “my Social Security Account”. This deters fraudsters from opening a “my Social Security Account” in your name!)
Still working at age 65? If you plan to continue health insurance through work and are not receiving Social Security benefits, you should still sign up for Medicare Part A. You can delay signing up for Medicare Part B until your employment or employer coverage ends. If you do not sign up for Medicare Part A at age 65, you may face additional penalties. Penalties for Part B can be avoided as you will be eligible for the eight-month Special Enrollment Period, which begins when your employment or group health coverage ends.
Already receiving Social Security benefits? Four months before turning 65, you will be automatically enrolled in Medicare Parts A and B. Your Medicare card should be mailed to you automatically and it typically arrives three months before your 65th birthday. If you do not receive your Medicare card around this time, make sure to follow up with Medicare to confirm you are enrolled properly.
Medigap and Medicare Advantage (Part C): When to sign up
You need your physical Medicare card to sign up for Medigap or Medicare Advantage (Part C). Larger companies sometimes provide additional benefits, allowing you to work with third-party companies like Via Benefits who are private Medicare Marketplace providers. They work with leading national and regional insurance carriers ensuring you can choose from quality plans available in your area1. Be sure to check with your old employer to see if they offer any optional Medicare assistance.
The Medigap Open Enrollment Period: A one-time, 6-month window starting the first month you are 65+ and enrolled in Medicare Part B. During this time, insurers cannot deny coverage or charge more due to pre-existing conditions.
The Medicare Advantage Open Enrollment Period for New Enrollees and General Enrollment: If you enroll in Medicare Parts A and B, you can apply for Medicare Advantage (Part C) within the first three months of Part A and B coverage. If you are already in a Medicare Advantage Plan, the annual enrollment window to switch or drop your Medicare Advantage Plan and return to Original Medicare is January 1st– March 31st of each year.
(Note: Changing from Medicare Advantage back to Original Medicare (Parts A and B) and applying for Medigap involves medical underwriting. Insurers can charge higher premiums that may be cost prohibitive or deny coverage based on health status. 2)
Medigap and Medicare Advantage (Part C): Key Differences
Medigap or Medicare Supplement Insurance – is extra insurance you can buy from a private health insurance company to help pay your share of out-of-pocket costs not covered by Original Medicare, like copayments, coinsurance, and deductibles3. Medigap is not government run, but “all Medigap policies are standardized by the federal government. This means, policies with the same letter offer the same basic benefits no matter where you live or which insurance company you buy the policy from. There are 10 different types of Medigap plans offered in most states, which are named by letters: A-D, F, G, and K-N. Price is the only difference between plans with the same letter, sold by different insurance companies.”4
The most comprehensive and most widely selected coverage for Medigap is Part G. Part N is the second most selected, but it has copays and does not cover select excess charges, which are uncommon. Medigap premiums are typically higher than Medicare Advantage plans but provide broader coverage because they work alongside Original Medicare rather than replacing it. The primary benefit is the ability to see any provider in the U.S. that accepts Medicare Parts A and B, while the main drawback is higher monthly premiums.
(Note: Medicare Part B typically covers 80% of approved medical outpatient services after the deductible is met, leaving 20% coinsurance. Medigap plans help cover out-of-pocket costs, including the remaining 20% coinsurance, as well as deductibles and other coverage gaps. Some plans can cover up to 100% of these expenses.)
Medicare Advantage (Part C) – “Medicare Advantage, also known as Medicare Part C, is an all-in-one alternative to Original Medicare. Medicare Advantage plans are offered by private companies that contract with Medicare. These plans bundle Part A, Part B, and usually Part D (prescription drug coverage) into one package.”5 Although these plans bundle Parts A and B, they do not replace the requirement to enroll in Original Medicare first.
Medicare Advantage may help pay for services Original Medicare does not cover, such as routine dental, hearing, and vision care. These plans typically have lower premium costs and offer fitness benefits, sometimes including free or discounted gym memberships. Although Medicare Advantage may appear enticing due to the lower premiums, it limits coverage to in-network providers, which can vary each year.
You do not know what your future health may hold. If you need to go to a certain specialist out of network (like at MD Anderson or the Mayo Clinic), you may not be covered by Medicare Advantage resulting in significant out-of-pocket costs for out-of-network care.
Medicare Part D (Prescription Drug Coverage)
Selecting a Plan
Conclusion
Medicare is not just a healthcare decision; it is an important part of your overall retirement plan. Making informed decisions early can help you avoid unnecessary penalties, reduce out-of-pocket costs, and ensure your coverage aligns with your broader financial goals. If you are approaching age 65 or would like a second opinion on your current coverage, we encourage you to reach out to GHP Investment Advisors to discuss your options. Our team can help you navigate the Medicare enrollment process and evaluate how your coverage choices fit within your overall financial plan.
The GHP Investment Advisors Financial Concierge Newsletter is published as a service to our clients and other interested parties. This material is not intended to be relied upon as a forecast, research, investment, accounting, legal or tax advice and is not a recommendation offer or solicitation to buy or sell any securities or to adopt any investment strategy. The views and strategies described may not be suitable for all investors. References to specific securities, asset classes and financial markets are for illustrative purposes only. Past performance is no guarantee of future results.
Sources:
1 Via Benefits: How Via Benefits Works – https://help.viabenefits.com/help-articles/how-via-benefits-works
2 Medicare.gov: Joining a Plan – https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan
3 Medicare.gov: What’s Medicare Supplement Insurance – https://www.medicare.gov/health-drug-plans/medigap
4 Medicare.gov: Get Medigap Basics – https://www.medicare.gov/health-drug-plans/medigap/basics
5 AARP: How are Medigap and Medicare Advantage different – https://www.aarp.org/medicare/faq/medigap-vs-advantage/ of the donation, up to $50,000, with a maximum eligible contribution of $100,000 per year for joint filers. Unused credits can be carried forward, and to claim the credit, donors must obtain a certificate from the qualifying organization. GHPIA is familiar with Colorado tax regulation, but the donor should always check with their CPA to help with state specific tax advice.
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Bottom Row L to R: Carin Wagner, Angela Kennedy Lee, Jenny Merges, Brian Friedman, Deirdre Mcguire, Barbara Terrazas, Reed McCoy
