Welcome to medicare
Welcome to the world of Medicare! This is an exciting new chapter in your healthcare journey, and it can be confusing! However, we are here to help you navigate every step of the way. If you haven’t already received your Medicare & You Handbook, click here to download it https://www.medicare.gov/publications/10050-medicare-and-you.pdf
If you wish to Understand your ABC’s of Medicare take a look at this video. https://youtu.be/MlNw4LovNjE
You have options to consider and maybe why you shouldn’t take Medicare https://youtu.be/L2goGwp4Co8 see section below regarding COBRA timebomb!
Remember, this may seem confusing or overwhelming, but no need to worry about it. If you are the type that wants to know everything in detail, we’ve given you some links for your learning pleasure. If not, we walk you through your own personal journey based on your personal situation. The conversations we have will help you grasp the concept, and we will make recommendations and get your applications completed for the plans that you wish to enroll in. Please remember in addition to Medicare, at some point you will need other services that might not be covered through Medicare, this healthcare MAP will give you an idea of what you might encounter and should plan in advance for. We can also guide you through that process.
We understand Medicare can initially seem complex, with many different moving parts, plans, options, and decisions to be made, but don't worry, we are here to be your personal tour guide. Here’s a link to take you through some of the Parts https://insadvocates.com/parts-of-medicare-abcd-1
Together, we can explore the different parts of Medicare (Parts A, B, C, and D) and determine which coverage best suits your needs and budget. We'll also discuss options for Medicare Advantage plans and explore supplemental insurance (Medigap) if needed. A link to take you through some of the costs https://insadvocates.com/medicare-costsand
Also, if you are a high-income earner where you have an adjusted gross income for the last 2 years of $212k or more, IRMAA won’t be your best friend, but we have some recommendations around that: https://insadvocates.com/meet-irmaa
You can certainly APPEAL your Medicare IRMAA Premium if you had a life-changing event that reduced your household income. Please review this link: https://www.ssa.gov/medicare/lower-irmaa
One item to keep in the back of your mind; as you get older and you need more care, you might want to be in a MedSup plan opposed to an Advantage plan. I’ve had many kids of adults call me asking how to get them back on a MedSup because the facility they are in is not having an easy time getting appropriate coverage. It is not an easy process to get back onto a MedSup plan, so I always recommend using the MedSup over an Advantage plan. Sometimes it is so much easier to stay on a MedSup and have the kids, chip in to pay the monthly cost of the MedSup. This is always cheaper than the Advantage Maximum Out of Pocket amounts. Remember, one cancer situation and you are in an Advantage plan, especially an HMO, and the facility isn’t in their network, YOU CAN’T GO. How much control do you want with your healthcare? Want a better understanding, listen to this video. There are 10 standardized Medicare plans available, most popular are the Plan G & N, there are 3 differences to be aware of as pointed out in the link on the chart.
We are here to answer any questions, explain your coverage options clearly, and help you create a personalized roadmap to ensure you get the most out of your Medicare benefits.
Schedule your Personalized Appointment: https://bookings.cloud.microsoft/book/Sue1@InsAdvocates.com/?ismsaljsauthenabled=true
Now, if you are still working, we will analyze whether it makes sense to move from your employer plan and go full blown Medicare before making any changes. We have some great informative videos you’ll want to refer to. You can watch them if you want to understand the process, or you can just rely on us to take you through the process. If you are currently on an HSA (Health Savings Account-High Deductible Plan), make sure you watch the link on HSA & Medicare under our video section https://insadvocates.com/medicare-101-videos-1
If you are contributing to your HSA, you will want to stop those contributions 6 months prior if you apply for Medicare Part A&B. You should probably even contact your CPA just to have him shed some light on this situation (if they can't, you have the wrong Accountant).
~
OUR PRIORITY~We are here to support you on this journey! Your 1st Step is to obtain your Medicare Parts A & B if needed as this is the longest process. Always check with us 1st to make your you are going to need to sign up for Part B because there is a monthly premium that starts at $202.90 starting Jan 1st, 2026 APPLY Again, if you are a high income earner, your costs could be a lot more Medicare Costs per Income Level plus an additional amount for Rx coverage too.
If you are leaving an employer plan and not just turning 65, you will need your employer to fill out this form https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms-l564e.pdf and attach it with your Part A&B application. You can do this online or Fax to Social Security. You would need 2 forms, the one above and your personal Part B Request form https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms40b-e.pdf
If you’re happy with the service we provide, we’d be grateful if you could share our information with your friends, family, colleagues, or anyone who might benefit. As we serve all 45 states, referrals are the only way we can ensure that our Medicare community is fully protected from all the ‘ifs,’ ‘ands,’ ‘buts,’ and ‘maybes’ that can complicate healthcare. We truly appreciate your help in supporting our advocacy for the senior population. If you liked what we did for you, we greatly appreciate you rating us on GOOGLE https://insadvocates.com/testimonials-1
PLEASE REMEMBER—Medicare does NOT cover Long-Term Care. If you don’t have a plan in place, your hard-earned retirement savings could be at risk, or you may have no choice but to rely on Medicaid. With people living longer than ever, planning ahead isn’t just smart—it’s essential. Don’t wait until it’s too late. Let’s talk about all your options today!
💥COBRA Timebomb💥
If you just elect COBRA thinking it will cover everything…THINK AGAIN! Because you are no longer an ACTIVE employee, It is SECONDARY CLAIMS PAYOR, so it will not protect you properly without Medicare Part B.
🔴 The key rule (this is where people get burned): Once you’re 65 and no longer actively working,
👉 Medicare becomes primary
👉 COBRA becomes secondary
But here’s the catch…
➡️ COBRA only pays after Medicare pays
➡️If you don’t have Part B, Medicare pays $0 for outpatient/doctor services
So what happens?
· You go to the doctor
· No Part B → Medicare doesn’t pay
· COBRA says: “We are secondary—we pay what Medicare would have left over”
· Since Medicare paid nothing…
👉 COBRA may also pay little or nothing 💥Timebomb that leaves you holding the bill
🧠 Think of it this way:
COBRA is not a replacement for Medicare at your age—it’s more like a backup plan.
If the primary (Medicare Part B) isn’t in place, the backup doesn’t work correctly.
⚠️ Real-world example:
· Surgery or outpatient procedure = $20,000
· No Part B → Medicare pays $0
· COBRA processes as secondary → may deny or pay very little
👉You could owe most of the bill
✅ What you should strongly consider:
1. Enroll in Medicare Part B ASAP
o Since you just lost employer coverage, you likely qualify for a Special Enrollment Period (SEP)
o This lets you enroll without penalty if done timely
2. Then COBRA can work properly
o Medicare (A & B) = primary
o COBRA = secondary (may help with deductibles, coinsurance, etc.)
o But Why Take COBRA if full blown Medicare with a MedSup or Advantage is Cheaper
🚨 Timing matters A LOT
If you delay Part B:
· You risk claim denials
· You could face a lifetime late enrollment penalty
· You may have gaps in coverage
💡 Strategic insight (this is where I’d challenge the typical thinking):
Many people assume:
“I’ll just take COBRA—it’s what I know.”
But at 67, that can be one of the most expensive mistakes because COBRA was designed for under-65 employees, not Medicare-eligible individuals.
Bottom line:
✔️ Yes, you can take COBRA
❌ But without Part B, it does not function correctly
👉 Medicare Part B is the foundation—you need it first
This is exactly the kind of scenario where a small timing decision can save (or cost) thousands.
Best regards,
https://insadvocates.com/medicare
PLEASE REMEMBER THIS: Medicare DOES NOT pay or provide any assistance for Long Term Care, Assistant Living
