Straight answers

Medicare is a federal health insurance program for people 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. It consists of different parts: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage).

A Medicare Supplement (Medigap) works alongside Original Medicare to help cover out-of-pocket costs like copays and deductibles, and lets you see any doctor that takes Medicare. Medicare Advantage (Part C) bundles your coverage into one plan from a private insurer, on a provider network. It often includes drug coverage and extra benefits. Most of our clients keep their freedom with Original Medicare plus a Supplement, and we suggest Advantage mainly when a Supplement is out of reach. You can't have both at the same time.

If you don't have creditable drug coverage (coverage as good as Medicare Part D), you should consider enrolling. If you delay enrollment without creditable coverage, you may face a late enrollment penalty added to your premium for as long as you have Part D coverage.

Yes, during the Annual Enrollment Period (October 15 to December 7), you can switch Medicare Advantage plans, switch from Original Medicare to Medicare Advantage (or vice versa), and join, switch, or drop Part D plans. Some plans also allow changes during special enrollment periods.

Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Most people don't pay a premium for Part A if they or their spouse paid Medicare taxes while working.

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and some home health services. There's a monthly premium for Part B, which varies based on your income.

Original Medicare (Parts A and B) generally doesn't cover prescription drugs. You need to enroll in a standalone Part D plan or a Medicare Advantage plan that includes drug coverage (MAPD) to get prescription drug benefits.

Original Medicare doesn't cover routine dental or vision care. But many Medicare Advantage plans include these benefits. You can also purchase separate dental and vision insurance to supplement your coverage.

Medicare costs vary. Part A usually has no premium if you paid Medicare taxes for 10+ years. Part B has a standard premium ($202.90/month in 2026), which may be higher based on income. Part D and Medicare Advantage premiums vary by plan.

The Part B deductible is $283 per year (2026). After meeting the deductible, you typically pay 20% of the Medicare-approved amount for most doctor services and outpatient therapy.

IRMAA (Income-Related Monthly Adjustment Amount) is an extra charge added to Part B and Part D premiums for higher-income beneficiaries. It's based on your modified adjusted gross income from two years prior.

You can enroll online at ssa.gov, by calling Social Security at 1-800-772-1213, or by visiting your local Social Security office. If you're already receiving Social Security benefits, you may be automatically enrolled in Parts A and B.

You'll typically need your Social Security number, date of birth, and information about any current health coverage. For Medicare Advantage or Part D plans, you'll also need your Medicare number (from your red, white, and blue Medicare card).

Yes, but your enrollment timing depends on your employer's size. If your employer has 20+ employees and you have group health coverage, you can delay Part B without penalty. Otherwise, you should enroll during your IEP to avoid late enrollment penalties.

ACA (Affordable Care Act) coverage is sold on the federal Marketplace, sometimes called Obamacare. You qualify if you are a citizen or lawful resident, not incarcerated, and do not have coverage through work. Open Enrollment runs November 1 to January 15 each year. Your income decides whether you get a premium tax credit to lower the cost.

The subsidy cliff is 400% of the federal poverty level, around $62k for one person in 2025. Above it you get no Marketplace subsidy in 2026, because the larger pandemic-era credits expired January 1, 2026. If you are above the cliff, Affordable Choice may cost less than full-price ACA.

ACA is major medical with percentage cost-sharing, like 20% after your deductible. Affordable Choice pays a set benefit per event, such as a fixed amount per hospital day. ACA fits people who see doctors often or take prescriptions; Affordable Choice is cheaper monthly and fits healthy people who want predictable costs.

Yes. Losing job-based coverage opens a 60-day Special Enrollment Period, so you can sign up outside the usual window. ACA or Affordable Choice is usually cheaper than continuing your old plan through COBRA.

Yes. If 1099 work is your income and you cannot join a spouse's employer plan, you can deduct 100% of your health premiums on your tax return. That lowers what the coverage really costs you.

Term life is temporary, often 10, 20, or 30 years, with lower premiums and the most coverage per dollar. Whole life is permanent, with higher premiums but level rates and cash value that grows tax-deferred. Most families start with term and add whole life later if they need it.

A common rule of thumb is 5 to 10 times your yearly income, enough to cover your mortgage and debts, final costs, and several years of living expenses for the people who depend on you. An agent can help you size it to your situation.

Buy it while you are young and healthy, because rates only rise with age. If you are starting a family or carry debt, locking in term coverage early is the smart move. Many term policies also let you convert to permanent coverage later without a new medical exam.