Medicare Enrollment – What You Need to Know

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Is your mailbox overflowing with materials from companies discussing Medicare enrollment, Medicare Advantage plans, and other pharmacy-related plans? All of these letters tell you that you must decide now! The amount of information is overwhelming—how will you possibly sort through it all and figure out what you need to do? 

The Financial Planners at Envision Financial Planning are here to help. We don’t sell Medicare supplements or Medicare Advantage Plans, but we have walked through this process with hundreds of clients over the years and thought some tips and insights from our experience might be helpful.


It depends! The Medicare initial enrollment period starts three months before your 65th birthday and extends for three months after your birthday. For example, if your birthday is March 15th, you can sign-up from December 1 through June 30th. If you’re already receiving Social Security benefits when you turn 65, you will automatically be enrolled in Medicare Part A & Part B.  

However, if you OR your spouse is currently working and is covered by an employer sponsored health plan covering 20 employees or more, you will likely want to enroll in Part A only. Part A covers care in a hospital, skilled nursing facility, and hospice. For most people, there is no charge for Part A.

The Medicare Special Enrollment Period applies if you’re currently covered by group insurance through an employer or a spouse’s employer with more than 20 employees. You may sign up for Medicare without penalty while you are covered by a group health plan or during the eight-month period that begins the month after your employment ends or the coverage ends, whichever comes first. Note that COBRA and retiree health plans are not considered “insurance based on current employment” and are not eligible for the special enrollment period when that coverage ends.


The process for enrolling in Medicare is surprisingly easy. But before enrolling, you will make a choice about how you want your Medicare delivered. Unlike with an employer health plan, you have MANY options to choose from.

It’s not a good idea to select a plan based on feedback from friends, neighbors, or family members without doing your own research. The best plan for you will depend on personal factors such as your current medications, your age, and whether you live part of the year in another state.


How Medicare is delivered:

The first step in selecting a Medicare plan is to understand the various coverage choices.

Medicare Part A. Also called hospital insurance, Medicare Part A covers care in a hospital, skilled nursing facility, and hospice. It provides limited coverage for nursing home and home health services.

Medicare Part B. Medicare Part B, which is optional, covers doctor visits, lab tests, outpatient surgeries, preventative care, and medically necessary services and equipment. Together, Medicare Part A and Part B are often referred to as traditional or original Medicare.

Medicare Part C. Commonly known as Medicare Advantage, Medicare Part C is offered by private insurance companies and health providers such as Blue Cross. Medicare Advantage plans must cover the same services provided by traditional Medicare and may cover other services such as prescription drugs, dental, hearing, and vision care. This alternative to traditional Medicare usually takes the form of a health maintenance organization (HMO) plan or a preferred provider organization (PPO) plan. With an HMO plan, you will select a primary care doctor. Except for emergencies, that doctor will refer you only to health providers within the HMO network. With a PPO, you have the option of getting care outside the network, but your copay will be higher than for visits to in-network providers.

Medicare Part D. Medicare Part D is a standalone plan that covers prescription drug costs. This coverage option is offered by private insurance companies and health providers.


Medigap, also called Medicare Supplement Insurance, is another type of optional coverage offered by private insurance companies. It is designed to pay some or all of your Medicare Part A and B coinsurance and deductibles.

The 10 available plan options are standardized according to federal and state regulations. For example, all Plan A Medigap plans cover the same things. All Plan G Medigap plans cover the same things. Premiums vary between carriers, so it pays to shop around. You cannot buy a Medigap plan if you enroll in a Medicare Advantage plan, because Medicare Advantage plans offer their own schedule of deductibles, coinsurance, and/or copays.


Medicare is not free. Most people do not pay a premium for Medicare Part A, but they are responsible for deductibles and coinsurance unless enrolled in a Medigap or Medicare Advantage plan. 

In addition, most people pay a Medicare Part B premium of $164.90 per month and an average of $40 per month for the Part D premium. Part B has an annual deductible of $226 in 2023. Those not currently collecting social security benefits or those with higher income levels may pay a higher rate for their Part B coverage. If you receive social security benefits, your Part B premium will be automatically deducted from your monthly benefit checks. If not, Medicare will bill you quarterly for your premiums.

The premium for Medicare Advantage (also known as Part C), which includes both Part A and Part B and Part D, depends on the plan. If you opt for a Medicare Advantage plan, you may pay an extra premium (on top of your Part B premium), although some providers may offer a zero-premium option.

Part D or prescription drug coverage will have a premium set by the insurance company. If your income is over a certain level, your premiums will be higher.

If your income is above certain levels, you may have to pay an Income-Related Monthly Adjustment amount (IRMAA) as part of your Part B and Part D prescription drug premiums. The IRMAA is based on your modified adjusted gross income from your tax return filed two years prior to the current year. If your income for the current year will be substantially lower, contact your local social security office or submit this form  to ask for an adjustment to your premium. Reducing your work hours, retiring, getting married or divorced, or losing a spouse may result in an adjustment in premiums.            

See below for more information on how premiums increase based on income.


It’s up to you to understand how the Medicare option you choose covers a test, treatment, or medical equipment. Keep in mind that traditional Medicare does not cover most hearing, dental, vision, or long-term care costs.

Every year between October 15 and December 7, you can elect to make changes to your Medicare coverage. The changes become effective on January 1 of the following year. If you don’t wish to make changes, you do not need to do anything during open enrollment. If you opt for a Medicare Advantage plan, your Medicare Advantage provider will send a letter in September of each year, outlining changes in premium and coverage for the upcoming plan year. This is a good time to ensure that the plan still meets your needs. We recommend shopping your Rx plan every year using the tool at

For more information about Medicare and your choices, download the easy-to-understand Medicare & You handbook from


If you’re a Tennessee resident and your employer sponsored health plan was through BlueCross, you may find the BlueCross Medicare Advantage Plans appealing. The network of doctors is generally similar to Network S plans. You can get more information on the plans available at

If you’re a Florida resident, you may want to explore Medicare Advantage as well. With a large number of retirees, doctors and hospitals compete heavily for patients. Please be sure to check that your primary care doctor, cardiologist and any other specialists are in the network. Also, our clients seem to prefer PPO networks rather than HMO’s due to greater flexibility.

United Healthcare, primarily through their relationship with AARP, is the largest provider of “Medigap” policies. If you’re an AARP member, definitely include them in your search. BlueCross is the second largest provider nationally and is a familiar name to many of our clients.

If you opt for traditional Medicare, your Medicare supplement provider and your prescription drug provider may be different. The “best” prescription drug provider for your situation will depend heavily on the medications you take (brand versus generic) and which pharmacy you prefer. We often see clients realize large savings by evaluating their Rx provider each year based on their current prescriptions. Additionally, a husband and wife may be better off with different providers. has a great tool that can provide information on the lowest cost provider based on your Rx history. We also have another blog post on how to shop your Rx plan!

If you travel quite a bit, traditional Medicare and a supplement may be your best option since you can see any doctor that accepts Medicare.


If your filing status and yearly income in 2021 was 
File Individual Tax ReturnFile joint tax returnFile married & separate tax returnPremium for each month (in 2023)Premium for each month (in 2023)Increase in Premiums
 For Part BFor Part D/Rx 
$97,000 or less$194,000 or less$97,000 or less$164.90your plan premium$0
above $97,000 up to $123,000above $194,000 up to $246,000not applicable$230.80$12.20 + your plan premium$78.10
above $123,000 up to $153,000above $246,000 up to $306,000not applicable$329.70$31.50 + your plan premium$196.30
above $153,000 up to $183,000above $306,000 up to $366,000not applicable$428.60$50.70 + your plan premium$314.40
above $183,000 and less than $500,000above $366,000 and less than $750,000above $97,000 and less than $403,000$527.50$70.00 + your plan premium$432.60
$500,000 or above$750,000 and above$403,000 and above$560.50$76.40 + your plan premium$472.00

Please keep in mind that these monthly premiums are per person. So a couple will pay double the amounts shown here.

Let us know if you have any additional questions.

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Our approach is to discover a client’s goals, determine the personal financial plan that is needed, and aid the client in reaching those goals. Our success is measured by how well our clients achieve their goals.
Hank has had a distinguished career in the financial services industry, including more than 40 years in the financial planning and securities fields. From 1985 to 2013, Hank provided fee-only financial planning services through his firm, Lifetime Planning, Inc. Hank merged his practice with Stacey’s in 2014. In addition, Hank is a member of both the local and the national chapters of the Financial Planning Association (FPA).
Hank received his bachelor’s degree in business administration from the University of Mississippi, where he also lettered in football. He received his initial securities training at Merrill Lynch. He was a financial planning consultant for the Memphis office of Ernst & Young and financial planner at Morgan Keegan & Company, Inc. from 1982 through 1984. In April 1984, Hank completed his CERTIFIED FINANCIAL PLANNER™ professional requirements with the College for Financial Planning in Denver, Colorado.
In addition to his financial planning practice, Hank has enjoyed serving on the boards of Presbyterian Day School, Second Presbyterian Church, University of Mississippi, and the Christian Community Foundation. Hank served as the chief financial officer of the Christian Community Foundation from its inception in October 1998 until October 2000. Hank enjoys reading, hunting, and attending baseball and college football games.
Clay serves Envision Financial Planning’s clients as the investment officer and portfolio manager. His duties include overseeing the firm’s investment process and money management strategies with a strong focus on “goals-based” investment planning.
As a firm, we believe in concentrating on things we can control such as:
Clay is a native Memphian and a graduate of the University of Mississippi. He began his career working for a regional broker/dealer specializing in fixed-income securities, and prior to joining Envision, Clay was an investment research analyst and portfolio manager for a private wealth management firm in Memphis. Clay currently holds his FINRA Series 66 securities registration and obtained his CERTIFIED FINANCIAL PLANNER™ designation in 2021.
In his free time, Clay enjoys playing golf, exercising, reading, and cooking with friends and family. He and his wife, Margot, have two boys named Callan and Wiley.