5 Things to Consider When Enrolling in Medicare
Published in
All Insurance Industry Insights on Thursday, August 7, 2025 by Nathan Link
As individuals approach age 65, or qualify earlier due to a disability, understanding the health care options becomes progressively significant. Medicare, the federal health insurance program, offers various types of coverage designed to meet a wide range of individual needs.
Whether you are enrolling for yourself or helping another individual, there are five important takeaways to consider when planning for Medicare.
Eligibility and Enrollment Periods
Commonly, most become eligible for Medicare starting at age 65, though others qualify earlier due to certain health conditions or disabilities. It is crucial to understand the initial enrollment period (which begins three months before the month you turn 65 and continues for three months after). Coverage then begins the month after signing up. Missing this seven-month window could lead to late penalties and delays in coverage. It is crucial to familiarize yourself with Medicare enrollment timelines to avoid gaps in coverage when life changing events occur.
Understand Your Options: Original Medicare and Medicare Advantage
Medicare offers two primary paths for coverage. When selecting a plan, it is important to review the differences in costs, provider networks, and benefits to determine which plan fits your health care needs best.
Original Medicare includes Part A for hospital insurance and Part B for medical insurance, covering services like hospital stays, doctor visits, and outpatient care. Alternatively, Medicare Advantage, also known as Part C, is offered through private insurers and includes all the benefits of Part A and B. Many plans also offer additional benefits like prescription drug coverage, dental, vision, and wellness programs.
Prescription Drug Coverage
Medicare Part D helps cover the cost of prescription drugs. Even if you’re not currently taking medication, it’s often advised to still enroll when first eligible. Delaying enrollment can result in permanent late enrollment penalties.
Supplemental Coverage Options
Original Medicare does not cover everything. You may face deductibles, copayments, or services that are not included. Medigap policies, sold by private insurers, help address these gaps and help pay some of those costs and offer additional financial protection. Each Medigap plan is standardized but may vary in premium and availability.
Annual Coverage Changes
Medicare plans and pricing can change annually. During the Annual Enrollment Period, which runs from October 15 to December 7, you can switch plans, update your prescription drug coverage, or adjust your Medigap policy.
Reviewing your coverage regularly ensures access to the most appropriate and cost savings option.
Making Confident Medicare Decisions
Enrolling in Medicare is a big milestone, and we’re here to help make the process clear and comfortable. At PDCM, we genuinely care about helping you understand your options so you can feel confident in your coverage. If you have questions or just want someone to walk through it with you, reach out to Nathan. Contact Nathan at 319-296-7036 or at nlink@pdcm.com
Written by
Nathan Link