Resources to Help You With Medicare

Surveys show that most seniors do not know where to begin with Medicare when they become eligible. A wrong move with your Medicare could easily wipeout  your savings or retirement nest egg. To complicate things even more, the system is always changing. Pathway Health Insurance Experts has been helping people with their Medicare coverage for more than 30 years. We work hard to stay on top of Medicare rules and regulations, and all the various plan options available. Simply put, we go the extra mile to pass that knowledge on to you, so you can make wise decisions about your Medicare benefits and protect the future of your health and finances. The following resources and guide are provided to help you get started on your Medicare Journey.


A Guide for Navigating the Medicare System Wisely (and Timely)

Enrolling in Medicare at the right time is important when it comes to avoiding costly mistakes. If you delay or miss your opportunity to enroll in Medicare when you first become eligible, you could incur late enrollment penalties and gaps in coverage.  Equally important is selecting the right Medicare option for your healthcare needs and budget. Selecting the wrong plan could wipe out your life savings with just one major illness or hospital visit. Review our easy-to-follow guide below to get started on your Medicare Journey.


Step # 1

Before selecting a plan, estimate your costs. Review your overall healthcare costs, including regular visits, specialists you see, prescription drug costs and any procedures you know you will need.

Step # 3

Understanding your Medicare options can save you! Selecting the wrong Medicare option can cost you dearly. If you miss certain enrollment deadlines, you can also incur costly penalties. Visit our Medicare basics page to get started.

Step # 2

Check your plan’s providers. Make sure the plan you choose accepts Medicare and that your doctors are part of any preferred network to avoid extra costs and surprise fees.

Step # 4

Consult with a Professional for FREE. We’ll do the work for you, at no cost or obligation to you. We help you assess your healthcare needs and find the Medicare option that provides the benefits you need at a price you can afford.

Step # 5 – Enroll in Medicare

When you are turning 65, you will need to enroll in Medicare, it is not automatic.

You need to enroll in original Medicare (Parts A & B) before you can buy a Medicare Advantage or Supplement plan. To enroll, you will provide proof of your eligibility. This can be a birth certificate, proof citizenship, W-2 or tax forms, and or military records.

Initial Enrollment Period: 7 months, which starts 3 months before your 65th birthday, and includes your birthday month, and ends 3 months after your 65th birthday.

See more on how, when and where to apply in the FAQs section below.

Frequently Asked Questions About Medicare

Is Medicare Free?

Most people get Part A for free, which is Hospital Coverage. Most people will pay a standard Part B premium for Medical coverage which varies depending on income. Additionally, you will pay a separate premium for Part D, prescription drug coverage. See our page on Medicare Premiums for more info.

I'm turning 65 soon, when do I sign up for Medicare?

The initial enrollment period for those aging into Medicare is 7 months, which starts 3 months before your 65th birthday, and includes your birthday month, and ends 3 months after your 65th birthday.

Where do I sign up for Medicare?

You can apply online or call your local Social Security office. You’ll enroll, create your Medicare account, track your Medicare information such as bills, claims, health information and more, as well as print your Medicare card.

Click here to apply online at Social Security.

What documentation do I need to sign up for Medicare?

To enroll, you will be required to provide proof of your eligibility. Some acceptable documents are birth certificate, proof citizenship if not born in the US, W-2 or tax forms, and or military records.

I am 65, but I'm still covered under my employer's plan, do I have to sign up for Medicare?

You can continue to receive employer benefits and delay enrollment. If you are still receiving work benefits, you still have the option of enrolling in Medicare Part A during your initial enrollment age, if you decide it is wise for your specific healthcare needs. Remember, for most people the Part A premium is free. Also, keep in mind that Medicare is not automatic (as discussed above) so you will need to enroll yourself when your enrollment period begins.

It’s important to note that you can only delay enrolling in Part B and Part D without incurring late enrollment penalties if you have creditable coverage from your employer, or your spouses employer. There are many things to consider and you should talk to a professional to make sure you are making the right moves.

Can my spouse and I be on the same Medicare plan?

No, Medicare is an individual plan. Medicare does not have spousal or dependent coverage. If your spouse has reached age eligibility (65), then they can enroll in Medicare of their own accord 90 days in advance of the month they turn 65.

Does Medicare cover all of my healthcare costs?

Original Medicare does not. There are copays, coinsurance, and deductibles. You may get more of your costs covered with an Advantage Plan, which may or may not have additional benefits such as vision, dental and hearing. OR, you can purchase a separate Medigap policy to fill in the gaps of your Original Medicare. For more info, visit our Medicare Premiums page or view our Medicare Options Compared chart.

When can I buy a Medicare Advantage Plan or Medicare Supplement?

Both of these Medicare options are sold by private carriers.  You do, however, have to be already enrolled in Original Medicare before you can buy or switch to these options.

Once enrolled, you must act during annual open enrollment if you need to switch to Medicare Advantage or change your existing Advantage plan.

For Medicare Supplements – note you have a once in a lifetime window that begins the month you become eligible for Medicare and allows you to enroll in any Medigap plan without answering health questions, meaning you won’t be denied coverage or pay higher premiums for health problems.  After this window closes, if you wish to buy a Supplement plan, you can do so at any time of the year, but you’ll most likely have to go through medical underwriting.

How do I get a Part D Plan (Prescriptions)?

Prescription drug coverage is Part D of Medicare and is offered by private carriers who contract with Medicare. Even if you do not take medications routinely, you should enroll in a plan as soon as you are eligible to avoid penalty surcharges. Because premiums vary greatly, you should carefully weigh your prescription costs against all variables of these plans. Selecting the wrong plan can wind up costing you thousands.  Some Medicare Advantage plans may offer prescription coverage as well.

Is dental, vision, hearing or any other ancillary benefits included with my Medicare coverage?

Typically, Medicare does not cover these costs unless they are related to services received in a hospital. Medicare does however cover some eye care services for diabetics, such as testing and treatment for diabetic retinopathy, or glaucoma. It also covers other eye disease, such as age-related macular degeneration (AMD). The only way to have most of these types of services paid for by Medicare is through a Medicare Advantage plan.