If you’re about to apply for Medicare, congratulations—you’re entering a new phase of healthcare coverage. However, Medicare is not as straightforward as many assume. There are critical decisions to make that will impact your healthcare costs and coverage for years to come.

Applying for Medicare? Here Are the Top 5 Things You Need to Consider

Here are the top five things to consider when applying for Medicare.

1. Understand Your Enrollment Period

Timing is everything with Medicare. Your Initial Enrollment Period (IEP) starts three months before your 65th birthday and lasts for seven months. Missing this window could result in permanent late enrollment penalties, especially for Part B and Part D.

If you’re still working and covered by an employer plan, you may be able to delay Part B without penalty—but be sure to check the rules to avoid unexpected costs.

2. Choosing Between Original Medicare and Medicare Advantage

You have two primary options for Medicare coverage:

• Original Medicare (Parts A & B) – Covers hospital and medical expenses, but you’ll need a separate Part D plan for prescriptions and may want a Medigap policy for out-of-pocket costs.
• Medicare Advantage (Part C) – A private insurance alternative that often includes prescription drug coverage and additional benefits like dental and vision, but comes with network restrictions.

Understanding the differences is key to choosing the plan that fits your healthcare needs and budget.

3. Prescription Drug Coverage (Part D) Matters

Even if you don’t take medications now, enrolling in Part D when you’re first eligible can prevent future penalties. Drug plan formularies (covered medications) vary, so compare plans to ensure your prescriptions are covered at the lowest cost.

4. Medigap vs. Medicare Advantage: What’s Right for You?

If you go with Original Medicare, consider a Medigap (Supplement) policy to cover deductibles and co-pays. These plans provide more predictable healthcare costs but require an additional monthly premium.

Medicare Advantage plans often have lower upfront costs but come with provider network restrictions. The right choice depends on your health needs and travel habits.

5. Be Prepared for Out-of-Pocket Costs

Medicare is not free. Part B premiums, deductibles, and co-pays can add up. Budgeting for healthcare expenses—including possible long-term care—should be part of your retirement plan.

Final Thoughts

Medicare decisions can be complex, but making informed choices early on can save you thousands over time. Understanding your enrollment timeline, coverage options, and potential costs will help ensure you get the right coverage for your needs.