As you approach your sixty-fifth birthday, you may be anticipating enrolling in Medicare, the predominant health care coverage for older Americans.

However, the nuances of Medicare and its affiliate programs can be confusing, making it difficult to know what to expect leading up to your time to enroll. Here are two main steps you can take to help prepare for what’s coming down the pike.

Know when to enroll

When you turn sixty-five, you will have a seven-month window for your initial enrollment period, which spans three months before your birth month, your birth month, and three months following it. If you miss this window, you can enroll during the general enrollment period from January 1 to March 31. However, this may incur late penalty fees, which you’ll have to pay as part of your premiums for the duration of your coverage.

There are two instances where you wouldn’t have to fret about signing up right away. First, if you begin receiving your social security benefits at least four months ahead of your sixty-fifth birthday, you will automatically be enrolled in Medicare, freeing you of the responsibility. Second, if you are still getting coverage through your employer or other means, you may be able delay getting Medicare depending on your circumstances. Once you lose that coverage, you will have eight months to enroll in Medicare to avoid penalties.

After you sign up, you won’t be able to make any changes until the next annual enrollment period, which runs from October 15 to December 7. During this time, you can change, drop, or add coverage based on how your needs have shifted.

Investigate and compare plans

Which plan is right for you will likely hinge on your existing medical needs, your preferred health-care providers, and your financial status. Before enrolling, compare each one thoroughly to ensure you comprehend the services they cover, their associated costs, and their billing procedures. It’s best not to wait until the last minute to decide which plan you want to help you avoid choosing one that may not align with your best interests.

Original Medicare
This program guarantees access to essential health care services and is widely accepted by the majority, or if not all doctors and hospitals throughout the United States. It is divided into two key parts: Part A and Part B. The first encompasses hospital expenses, while the second covers costs associated with doctor’s visits and various outpatient medical services. Original Medicare doesn’t cap your out-of-pocket (OOP) costs and lacks coverage for prescription drugs, so if you don’t have a stand-alone drug plan, you might want to enroll in Part D as well which you can run through a private insurer.

Medicare Advantage
Also known as Medicare Part C, this program provides an alternative to how you receive your benefits. On top of the same services Original Medicare covers, including doctor’s visits, hospital stays, and preventive care, Medicare Advantage may also cover long-term care as well as vision, dental, and hearing care, with some plans even some plans offering prescription drug coverage. The most common Part C plan types are a health maintenance organization (HMO), which requires you to use their network of providers (excluding for emergencies) and offers lower premiums; a preferred provider organization (PPO), a more flexible option that has higher premiums but allows you to go out-of-network if you wish; and private fee-for-service (PFFS), enabling you to seek medical services from any doctor and hospital but there is usually a higher premium associated with this option.

Medical Supplement Insurance (Medigap)
While Medicare Advantage is another way to receive your Medicare benefits, Medigap is strictly an optional supplemental policy that bridges the gap in your Original Medicare. The primary purpose of it is to reimburse you for OOP costs. Depending on your plan, it will cover all or a portion of your Medicare Part A and Part B copayments and deductibles. However, policies vary by state, and your place of residence determines your options. While Medigap can be invaluable for predicting and managing your OOP costs, it’s essential to be aware of some drawbacks: it can be expensive, it does not cover prescription drugs, and switching policies can be challenging once you’ve made a decision.

You can simplify the Medicare maze by understanding what each plan offers and weighing the benefits and drawbacks of each. Seek expert advice from a Medicare specialist, who can walk you through your options, answer your questions, and help ensure a smooth transition into this new chapter of your life.