Getting Ready to Turn 65? Know Your Medicare Options!

Serving Florida Businesses and Residents throughout
Fort Myers, Tampa, Lakeland, Sarasota, and all of West, Central, and Southwest Florida

Choosing Medicare Coverage Can Be Daunting – We’re Here to Help

If you’re about to turn or have recently turned 65, you’re eligible for Medicare! The licensed agents at Bay Insurance understand the complexities and challenges that come with choosing health coverage, and we’re ready to guide you through the process to find the perfect Medicare plan for your unique needs.

Understand Your Medicare Options

From Original Medicare to Medicare Advantage Plans to Medicare Supplements (Medigap/MedSupp), the licensed insurance agents at Bay will answer all your questions and help you find the plan that works for you.

Part A – Hospital Insurance:

Covers hospital stays, hospice care, skilled nursing facility care, and some home care.

Part B – Medical Insurance:

Covers medical supplies, outpatient care, some doctors’ services, and preventive services.

Part C – Medicare Advantage:

Combines Parts A and B, plus vision, dental, and hearing, and may include Part D prescription drug coverage.

Part D – Prescription Drug:

Covers prescription drugs and many recommended shots and vaccines.

Medicare Supplement – Medigap:

Helps pay for some costs not covered by Parts A and B.

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Medicare Supplement vs Medicare Advantage

Medicare Part C, or Medicare Advantage, is often structured as a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO). Here are some of the key differences between these two options:

	Medicare Supplement (Medigap)	Medicare Advantage (Part C)
How it works	Works with Original Medicare	Replaces Original Medicare
Monthly cost	Higher premium	Lower (sometimes $0)
Doctor access	Any doctor nationwide	Network-based (HMO/PPO)
Out-of-pocket costs	Very low & predictable	Pay as you go (copays, coinsurance)
Max out-of-pocket	No cap, but minimal costs	Annual cap for protection
Referrals	Not required	May be required (HMO)
Travel flexibility	Excellent (nationwide)	Limited to local network
Prescription drugs	Separate plan needed	Usually included
Extra benefits	None	Dental, vision, hearing & more

Simple way to think about it:

• Supplement = More freedom, fewer surprises
• Advantage = Lower cost, more structure

HMO vs. PPO
(Medicare Advantage Plans)

	HMO Plan	PPO Plan
Monthly cost	Lower	Slightly higher
Primary doctor required	Yes	No
Referrals needed	Yes	No
Stay in network?	Yes (except emergencies)	Not required
Out-of-network coverage	Not covered	Covered (higher cost)
Flexibility	Lower	Higher

Simple way to think about it:

• HMO = Save money, stay in network
• PPO = Pay more, get flexibility

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Turning 65 Medicare FAQs

What’s my initial enrollment period?

Medicare enrollment is a 7-month window, from 3 months before the month you turn 65, through your birth month, and the following 3 months. If your birthday is in July, your enrollment window will be from April to October.

Can I keep my Primary Care Physician when I enroll in Medicare?

With Medicare Supplement: Yes, you can always keep your doctor.

With Medicare Advantage: It depends—sometimes yes, sometimes no, depending on the plan’s network.

Do I Have to Sign Up for Medicare When I Turn 65?

Not always. If you’re still working and have qualifying coverage through your employer or your spouse’s employer, you can delay enrollment without penalty.

What Happens if I Miss My Initial Enrollment Period?

If you miss your initial window, you’ll have to wait for the General Enrollment Period of January 1-March 31, and coverage won’t start until July 1. Missing your period can also lead to late enrollment penalties and increased monthly premiums.

Can I Change My Medicare Plan Later On?

Yes! You can change your plan during the Annual Enrollment Period, which is October 15-December 7 each year.
If you make any changes to your coverage during this period, they will go into effect on January 1.

What if I’m unsure about my eligibility?

We encourage you to visit medicare.gov to learn more about eligibility.

Are there advantages to opting into Medicare Supplement/Medigap?

Yes! There are several advantages to opting into Medicare Supplement when turning 65, including guaranteed acceptance, lower out-of-pocket costs, and more flexibility. Additionally, Florida Blue’s Same Age Forever2 program locks in your rate at age 65 forever, so your premium will never go up due to age.

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Getting Ready to Turn 65? Know Your Medicare Options!

Apply 3 Months Before & After
Your Birthday

Keep Your Doctor & Hospital

We’ll Guide You Through Every Step