First-Time Medicare? Here’s What You Need to Know
Turning 65 or getting Medicare for the first time can feel overwhelming—but it doesn’t have to be. Whether you live in Phoenix, Gilbert, Chandler, Mesa, Queen Creek, or anywhere in Arizona, this FAQ will walk you through the essential things to know so you can make confident decisions about your coverage.
1. When do I first become eligible for Medicare?
Most people become eligible for Medicare at age 65. Your Initial Enrollment Period (IEP) starts 3 months before your 65th birthday, includes the month you turn 65, and ends 3 months after.
Total of 7 months to enroll without penalty.
2. Do I get Medicare automatically?
It depends:
If you’re already receiving Social Security benefits, you are usually enrolled automatically in Part A and Part B.
If you are not receiving Social Security yet, you’ll need to sign up manually through the Social Security Administration (online, by phone, or in person).
3. What are the different parts of Medicare?
Medicare has four main parts:
Part A: Hospital insurance (inpatient care)
Part B: Medical insurance (doctor visits, outpatient care)
Part C: Medicare Advantage plans offered by private companies that combine Parts A and B and often include extra benefits
Part D: Prescription drug coverage
4. Do I have to pay for Medicare?
Part A is usually free if you or your spouse worked 10+ years.
Part B has a monthly premium.
Part C (Medicare Advantage) and Part D vary in cost based on the plan.
You are also responsible for deductibles, copays, and coinsurance.
5. What’s the difference between Original Medicare and Medicare Advantage?
Original Medicare (Part A and Part B):
Use any doctor that accepts Medicare
Does not include prescription coverage (you’ll need Part D)
You can add a Medigap (Supplement) plan to help cover out-of-pocket costs
Medicare Advantage (Part C):
All-in-one plan from private insurance companies
Usually includes drug coverage
May include dental, vision, hearing, and other extras
Must use network providers (HMO or PPO plans)
Which one is best depends on your health needs, budget, and doctor preferences.
6. Do I need a Part D prescription plan if I don’t take any medications?
Yes. If you delay enrolling and do not have other creditable drug coverage, you could face a late enrollment penalty later. Choosing a low-cost Part D plan now can help you avoid paying more in the future.
7. What is a Medicare Supplement (Medigap) plan?
A Medigap plan is separate insurance that works with Original Medicare. It helps pay for costs that Medicare doesn’t cover, such as deductibles, copayments, and coinsurance. Medigap plans do not include prescription coverage, so most people also add Part D.
8. When is the best time to get a Medigap plan?
The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This lasts 6 months and starts the month you are both 65 or older and enrolled in Part B. During this window, you cannot be denied or charged more because of your health.
9. What if I’m still working at 65 and have employer insurance?
You may be able to delay Part B without penalty if your employer coverage is considered “creditable.”
However, not all employer plans qualify. It’s important to talk to a professional before delaying Medicare so you don’t risk penalties or gaps in coverage.
10. What happens if I miss my Initial Enrollment Period?
You may have to:
Pay lifetime late penalties
Wait until the General Enrollment Period (January 1–March 31)
Have a delay in coverage starting
It’s best to explore your options before your 65th birthday to avoid issues.
11. When can I change my Medicare plan later?
Annual Enrollment Period (October 15–December 7): Change Medicare Advantage or Part D plans
Medicare Advantage Open Enrollment (January 1–March 31): Switch Advantage plans or go back to Original Medicare
Special Enrollment Periods: Available if you move, lose coverage, or have other qualifying events
12. Is dental, vision, or hearing covered by Medicare?
Original Medicare does not cover routine dental, vision, or hearing services. You can get these through some Medicare Advantage plans or through stand-alone dental and vision insurance.
13. How do I choose the right Medicare plan?
Consider:
Your current doctors
Prescription medications
Your health conditions
Your budget
Whether you travel or stay local
A licensed agent can help compare all your options and explain them in plain language so you feel confident in your choice.
14. Can someone help me enroll for free?
Yes. Working with a licensed, independent agent does not cost you anything. Agents like me can compare plans, check your doctors and prescriptions, explain benefits, and handle enrollment for you at no extra cost.
Final Tip: Don’t wait until your birthday month.
Most Medicare mistakes happen because people wait too long to start. Start exploring your options early, ask questions, and get guidance before making any decisions. Medicare is an important step, and the right plan can make a big difference.
Need one-on-one help?
I’ve helped many people in Phoenix and the East Valley enroll in Medicare for the first time with confidence and peace of mind. I’d be happy to walk you through the process step-by-step.
Call Daisy Nadolski for a no-cost Medicare review.
Serving Phoenix, Gilbert, Chandler, Mesa, Queen Creek, Scottsdale, and surrounding areas.
