Medicare Open Enrollment period starts on October 15th. Making the correct choices when you initially sign up for Medicare – and every year when you must review your drug coverage – could save you a fortune. Or cost you a fortune, if you make a mistake. Thus, MedicareBeware!

Medicare is not a one-time event where you sign up and forget it. Portions of Medicare require annual review and potential changes in coverage – if you move to another state, or if you find you cannot afford the premiums of the plan you initially chose. Miss a deadline and you could find yourself without coverage or paying too much.

Medicare is not even a one-time age-65 event. You may delay applying for Medicare if you have comparable coverage from work, or from your spouse’s job – assuming that the employer’s insurance does not require you to sign up at age 65. In fact, you shouldn’t even sign up for the free Part A if your employer plan includes a health savings account.

The Complexity of Medicare
Medicare is complex. Traditional Medicare is a combination of Parts A (hospitalization) and B (physicians and testing) and a Supplement (to cover things like co-pays and the portion of care that Medicare doesn’t cover), and a Part D Drug plan (required even if you don’t currently take prescription medicines)!

Choosing a supplement is easy. You cannot be turned down for the best, most comprehensive (and most expensive) plan – currently plan G – if you sign up within 6 months of signing up for original Medicare – even if you already have health issues. But after that initial period, you are not guaranteed the most comprehensive supplement. Once you have that comprehensive supplement, you’ll want to keep it – unless you simply can’t afford it.

Choosing a Part D Drug plan is easy – and a “must” — even if you currently don’t take meds. (If you don’t sign up immediately upon applying for Medicare you’ll face a significant monthly penalty later when you will want drug coverage and the payment cap) BUT, you must review your Part D plan every year during open enrollment. That’s because the plans change the drugs they cover, and the copays, as well as the monthly premium.

One saving grace is the fact that your out -of -pocket cost can never be more than $2100 (in 2026) – even if you take expensive drugs. You might have to pay that amount in the first month or two, but nothing after that. (See detailed Part D column in this series.)

The Allure of Advantage
Dealing with all those moving parts is one reason more than half of America’s seniors have turned to Medicare Advantage all-in-one plans, which have been widely publicized. Late night TV commercials entice signups with promises of dental and vision care in Advantage plans, and lower premiums.

But as the government squeezes reimbursements to the plans, the plans (mostly for-profit insurance companies) must limit care to report profits. And you’re the one caught in the squeeze!

For years I have been warning that Advantage plans are a form of “managed care” – requiring permission for testing, and limiting access to physicians and hospitals that are part of the group. Now, many healthcare providers and hospitals are dropping out of Advantage plans, because of the paperwork nightmare and the limited reimbursement. Patients must choose from those remaining.

Most people don’t find out about the limitations of Advantage plans until it is too late! They have a serious illness and can’t get the care they want and need. At this point, they want to switch back to Traditional Medicare – something that can only be done during open enrollment.

BUT, THERE IS ONE BIG DRAWBACK! Once you have a serious illness you will not be eligible for the complete coverage of the best supplements, even if you switch back to Traditional Medicare. You may only qualify for a lesser supplement that leaves you more exposed to costs. Still, on original Medicare you’ll have choice of providers.

Getting Trusted Advice
You can easily sign up for Medicare online at SSA.gov – including Medicare Parts A and B. Then use as the Medicare.gov search engine for your Medigap Supplement and your Part D drug plan. At Medicare.gov you can even compare Advantage plans and coverage.

But if you don’t understand the pitfalls described in this column, the Medicare.gov search engine won’t help you avoid expensive mistakes in basic choices. It assumes you know what coverage you want – and just need help in choosing one policy over another.

If you’re seeking personalized help, you should be careful to get if from knowledgeable, licensed individuals – likely not your homeowner’s or auto insurance agent. And certainly not from an Advantage salesperson who earns a larger commission for selling those plans than traditional supplements.

Here are a few online resources you can trust: eHealth.com and BoomerBenefits.com. You can also turn to your State Health Insurance Assistance Program. Find specific advice from trained volunteers for your state through ShipHelp.org.

And if you want personalized, ongoing guidance from a true expert, go to www.65-Incorporated.com, where Medicare expert Diane Omdahl provides her expertise for a fee. Importantly, 65-Incorporated does not sell any Medicare products or policies, nor do they receive any fees for referrals.

It’s worth the time to investigate your choices, not only because so much money is involved, but because the consequences of making a bad choice will have such a big impact on your care. And that’s The Savage Truth.