October marks an important time of year for anyone navigating Medicare—the annual open enrollment period (October 15–December 7). During this window, you can review your coverage, make changes to your Medicare Advantage or Prescription Drug plan, and ensure your healthcare fits your current needs.
At Grunden Financial Advisory, Inc., we know that Medicare decisions can feel overwhelming, especially if you’re approaching age 65 or helping a loved one enroll for the first time. That’s why we recently hosted a webinar, featuring Paul Terrell of Terrell Insurance Services, to walk through what Medicare covers, what it costs, and how to choose the right supplemental coverage.
In case you missed the session, we’ve linked the full recording here. Below are some highlights from the webinar, as well as steps you can take to make the most of open enrollment.
Medicare Overview: A Brief History
Medicare was signed into law in 1965 and began operation in 1966, providing a vital safety net for older Americans and certain individuals with disabilities. But despite being a federal program, Medicare doesn’t cover 100% of medical costs. You’re responsible for deductibles, copays, and coinsurance, and there’s no cap on out-of-pocket expenses under Original Medicare (Parts A and B). That’s why understanding your coverage options and supplementing wisely is so important.
Breaking Down the Parts of Medicare
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Part A – Hospital Insurance
Part A covers inpatient hospital stays, skilled nursing facility care, hospice, and some home health services. Most people pay $0 per month for Part A if they or their spouse paid Medicare taxes while working.
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Part B – Medical Insurance
Part B covers outpatient care, doctor visits, lab tests, and preventive services. In 2025, most people will pay about $185 per month, though higher-income earners (over $106,000 for individuals or $212,000 for couples) will pay more under the Income-Related Monthly Adjustment Amount (IRMAA). If you already receive Social Security benefits, your premium is automatically deducted from your check; if not, you’ll pay by mail or bank draft.
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Part C – Medicare Advantage
Introduced in 1997, Medicare Advantage plans (Part C) combine hospital, medical, and often prescription coverage under one plan managed by private insurers. We’ll explore Medicare Advantage in greater detail below, alongside Medicare Supplement (Medigap) plans.
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Part D – Prescription Drug Coverage
Launched in 2006, Part D helps cover prescription medications. IRMAA may also apply here for higher-income beneficiaries.
Medicare Supplement vs. Medicare Advantage: Understanding Your Options
For many new enrollees, the most confusing part of Medicare is choosing between a Medicare Supplement plan (also called Medigap) and a Medicare Advantage plan (Part C). Both help manage expenses that Original Medicare doesn’t fully cover, but they do so in very different ways.
Think of a Medicare Supplement plan as “paying up front” for peace of mind. You’ll pay a higher monthly premium, usually between $100 and $200, depending on your plan, but you’ll have minimal out-of-pocket costs when you receive care. For example, under Plan G, you pay only the Part B annual deductible ($257 in 2025), and afterward, Medicare and your supplement handle the rest for covered services like hospital stays or surgeries.
Another advantage of Medigap is flexibility: you can see any doctor in the United States who accepts Medicare, no networks or referrals required. For frequent travelers or those with specialists across multiple states, that freedom can be invaluable.
The tradeoff, however, is cost and maintenance. Premiums increase over time, and prescription coverage isn’t included—you’ll need to purchase a separate Part D plan, which can cost around $100 per month. If you want to switch supplement providers later, you may need to answer health questions, and approval isn’t guaranteed.
By contrast, Medicare Advantage operates more like traditional insurance, meaning you “pay as you go.” Many plans have no monthly premium, and they include built-in prescription coverage. Advantage plans often come with extra perks such as dental, vision, hearing, and even fitness memberships at no additional cost.
However, these plans typically require you to use a network of doctors and hospitals (either an HMO or PPO), and you’ll pay copays for most non-preventive services. While most Advantage plans have an annual out-of-pocket maximum, it can exceed $6,000, meaning your costs can add up if you need frequent care. Referrals to see specialists are also common, and not every doctor accepts Medicare Advantage plans.
Ultimately, the choice depends on your priorities. If you value flexibility and predictable costs, a Medicare Supplement plan might be worth the higher premium. If you prefer lower upfront expenses and are comfortable using a provider network, a Medicare Advantage plan could make more sense. Both options have strengths but what matters most is how they align with your health needs, travel habits, and budget.
Why Open Enrollment Matters
Medicare’s annual open enrollment period, from October 15 to December 7, is your chance to make sure your coverage still fits your needs. Whether you’re switching from Original Medicare to a Medicare Advantage plan, joining or changing a Part D prescription plan, or simply reviewing your current coverage, this period is critical. Even if you’re happy with your plan, benefits, provider networks, and costs can change each year, so a quick review can help prevent surprises down the road.
To make the most of open enrollment, start by reviewing what you spent last year on premiums, prescriptions, and out-of-pocket costs. Compare available plans using Medicare’s Plan Finder or a trusted advisor, especially if your health or medications have changed. Check that your preferred doctors and hospitals are in-network if you’re considering a Medicare Advantage plan, and think about your lifestyle. Finally, don’t wait until the last minute: enrollment closes December 7, with changes taking effect January 1, 2026, so give yourself time to make thoughtful choices.
The Bottom Line
Preparing for Medicare isn’t just about understanding what’s covered but ensuring your healthcare choices fit your lifestyle, financial goals, and peace of mind. The right coverage can help protect both your health and your savings.
And with the right guidance, it doesn’t have to feel overcomplicated. At Grunden Financial Advisory, Inc., we’re here to help you align your healthcare coverage with your overall retirement plan so you can move into this next chapter with confidence.
Watch our webinar here to learn more before open enrollment ends on December 7.
