What happens when Medicare coverage begins

Hi Toni: In September I retired at 70 and my Medicare Part B begins December 1. I will no longer have employer health insurance but one option I have is COBRA. I do have health issues, which is why I retired. My cardiologist informed me last week that the only thing that will improve my health is having heart surgery.

I would like to know what Medicare's health network is so I can make sure that all of my doctors are in it. I'm confused about which Medicare option to enroll in and cannot lose my cardiologist.

Should I enroll in Medicare's network with a Medicare supplement, go with a Medicare Advantage network plan, or stay with my current COBRA plan until it ends in about 18 months? I read your article last week about how insurance companies are terminating Medicare Advantage plans nationwide and I do not want to be caught in this situation. Toni, I need your guidance.

Kellie, Dallas

Kellie: Since you are retired and are enrolled in Medicare with your Medicare Part B beginning Dec. 1, I have good news for you! There is NO network of hospitals, doctors, or any other medical providers for Original Medicare. I repeat ... there is no network. You will be completely in charge of your Medicare.

Kellie, you do not have to worry about finding a network provider because almost all providers accept Medicare and it's available nationwide. Your Medicare adventure is beginning Dec. 1 and your concern about your health issues will be taken care of because you will be in your Medicare Supplement/Medigap Open Enrollment Period and guess what? You can enroll in a Medicare Supplement without having to answer one underwriting question for the next six months.

The best time for someone to purchase a Medicare Supplement is during the Medicare Supplement/Medigap Open Enrollment Period which is the six-month time period beginning the first day of the month in which you have just enrolled in Medicare Part B for the first time, like you have done retiring at 70.

This special six-month enrollment time is also for those who turn 65, like I did five years ago, when I enrolled in Medicare Parts A and B with a Medicare Supplement Plan G with a stand-alone Medicare Part D plan. My plans began May 1.

My advice to you, Kellie, would be to NOT enroll in the COBRA plan because after you are enrolled in Medicare for six months, then you are out of the Medicare Supplement/Medigap Open Enrollment Period and will have to answer health questions.

You mentioned the termination of some Medicare Advantage plans effective Dec. 31. On Oct. 2, the termination letter was mailed explaining the special federal right to buy a Medicare Supplement without medical underwriting and receive a Medigap Guarantee Issued policy with a Special Enrollment Period of Dec. 8, 2026, to Feb. 28, 2027. After this time period, medical underwriting will be required to qualify.

Medicare's Open Enrollment Period was designed for anyone who wants to change their Medicare Advantage or Part D plan or leave Original Medicare and enroll in a MAPD plan.

So Kellie, if you decide that you want to change from Medicare with a Supplement to an MAPD plan, then Oct. 15 to Dec. 7 is your special time to make the change.

Remember...with Medicare, what you don't know will hurt you!

Toni King is an author and columnist on Medicare, Social Security, and long-term care issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.

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