Medicare Decision Worksheet

1

Your situation right now

When do you become eligible for Medicare?

Turning 65 soon Already 65 or older Under 65, due to disability

Are you still covered by employer health insurance?

Yes — my own employer Yes — spouse's employer No

If yes, confirm whether your employer coverage is "creditable" before dropping Part B or D.

Are you still within your 6-month Medigap open-enrollment window?

Your Part B effective date is on your Medicare card. The window opens that day.

Yes No / window closed Not sure

Do you travel often or spend time in more than one state?

Advantage plans are mostly local. Supplement plans work nationwide.

Yes No

2

How you think about cost

There is no universally cheaper option. The comparison depends on how much care you use.

Which matters more to you right now?

Lower monthly premium Predictable total cost when I need care Not sure yet

In a serious-illness year — which matters more?

A hard cap on what I'd pay A lower premium even if exposure is higher I want to understand both first

Roughly, your monthly retirement income:

Higher earners pay an income-related adjustment (IRMAA). It affects both paths.

3

What you've been told

Use this to flag claims from sales presentations that deserve independent verification.

Was any of this emphasized in a sales presentation?

$0 monthly premium Extra benefits (dental, vision, gym, OTC card) A cap on out-of-pocket costs "One card covers everything" A deadline or limited-time offer A large or local provider network

Notes on what you were told (write it down while it's fresh):

4

Your questions before you decide

Write down what you still need to know. Bring this list to your next conversation.

Questions for your broker or SHIP counselor

Questions for Fern

Things to verify independently (at Medicare.gov or with your doctor's office)

5

Before you sign: the 5-step check

You're entitled to have every one of these answered. Tick each before you commit to anything — calmly, on your own timeline.

1 · Understand who's helping you

Are they an independent broker (all plans) or captive (one company)? Did you check with your free state counselor (SHIP) first?

2 · Confirm your doctors

Called each doctor's office to confirm they take the exact plan? Checked your hospital and urgent care are in-network?

3 · Check your prescriptions

Entered your drugs at Medicare.gov to see their tier? Checked for prior authorization or step therapy?

4 · Run the worst-case math

Found the plan's Maximum Out-of-Pocket (MOOP)? Compared [Advantage + MOOP] vs. [Medigap Plan G + Part B deductible]?

5 · Know your state's rules

Looked up your state on Medicare by State? Understand whether you can switch to Medigap later without underwriting?

Browse by topic