If you’re planning a trip — whether it’s across the country or across the globe — it’s important to understand how your Medicare coverage works when you’re away from home. Medicare offers excellent benefits for U.S. residents, but those benefits can vary depending on where you travel and what kind of plan you have.

This guide breaks down what’s covered, what’s not, and how to stay protected while traveling.

Medicare Coverage While Traveling Within the United States

When you travel within the U.S. and its territories, you can typically use your Medicare coverage without any issues.

Where You’re Covered

Medicare coverage applies anywhere in:

• All 50 states

• The District of Columbia

• Puerto Rico

• Guam

• The U.S. Virgin Islands

• American Samoa

• The Northern Mariana Islands

As long as your healthcare provider accepts Medicare, your coverage works the same as it does at home.

Original Medicare (Parts A & B)

If you have Original Medicare, you can visit any doctor or hospital that accepts Medicare nationwide — no referrals or network restrictions required.

This is especially convenient for retirees who travel frequently or live part-time in another state.

Medicare Advantage (Part C)

If you have a Medicare Advantage plan, coverage can depend on your provider network.

• HMO plans often limit coverage to in-network providers, except in emergencies.

• PPO plans usually allow out-of-network care at a higher cost.

Before you travel, check your plan’s policy for out-of-area coverage to avoid unexpected bills.

Medicare Coverage While Traveling Outside the United States

Medicare coverage outside the U.S. is very limited.
In most cases, Medicare does not pay for medical care you receive abroad, but there are a few exceptions.

Limited Exceptions

Medicare may cover care outside the U.S. only if:

1. You’re in the U.S. when a medical emergency occurs, and the nearest hospital that can treat you is in a foreign country (e.g., you’re in Canada near the border).

2. You’re traveling between Alaska and another U.S. state, and a foreign hospital is closer than the nearest U.S. hospital.

3. You live in the U.S. and a foreign hospital is closer to your home than the nearest U.S. hospital (rare cases near the border).

Outside of these limited cases, you’ll likely pay 100% of the costs out of pocket.

How to Get Travel Medical Coverage Abroad

Since traditional Medicare rarely covers foreign travel, many retirees and travelers choose to supplement their coverage.

1. Medigap Plans

Some Medigap (Medicare Supplement) plans — specifically Plans C, D, F, G, M, and N — offer foreign travel emergency coverage.
These plans typically cover 80% of eligible emergency care costs after you meet a small deductible, for care received within the first 60 days of your trip.

2. Medicare Advantage Plans with Travel Benefits

Certain Medicare Advantage plans include worldwide emergency coverage. Always confirm the details with your insurer before leaving the country, since benefits and limits vary by plan.

3. Travel Health Insurance

Even if you have Medigap or Advantage coverage, consider purchasing travel medical insurance for added peace of mind.
These policies can cover:

• Emergency medical care

• Medical evacuation or air transport

• Trip cancellation or interruption

• Lost baggage or travel delays

Tips for Traveling with Medicare

Before you pack your bags, keep these travel tips in mind:

• Bring your Medicare card and a copy of your supplemental insurance card.

• Contact your plan provider to verify out-of-area or foreign travel coverage.

• Locate nearby hospitals in your destination before you go.

• Keep receipts and documentation if you pay for care abroad — you may be able to submit them for partial reimbursement.

• Consider additional coverage if you’re traveling internationally for an extended period.

The Bottom Line

You can confidently use Medicare while traveling within the United States, but coverage outside the U.S. is limited. To avoid unexpected expenses abroad, consider a Medigap plan, a Medicare Advantage plan with global coverage, or travel insurance that protects you wherever you go.

At Lehigh Valley Medicare Advisors, we help clients understand their healthcare and retirement options — including how Medicare fits into their long-term plans.
If you have questions about how to protect your health (and your finances) while traveling, we’re here to help.

Medicare can be confusing — especially when it comes to when and how you can make changes to your coverage. If you’ve chosen a Medicare plan and later realize it’s not the right fit, you might wonder: Can I change my Medicare plan mid-year?

The answer depends on the type of plan you have and your specific situation. Let’s break down when you can make changes, what options you have, and how to avoid costly coverage gaps.

When Can You Change Your Medicare Plan?

Generally, you can only change Medicare plans during certain times of the year — but there are a few exceptions that allow mid-year changes. Understanding these Medicare enrollment periods will help you know when you can switch.

1. Annual Enrollment Period (AEP)

• Dates: October 15 – December 7

• What you can do:

  • Switch from Original Medicare to a Medicare Advantage plan (Part C)

  • Switch from Medicare Advantage back to Original Medicare

  • Change or add a Part D prescription drug plan

Changes made during this period go into effect on January 1 of the following year.

Even though it’s not technically “mid-year,” this is the main window for making adjustments to your coverage each year.

2. Medicare Advantage Open Enrollment Period (MA OEP)

• Dates: January 1 – March 31

• Who it’s for: People already enrolled in a Medicare Advantage plan.

• What you can do:

  • Switch to another Medicare Advantage plan

  • Drop your Medicare Advantage plan and return to Original Medicare

  • Add a standalone Part D drug plan if you return to Original Medicare

This period allows a one-time plan change per year — perfect if you realize early in the year your Advantage plan isn’t what you expected.

3. Special Enrollment Periods (SEPs)

This is where mid-year plan changes become possible. You may qualify for a Special Enrollment Period if certain life events occur. SEPs let you make changes outside of the standard enrollment windows.

Common reasons you may qualify for an SEP include:

• Moving to a new address that’s outside your plan’s service area

• Losing employer or union coverage

• Qualifying for Medicaid or Extra Help

• Your plan terminates its contract with Medicare

• Significant changes to your plan’s costs or coverage

Each situation comes with its own SEP rules and time limits, usually lasting 2–3 months from the qualifying event.

What If I Want to Change My Part D (Prescription Drug) Plan?

If you only want to switch your Medicare Part D drug plan, you can do so during:

• The Annual Enrollment Period (Oct 15 – Dec 7), or

• If you qualify for a Special Enrollment Period.

For example, if you move to a new state or lose other prescription coverage, you’ll have a window to make changes mid-year.

Can I Switch from Medicare Advantage Back to Original Medicare Mid-Year?

Yes — but only during certain times:

• During MA Open Enrollment (Jan 1 – Mar 31), or

• If you qualify for a Special Enrollment Period.

When you switch back to Original Medicare, you can also enroll in a Medicare Supplement (Medigap) plan. However, keep in mind that depending on your state and situation, you might need to go through medical underwriting to be accepted for Medigap coverage.

How to Change Your Medicare Plan

If you qualify for an enrollment period and want to make a change, here’s what to do:

1. Review your current coverage – Identify what’s not working (costs, network, prescriptions, etc.).

2. Compare new plans – Use Medicare.gov’s Plan Finder or work with a licensed Medicare advisor.

3. Check for penalties or coverage gaps – Make sure your switch won’t leave you without drug coverage or duplicate benefits.

4. Enroll in your new plan – Once approved, your new plan typically starts the first of the following month.

Why Reviewing Your Medicare Plan Matters

Your healthcare needs and financial situation can change — and so can Medicare plan options. Reviewing your plan annually ensures:

• You’re not overpaying for premiums or prescriptions

• Your preferred doctors and pharmacies remain in-network

• You’re taking advantage of updated plan benefits

Final Thoughts

So, can you change your Medicare plan mid-year?
Yes — but only if you qualify for a Special Enrollment Period or are within a defined Medicare enrollment window.

If you’re unsure whether you’re eligible to make changes or which plan fits your current needs, the licensed professionals at Lehigh Valley Medicare Advisors can help you review your options, compare plans, and ensure you’re getting the coverage and value you deserve.

Make An Appointment Today!

When it comes to Medicare, one of the most common questions people ask is: Should I choose Original Medicare or Medicare Advantage? At Lehigh Valley Medicare Advisors, we help you compare your options so you can make the best decision for your health and budget. In this guide, we’ll break down what Medicare Advantage is, how it works, and what Lehigh Valley residents should know before enrolling.

What Is Medicare Advantage?

Medicare Advantage (also known as Medicare Part C) is an alternative to Original Medicare. These plans are offered by private insurance companies approved by Medicare, and they combine the benefits of:

• Part A (Hospital Insurance)

• Part B (Medical Insurance)

• Often Part D (Prescription Drug Coverage)

• Additional perks like vision, dental, hearing, and fitness benefits

Medicare Advantage vs. Original Medicare

Key Differences

• Network Restrictions: Medicare Advantage plans typically require you to use doctors and hospitals within the plan’s network.

• Extra Benefits: Unlike Original Medicare, Advantage plans often cover services like dental, vision, and wellness programs.

• Out-of-Pocket Maximums: Medicare Advantage sets a yearly cap on how much you’ll spend, which Original Medicare does not.

Which Is Right for You?

Choosing between Medicare Advantage and Original Medicare depends on your healthcare needs, preferred providers, and budget. Our advisors in the Lehigh Valley can walk you through side-by-side comparisons.

Why Lehigh Valley Residents Choose Medicare Advantage

Healthcare needs in the Lehigh Valley are unique, and so are the Medicare Advantage options available here. Local residents often choose these plans for:

• Access to local provider networks in the Lehigh Valley region

• All-in-one coverage that bundles hospital, medical, and drug coverage

• Extra benefits like hearing aids or dental coverage that Original Medicare doesn’t provide

How to Enroll in a Medicare Advantage Plan

Key Enrollment Periods

• Initial Enrollment Period (IEP): When you first become eligible for Medicare

• Annual Enrollment Period (AEP): October 15 – December 7 each year

• Medicare Advantage Open Enrollment: January 1 – March 31

Getting Expert Help

Medicare rules can feel overwhelming. That’s why working with a local team like Lehigh Valley Medicare Advisors can make the process simple. We’ll help you compare plans, explain the fine print, and ensure you avoid costly mistakes.

Talk to a Lehigh Valley Medicare Advisor Today

Medicare Advantage plans can offer great benefits — but only if you choose the right one for your needs. At Lehigh Valley Medicare Advisors, we specialize in helping residents throughout the region find coverage that fits their lifestyle, healthcare needs, and budget.

👉 Call us today or schedule a consultation to review your Medicare Advantage options.

Navigating Medicare can be complicated, and even small mistakes can lead to higher costs, gaps in coverage, or penalties. Understanding the most common pitfalls and how to avoid them can save you money and ensure you get the healthcare coverage you need.

Mistake 1: Missing Your Initial Enrollment Period (IEP) 

Your Initial Enrollment Period begins 3 months before your 65th birthday month, includes your birthday month, and ends 3 months after.

How to Avoid It 

• Mark your calendar early and enroll as soon as possible.

• If you’re still working and have employer coverage, make sure you understand your Special Enrollment Period options to avoid penalties.

Mistake 2: Not Understanding Medicare Parts 

Medicare has multiple parts: Part A (hospital), Part B (medical), Part C (Medicare Advantage), and Part D (prescription drugs). Many people assume enrolling in Part A is enough.

How to Avoid It 

• Learn which parts you need based on your health, medications, and doctor network.

• Consider a Medicare Advantage plan if you want bundled coverage or Medigap if you want supplemental coverage.

Mistake 3: Delaying Enrollment in Part B or Part D (H2)

Failing to enroll in Part B or Part D on time can lead to lifetime late enrollment penalties.

How to Avoid It 

• Check if you qualify for a Special Enrollment Period (SEP) if you’re still working at 65.

• Keep documentation of your employer coverage to prove creditable coverage.

Mistake 4: Choosing a Plan Without Comparing Costs (H2)

Medicare premiums, deductibles, and copays vary between plans and regions. Choosing the wrong plan can result in unnecessary out-of-pocket costs.

How to Avoid It 

• Use the Medicare Plan Finder tool to compare costs and benefits.

• Review your plan annually during the Open Enrollment Period (Oct 15 – Dec 7) to make adjustments.

Mistake 5: Ignoring Prescription Drug Coverage 

Many people assume their Medicare Advantage plan or employer coverage fully covers all prescriptions. Skipping Part D can result in a late enrollment penalty if you ever drop coverage.

How to Avoid It 

• Check if your medications are on the plan’s formulary before enrolling.

• Consider a standalone Part D plan if you have specific prescription needs.

Mistake 6: Not Checking Provider Networks (H2)

Some Medicare Advantage plans have restricted networks, meaning your preferred doctors or hospitals may not be covered.

How to Avoid It 

• Verify your primary care doctor and specialists are in-network before enrolling.

• If you travel frequently, consider plans with broader networks or nationwide coverage.

Geo-Specific Note on Medicare 

Medicare is federal, but some states have programs that affect coverage:

• Pennsylvania: Medicare Savings Programs can help pay premiums if income is limited.

• California: Medi-Cal works alongside Medicare to reduce out-of-pocket costs.

Check your state health insurance assistance program (SHIP) for local resources.

Final Thoughts 

Avoiding common Medicare mistakes ensures you get the coverage you need without paying unnecessary penalties or out-of-pocket costs. Start early, compare plans carefully, and review your coverage annually.

With a little planning, you can navigate Medicare confidently and focus on your health, not your insurance.

Need Help With Your Medicare? Make an appointment today! 

For many Americans turning 65, one of the biggest questions is whether they need to sign up for Medicare right away—especially if they still have health insurance through their employer. Understanding the rules can save you money, prevent late enrollment penalties, and ensure you don’t have a gap in coverage.

Is Medicare Mandatory at Age 65?

Medicare is not mandatory. However, whether you should sign up at 65 depends on your personal situation. If you don’t enroll when you’re first eligible, you could face permanent late penalties—unless you qualify for a Special Enrollment Period (SEP).

Can I Delay Medicare If I Have Employer Coverage?

Yes, you may be able to delay enrolling in Medicare if you’re still covered by an employer’s health plan. The key factors include the size of your employer and whether your coverage is considered creditable by Medicare standards.

Large Employer Coverage (20+ Employees)

• If your employer has 20 or more employees, you can usually keep your employer’s health insurance and delay Medicare enrollment without penalty.

• Medicare becomes “secondary” insurance, meaning your employer plan pays first.

• Once you retire or lose that coverage, you’ll get a Special Enrollment Period to sign up for Medicare without penalty.

Small Employer Coverage (Fewer Than 20 Employees)

• If your employer has fewer than 20 employees, Medicare usually becomes the primary payer once you turn 65.

• In this case, you should sign up for Medicare Part A and Part B when you’re first eligible to avoid gaps in coverage.

• Not enrolling could leave you with unpaid medical bills, since your employer plan may only cover what Medicare doesn’t.

What About Medicare Part A?

Why Most People Sign Up for Part A at 65

• Part A (hospital insurance) is usually premium-free if you or your spouse paid Medicare taxes while working.

• Since it doesn’t cost most people anything, many choose to enroll at 65 even if they still have employer coverage.

When You Might Delay Part A

• If you’re contributing to a Health Savings Account (HSA), you may want to delay Part A enrollment.

• Once you sign up for Medicare, you can no longer contribute to an HSA.

Penalties for Delaying Medicare Incorrectly

Failing to enroll in Medicare on time can result in permanent penalties:

Part B Penalty

• Your monthly premium increases by 10% for every 12-month period you were eligible but didn’t sign up.

• This penalty lasts as long as you have Part B.

Part D Penalty

• If you go 63 or more days without creditable prescription drug coverage, you’ll face a late enrollment penalty when you sign up for Part D.

Key Takeaways

• Medicare is not mandatory, but delaying enrollment without the right coverage can be costly.

• If your employer has 20+ employees, you can delay Medicare and avoid penalties.

• If your employer has fewer than 20 employees, you generally need to enroll at 65.

• Always review your employer’s coverage to confirm if it’s creditable before deciding to delay Medicare.

Final Thoughts

The decision to delay Medicare depends on your job, your health coverage, and your retirement timeline. If you’re nearing 65, talk to your HR department and review your benefits carefully. Making the right choice now ensures you avoid penalties and have seamless coverage when you need it most.

Need Help With Medicare? Make An Appointment Today!

Enrolling in Medicare is an important milestone as you approach retirement age. But what if you miss your enrollment window? Unfortunately, delaying Medicare enrollment can result in costly lifetime penalties and gaps in health coverage. In this article, we’ll cover what happens if you don’t sign up on time, the penalties you might face, and how to avoid them.

Understanding Medicare Enrollment Periods

Before exploring the consequences, it’s important to understand when you’re supposed to sign up.

Initial Enrollment Period (IEP)

Your Initial Enrollment Period is a 7-month window:

• Begins 3 months before the month you turn 65

• Includes your birthday month

• Ends 3 months after your birthday month

Missing this window can lead to late fees and coverage delays.

Special Enrollment Period (SEP)

You may qualify for a Special Enrollment Period if you have credible coverage through an employer (your own or your spouse’s). Once that coverage ends, you have 8 months to sign up for Medicare without penalty.

General Enrollment Period (GEP)

If you miss both your Initial and Special Enrollment Periods, you’ll need to wait for the General Enrollment Period, which runs January 1 to March 31 each year. Coverage begins July 1—and penalties may apply.

Penalties for Not Signing Up on Time

Delaying Medicare doesn’t just affect when your coverage starts—it can also increase your monthly premiums for life.

Part A Penalty

• Most people don’t pay a premium for Part A (hospital insurance).

• If you do need to pay (because you don’t have enough work credits), your premium may go up 10% for twice the number of years you delayed enrollment.

Part B Penalty

• Part B (medical insurance) has a standard monthly premium.

• If you miss enrollment, your premium increases by 10% for every 12-month period you were eligible but didn’t sign up.

• This penalty is permanent—you’ll pay it as long as you have Medicare.

Part D Penalty

• Part D (prescription drug coverage) penalties apply if you go 63 days or more without drug coverage.

• The penalty is 1% of the national base premium multiplied by the number of months you delayed.

• Like Part B, this penalty is lifetime.

Coverage Delays if You Miss Enrollment

Even beyond penalties, missing your enrollment period means you could be without health insurance for months. For example, if you miss your Initial Enrollment Period and apply during the General Enrollment Period in January, your coverage won’t start until July 1—leaving a dangerous gap.

How to Avoid Medicare Late Penalties

Fortunately, you can avoid these issues with proper planning.

Mark Your Calendar Early

Know your Initial Enrollment Period and set reminders months in advance.

Confirm Employer Coverage

If you’re still working at 65, make sure your employer coverage counts as credible coverage so you won’t face penalties when you eventually switch.

Seek Professional Guidance

Medicare can be complicated. Working with a licensed Medicare advisor or using official resources like Medicare.gov can help ensure you enroll correctly and on time.

Final Thoughts

Missing your Medicare enrollment deadline can be costly. Late penalties for Parts A, B, and D can follow you for life, and coverage gaps could leave you without protection when you need it most. By understanding enrollment periods and planning ahead, you can avoid unnecessary fees and make the transition to Medicare smooth and stress-free.

Need Help With Medicare? Make An Appointment Today!

One of the most common questions people ask as they approach age 65 is: “Do I need to retire to qualify for Medicare?” The answer is no. Medicare eligibility is based on age or certain health conditions—not on whether you’re retired. Let’s break down how it works, especially if you’re planning to keep working past 65.

Medicare Eligibility Basics

Age-Based Medicare Eligibility

• Most people qualify for Medicare at age 65.

• Retirement is not required to start Medicare coverage.

Medicare for People Under 65

• Individuals may qualify earlier due to certain disabilities.

• Conditions like End-Stage Renal Disease (ESRD) or ALS can also make someone eligible before 65.

Do You Have to Be Retired to Get Medicare?

Medicare and Social Security Retirement Benefits

Medicare and Social Security are often linked in people’s minds, but they are separate programs. You don’t have to begin Social Security retirement benefits to enroll in Medicare.

Working Past Age 65

• Many people continue working after turning 65.

• You can enroll in Medicare even if you remain employed.

• Since Medicare Part A (hospital insurance) is usually premium-free, many workers sign up while keeping their employer health coverage.

Medicare Enrollment When You’re Still Working

Employer Coverage vs. Medicare

• If you have health insurance through your employer (or your spouse’s employer), you may be able to delay Medicare Part B (medical insurance) without penalty.

• The key is whether your employer coverage is considered “creditable coverage.”

Avoiding Medicare Late Enrollment Penalties

• If you don’t have creditable coverage and delay enrollment, you could face permanent penalties.

• It’s important to review your options carefully before deciding whether to delay Medicare.

Key Takeaways

• You do not need to retire to qualify for Medicare.

• Eligibility typically begins at 65, regardless of employment status.

• Employer coverage may influence whether you should enroll right away.

• Delaying Medicare without creditable coverage can lead to penalties.

Bottom Line:

Medicare eligibility is based on age or qualifying health conditions—not retirement. Whether you’re still working or fully retired, understanding how Medicare coordinates with your health coverage can save you money and help you avoid penalties.

Have Questions Regarding Medicare? 

Make an appointment with one of our professionals today. 

Introduction

• Navigating Medicare can be overwhelming.

• Common question: What is Medigap and do I need it?

• This guide explains what Medigap is, how it works, and who it’s for.

What Is Medigap?

Definition

• Medigap = Medicare Supplement Insurance

• Private insurance that helps pay for costs not covered by Original Medicare (Parts A & B)

Costs Covered by Medigap

• Copayments

• Coinsurance

• Deductibles

Purpose of Medigap

• Reduces out-of-pocket costs

• Provides predictable healthcare expenses

How Does Medigap Work?

Coordination with Medicare

• Medicare pays its share of approved healthcare costs.

• Medigap pays its share based on plan coverage.

Important Notes

• Only works with Original Medicare (not Medicare Advantage).

• Must be enrolled in Medicare Part A & B.

• Policies sold by private companies but standardized federally.

What Do Medigap Plans Cover?

Standardized Plans

• Labeled A, B, C, D, F, G, K, L, M, N

• Each plan offers different levels of coverage

Typical Coverage Includes

• Part A coinsurance & hospital costs

• Part B coinsurance or copayments

• Blood (first 3 pints)

• Part A hospice care coinsurance/copayment

• Skilled nursing facility coinsurance

• Part A &/or Part B deductibles (depending on plan)

• Emergency care abroad

Availability Notes

• Not all plans available in every state

• Some plans (e.g., Plan F) only available to those eligible before 2020

What Medigap Doesn’t Cover

• Prescription drugs (need Part D)

• Long-term care

• Dental, vision, hearing

• Private-duty nursing

When Should You Enroll in Medigap?

Open Enrollment Period

• Six months starting the month you’re 65 and enrolled in Part B

Benefits of Enrolling Early

• Guaranteed acceptance regardless of pre-existing conditions

• Avoids medical underwriting later

Medigap vs. Medicare Advantage

Key Differences

• Medigap supplements Original Medicare

• Medicare Advantage replaces Original Medicare, often including extra benefits

Important Note

• Cannot have Medigap and Medicare Advantage at the same time

• Consider which option aligns best with budget and healthcare needs

Is Medigap Right for You?

Ideal Candidates

• Want predictable healthcare costs

• Travel frequently (some plans cover international care)

• Prefer flexibility in choosing doctors/hospitals

Alternatives

• Medicare Advantage if you want vision, dental, or prescription coverage bundled

Final Thoughts

• Medigap reduces surprise medical bills and ensures manageable healthcare costs

• Compare options carefully

• Consult a trusted advisor to select the best plan

Need Help With Medicare?

Make an appointment with one of our professionals!

Overview of 2025 Medicare Costs

• Brief introduction to Medicare cost changes in 2025
• Why knowing premiums and deductibles matters for retirees in the Lehigh Valley

Medicare Part B Costs for 2025

Standard Monthly Premium

• 2025 premium amount: \$185/month
• Comparison to 2024’s \$174.70/month premium
• What this increase means for most beneficiaries

Part B Deductible

• 2025 deductible amount: \$257/year
• How the deductible works and when you pay it

Coinsurance and Out-of-Pocket Costs

• 20% coinsurance rule
• Examples of common Part B services

 Medicare Part A Costs for 2025

Premium-Free Part A

• Who qualifies for \$0 monthly premium
• Work history requirements

Premiums for Those Without Enough Work Credits

• Full premium: \$518/month (fewer than 30 quarters of coverage)
• Reduced premium: \$285/month (30–39 quarters of coverage)

Other Factors That May Affect Your Medicare Premium

Higher Income Premium Adjustments (IRMAA)

• Income thresholds and how they impact Part B and Part D premiums
• 2025 IRMAA surcharge ranges

Late Enrollment Penalties

• How penalties are calculated
• Strategies to avoid these costs

Medicare Advantage (Part C) Costs in 2025

• Average premium trends (slight decrease for 2025)
• Why costs vary by plan and location

Medicare Prescription Drug Plan (Part D) Costs in 2025

• Variation by plan and income level
• How to compare plans in the Lehigh Valley for best value

How Lehigh Valley Medicare Advisors Can Help You Save

• Personalized plan comparisons
• Guidance on avoiding penalties and excess costs
• Annual plan review for cost efficiency

Final Thoughts

• Summary of key 2025 Medicare cost changes
• Encouragement to review coverage before annual enrollment

Get Personalized Medicare Guidance Today

Ready to see how these 2025 Medicare changes affect you?

Contact Lehigh Valley Medicare Advisors for a free, no-obligation consultation.

We’ll help you:

• Compare plans side-by-side
• Identify ways to lower your out-of-pocket costs
• Avoid costly penalties
  📞 Call us today at 610-973-5334 or register for a obligation Free Consultation. 

1. Independent Advisors

We provide truly independent advice, meaning we are not tied to any single insurance provider. This independence allows us to present a range of Medicare plans, focusing solely on your specific needs, budget, and preferences. With unbiased guidance, you can be confident that our recommendations are based on what works best for you—not on commissions or sales targets.

2. No Hidden Fees for Services

One of the biggest advantages of working with us is the transparency around costs. Our consultation and plan selection services are provided without hidden fees, making sure you understand every aspect of your plan without worrying about extra charges. This open approach builds trust and ensures that you’re only paying for your selected Medicare coverage—no surprises.

3. Yearly Review of Your Plan

As healthcare needs can change over time, we offer an annual review of your plan. This yearly assessment helps you stay informed about any updates to your current coverage, new plan options, or adjustments that might benefit you based on your evolving healthcare needs. With this proactive approach, we help you keep your Medicare coverage in sync with your life changes, so you’re always getting the best possible care for your situation.

By choosing LV Medicare Advisors, you’re not only securing the right Medicare plan for today but also ensuring ongoing support and guidance into the future.

Medicare Advantage, sometimes known as “Part C,” is something of a catch-all choice for those who are ready to sign up for Medicare. Medicare Advantage plans are offered by private insurers in conjunction with the Medicare program, and can provide you with additional health insurance coverage.

What’s in them?

In addition to signing up for Medicare Part A (hospital stays) and Part B (medical coverage), Medicare Advantage plans offer their subscribers extra features. This frequently, but not always, includes the Medicare Part D prescription drug plan.¹

In some cases, Medicare Advantage plans offer coverage for areas not normally offered within regular Medicare plans. This can include dental, hearing, and vision insurance.¹

What are the rules?

Medicare pays for a fixed amount of your health care to the company offering your Medicare Advantage (MA) plan. Beyond that, each MA plan requires different out-of-pocket fees. Those fees can vary from plan to plan.¹

Depending on your plan, you may have different rules you need to follow when seeking a medical referral to get treatment from a specialist or if you are seeking non-urgent care (even from health care providers within the plan).

It’s also important to remember that rules, requirements, and features may change from year to year. It will be important to make sure that those changes line up with any treatment that you need.

What about my prescriptions?

While most MA plans offer Part D coverage for prescription drugs, some don’t. One example would be for Medicare Medical Savings Account plans. In cases where the plan can’t or chooses not to offer prescription drug coverage, you may have the ability to join a separate Medicare Prescription Drug Plan, depending on the type of plan you enroll in.¹

You will likely have a number of questions and concerns as you examine your options for Medicare Advantage plans. Discuss these with a trusted financial professional who can help you make choices that may best fit your lifestyle.

1. Medicare.gov, 2022

Lehigh Valley Medicare Advantage Plans

When you turn 65, you become eligible for Medicare if you:

1. Either receive or qualify for Social Security retirement cash benefits
2. Or, currently reside in the United States and are either:
   1. A U.S. citizen
   2. Or, a permanent U.S. resident who has lived in the U.S. continuously for five years prior to applying

How you enroll at age 65 depends on whether or not you are already receiving Social Security retirement benefits or Railroad Retirement benefits. Also, there are circumstances in which someone may become Medicare-eligible at age 65 but defers Medicare enrollment without future penalties—for instance, if an individual has qualifying insurance from an employer.

How much you have to pay for your Medicare coverage depends on your work history (i.e. if and how long you have paid Medicare taxes). Everyone owes a monthly premium for their medical insurance (Part B). Most people with Medicare get their hospital insurance (Part A) premium-free.

For questions regarding Medicare eligibility, call the Medicare Rights Center’s free national helpline at 800-333-4114 or contact Lehigh Valley Medicare Advisors.

© 2022 Medicare Rights Center. Used with permission.

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