Is Medicare Coverage Right for You?

Have you ever thought about what you’ll do for medical insurance when you retire? Medicare might be a great option for you. And since open enrollment is right around the corner, let’s cover some frequently asked questions you might have if you’re retired (or nearing retirement) and thinking about health insurance for your future.

What is Medicare?

Medicare is a type of health insurance provided by the United States federal government. There are two different types of Medicare: Original Medicare and Medicare Advantage.

Original Medicare includes three part: Part A (hospital insurance) and Part B (medical insurance), with the option to add Part D (prescription coverage). Part A covers things like in-patient hospital stays, hospice, nursing facility care, and “some home health care.”1  Part B covers things like doctor’s office visits, preventative care, and outpatient services. Part D is coverage for prescription and pharmacy services like medicine and vaccines.

Medicare Advantage (also known as “Part C” or “MA”) is often provided by private companies in collaboration with Medicare. The benefit of Medicare Advantage is that it covers all three parts (hospital insurance, medical insurance, and prescription services). Not only that, it sometimes includes extra benefits like dental, hearing, and vision.

How does medicare work?

Like most health insurance plans, Medicare includes an annual deductible, co-pays or coinsurance, and a monthly premium. If you enroll in the original form of Medicare, you’ll pay a specific deductible before Medicare kicks in to pay their part. Once you meet your deductible, you’ll then pay a percentage of the cost of services (coinsurance) or a specific dollar amount (copayment).


For most, there’s no premium for Part A. But if you’re in need of inpatient care at a hospital, you’ll pay a deductible of $1,556 per 60-day stay before Medicare kicks in to pay the rest.2 If you end up staying in the hospital for more than 60 days, you’ll pay a specific amount per day. Just note that there’s no out-of-pocket max with this kind of plan. If you have more than one inpatient hospital stay at least 60 days apart, you’ll have to pay the deductible again. If you have Part B, you’ll pay an annual deductible of $233 along with a premium of at least $170 per month (depending on your income).3

If you want even more payment coverage on the Original plan, you have the option to purchase a Medicare Supplement Insurance (Medigap). Medigap offsets your Medicare costs by helping you pay deductibles, copayments, and premiums.


If you choose to enroll in a Medicare Advantage plan, your premiums, deductibles, and copays will be different depending on the type of plan or provider you have. You can find cost estimates for MA plans by visiting

Am I eligible for Medicare?

If you are 65 years old (or turning 65 in the next three months), Medicare may be your right next step on your retirement planning journey. Turning 65 years old isn’t the only eligibility factor though. If you have a disability, you may also be eligible for Medicare along with those who have End-Stage Renal Disease.

When does open enrollment begin?

Initial enrollment for Medicare begins three months before you turn 65, the month of your 65th birthday, and three months after your birthday. Otherwise, general or open enrollment begins in January and runs through March 31st every year.

If you sign up for Medicare coverage before you turn 65, you should expect coverage to begin the month of your birthday. If you’re enrolling during the general open enrollment period, you should expect coverage to kick in about a month after you sign up.

Can I enroll in Medicare if I’m still working?

We understand that not everyone wants to retire at 65. Maybe you love your job or maybe you still have a retirement goal you’re working toward. That’s ok! And if that’s you, there’s good news: you can still enroll in Medicare…but only if you meet a few requirements:

  • As always, you have to be at least 65 years old (or older) to be considered for this type of medical insurance.
  • You’re self-employed.
  • Your employer has less than 20 employees.

If any of these things are true for you (or your spouse), Medicare might be a great option for health insurance. But if you or your spouse are still working for a company with a group health insurance plan, you should wait until you stop working or the plan ends to enroll.  For more information on Medicare, check out For additional options and counsel on health insurance plans, connect with a SageSpring advisor today.

Jeffrey Dobyns
Jeffrey T. Dobyns


President, SageSpring | Financial Advisor, RJFS 

Jeffrey T. Dobyns

President, SageSpring | Financial Advisor, RJFS

Jeff Dobyns has enjoyed extraordinary success providing comprehensive financial planning to retirees, entrepreneurs, entertainers, and executives by taking the time to truly know his clients, understand their goals and develop and execute their ongoing, strategic, financial plans.

Jeff earned his finance degree in business administration from Ohio University and has held executive positions with financial planning firms for more than two decades. After serving as Vice President of Investments of Lykins Financial Group, CPA’s, in his hometown of Westerville, Ohio, Jeff moved to Nashville, Tennessee to found SageSpring Wealth Partners in 2002. As its President, Jeff has led SageSpring to remarkable success, holding the distinction of being one of Raymond James’ top independent contractor offices, and a member of its Chairman’s Council*, every year since 2008.

Jeff’s true calling, however, is working directly with clients, helping them plan their financial futures in a manner that aligns with their values and helps provide them with financial confidence. To help meet these goals, Jeff leads the team of Dobyns Wealth Team and also incorporates the expertise of attorneys, accountants and other professionals to provide quality financial, tax and estate planning, and ongoing asset and risk management.

As independent advisory businesses, neither SageSpring Wealth Partners nor Dobyns Wealth Team hold any assets on behalf of clients, with such custodial and brokerage services being provided by Raymond James. As a leader in wealth management, Raymond James has an exemplary reputation and today serves more than $930 billion in client assets through 8,200 financial advisors worldwide (as of 9/30/2020).

In order to meet the highest standards of professionalism and ethics in the industry, Jeff is a CERTIFIED FINANCIAL PLANNERTM practitioner**, a Chartered Life Underwriter and a Chartered Financial Consultant. Jeff is also a participant of the Dave Ramsey SmartVestor program.

Jeff’s work and personal life are both guided by his faith and the Christian principles of honesty, generosity, compassion, and integrity. Accordingly, Jeff devotes considerable time and resources to a number of causes, including serving as a board member of Men of Valor, a prison ministry and mentoring program. He is also on the advisory board of The Signatry of Middle Tennessee, which works with families to increase their charitable giving to their favorite causes. Additionally, Jeff is on the advisory board for Halftime Institute, an organization that coaches marketplace leaders to discern and engage in their life purpose. Lastly, Jeff serves on the board of the Legacy Center of Nashville, a collaboration of independent coaching resources. He is a past board member of Porter’s Call, a Nashville charity that provides free counseling for musicians and their families, and the Martha O’Bryan Center, which empowers those in poverty to transform their lives through work, education, employment, and fellowship.

Jeff and his wife, Amy, are raising their family in Brentwood where they are members of the Brentwood Baptist Church, and their children, Gracyn, Hunter, and twins Tanner and Logan, attend the Christ Presbyterian Academy. For recreation, Jeff enjoys hunting, fishing and just being outdoors.

* Membership is based on prior fiscal year production. Re-qualification is required annually.

**Certified Financial Planner Board of Standards Inc. owns the certification marks CFP®, CERTIFIED FINANCIAL PLANNER, CFP® (with plaque design) and CFP® (with flame design) in the U.S., which it awards to individuals who successfully complete CFP Board’s initial and ongoing certification requirements.

SmartVestor is an advertising and referral service for investing professionals (“SmartVestor Pros”) operated by The Lampo Group, LLC d/b/a Ramsey Solutions (“Ramsey Solutions”). Pursuant to an arrangement between Ramsey Solutions, SageSpring Wealth Partners and your advisor, your advisor pays Ramsey Solutions a flat monthly fee to: (a) be a SmartVestor Pro, (b) advertise services through the SmartVestor website, and (c) receive client referrals in the form of an initial introduction to interested consumers who are located in your advisor’s Pros geographic region. SageSpring Wealth Partners does not endorse and are not affiliated with Ramsey Solutions, except with respect to the arrangement described above, and neither Ramsey Solutions nor its agents are officers or employees of SageSpring Wealth Partners. Further, neither Ramsey Solutions nor its agents are authorized to provide investment advice or act in any way on behalf of SageSpring Wealth Partners, except in connection with providing your contact information to your advisor.

Ramsey Solutions’ relationship and agreement is between SageSpring Wealth Partners only. Raymond James Financial Services, Inc. is not affiliated with the solicitor arrangement between Ramsey Solutions and SageSpring Wealth Partners.

Raymond James is not affiliated with any of the organizations mentioned above.