Quarry Road InsuranceAn independent agent in Lawson, Missouri. Medicare, supplements and life, since 1984.

If you are turning 65 this year, start here rather than with the mail.

You are about to get a great deal of mail. Some of it will be from Medicare and most of it will not be, and the ones that look most official are usually the ones trying to sell you something. It is worth knowing four things before any of it arrives, and they take about six minutes to read.

What the four parts actually are

Part A is the hospital. You have already paid for it through payroll taxes across your working life, so for almost everybody it costs nothing each month. It covers being admitted, a stay in a skilled nursing facility after a hospital stay, and hospice.

Part B is everything outside the hospital. Doctor visits, tests, outpatient surgery, durable equipment. It has a monthly premium, usually taken straight out of your Social Security check, and it pays about 80 percent. The other 20 percent has no cap, and that uncapped 20 percent is the whole reason the rest of this exists.

Part D is prescriptions, and it is sold by private companies rather than by Medicare. The plans differ less on premium than on which drugs they actually cover, so the right plan for you depends entirely on what is in your cabinet right now.

Then there is a fork. You either add a supplement, sometimes called Medigap, which covers most of that 20 percent and leaves you free to see any doctor who takes Medicare, or you take a Medicare Advantage plan, which replaces the whole thing with a private plan that usually costs less each month, often includes drugs and dental, and holds you to a network. Neither one is the right answer. Which one suits you depends on whether you travel, what your doctors accept, and how much variable cost you can absorb in a bad year.

Still working at 65?

If you are covered by an employer group plan with 20 or more employees, you can usually delay Part B without a penalty and pick it up when you retire. If the employer has fewer than 20, or you are on a spouse's retiree plan, or you are on COBRA, the answer is often the opposite and delaying costs you a permanent penalty. This is a five minute phone call and it is worth making before you decide anything.

What this costs you

Nothing. The carriers pay the commission, and it is the same commission whichever plan you choose, so there is no version of this where I earn more by steering you. That is worth saying plainly because it is the question everybody is too polite to ask.

What I would rather you ask is the harder one, which is whether an agent is any use at all when you could do this on the government site yourself. If your situation is simple, you take two prescriptions and you are not travelling, you probably could. Where it is worth having somebody is a working spouse, a drug that only two plans cover, a specialist you are not willing to give up, or a supplement application after the six month window has closed.

What to have on the table

• Your red, white and blue Medicare card if it has arrived
• A list of every prescription, with the dose and how often
• The names of the doctors you are not willing to change
• Your current insurance card, and your spouse's
• Roughly what date you plan to stop working

Photograph to shoot

An agent and a couple at a kitchen table, paperwork spread out, coffee. Shot from the side at seated height, warm daylight, no branded backdrop. This is the only photograph on the page and it has one job: showing that this happens at your table, not in an office.