In this Next Chapter Forum hosted by Renee Shaw, experts answer viewers’ questions about the Medicare federal insurance program for senior citizens. The program was recorded during the Medicare open enrollment period for 2026 coverage, which ends Dec. 7, 2025.
Below are summaries of several questions about Medicare and answers provided by the experts about selecting the right plans.
What are the differences between the Medicare “alphabet” policies?
Medicare is the federal health program for those over age 65 and also certain younger individuals who qualify, says Dr. Tricia Neuman, senior vice president and executive director for the Program on Medicare Policy at KFF. The program started 60 years ago with passage of the Medicare and Medicaid Act and has expanded since that time.
“Medicare is an important source of health insurance for people, and it has gotten more complicated over the years because there are more plans and more choices,” says Neuman. The best-known policies are identified by letters of the alphabet: Part A covers in-hospital care and inpatient services, and Part B pays for physician services, outpatient hospital services, and diagnostic tests.
“There is also a Part D of the Medicare program, which is the prescription drug portion,” adds Neuman. She says those ready to switch to Medicare once they reach age 65 need to enroll in Parts A, B, and D, and there are different ways to do this. Both Parts B and D have monthly premiums that for most people are deducted from their monthly Social Security distribution. The monthly premium for Part B in 2026 will be $202.90.
Angela Zeek, health and benefits unit manager with Legal Aid of the Bluegrass, says Medicare is required to deduct Part B premiums from enrollees’ Social Security payments unless they are exempt and qualify for what are known as Medicare Savings programs. “In Kentucky, we have three of those and they are income-based, but they provide an enormous amount of assistance,” Zeek says. “We encourage everyone to at least inquire to see if they are eligible.”
If a person reaches age 65 and becomes eligible for Medicare but still works, are they required to sign up for the program? If not, when should they do so?
Individuals do not have to sign up for Medicare once they reach age 65 but the panelists advise that the only reason not to is if the person is satisfied with the private insurance provided through their job.
Neuman says most people still working at 65 should consider signing up for Medicare Part A (hospitalization) since that policy does not have a premium, and then forego signing up for the other policies such as Parts B and D that do have premiums if their existing insurance is better. Zeek says 65-year-old employed persons who have a health savings account (HSA) and decide to enroll in Medicare Part A will need to stop contributing to that HSA in order to avoid incurring a tax penalty.
“When you delay enrollment into Medicare because you have access to that employer coverage, you actually get an eight-month special enrollment period to enroll in Medicare when you do lose your employer-based coverage,” says Olivia Wilson, public benefits counselor with Legal Aid of the Bluegrass.
It is important to know that there are penalties for not enrolling in Medicare Parts B and D if a person does not have other insurance coverage. The reason, say the panelists, is to keep overall costs down by having a vast group of enrollees in the system including those who are relatively healthy and those who require significant medical expenses.
“I always relate Medicare Part D to auto insurance or homeowner’s policy,” says Zeek. “You’re not always filing a claim with your homeowner’s insurance, but if you need to, it’s there to protect you – and that’s what Part D is.”
Persons planning to retire and end their employer-provided coverage should begin researching Medicare plans well in advance of their planned ending date and enroll three months before that date, advises Lindsay Medley, social worker with Lexington Senior Center.
What is a Medicare Advantage plan and how is it different from traditional Medicare?
Neuman says that over time, more health coverage has shifted from traditional Medicare to what are called Medicare Advantage policies, which are administered by private insurance companies. While they must provide the same medical benefits as Medicare does, they may do so through HMO or PPO plans that restrict access to certain provider networks. These plans may provide additional benefits such as vision and dental coverage not offered by traditional Medicare.
“If you’re at home and it’s during the open enrollment period, you’re probably going to see a lot of ads for Medicare Advantage, and this is an alternative to the traditional fee-for-service program,” Neuman says.
Most Medicare Advantage plans bundle the three main Medicare “alphabet” plans – A, B, and D – into one comprehensive plan that may offer a lower monthly premium but usually restricts where an enrollee can receive health care and also could have higher deductibles.
“You really need to look at Medicare Advantage plans and see if they’re going to work for you, because there’s a network that they will require you to seek your care within, and depending on the type of plan, you might not have any coverage outside of that network,” Wilson says.
Those with traditional Medicare Parts A and B who don’t want to enroll in Medicare Advantage often purchase supplemental coverage plans – also called Medigap – that are offered by private companies. These plans are optional and help defray out-of-pocket costs in traditional Medicare such as copays or deductibles. Unlike Medicare Advantage plans, supplemental coverage plans offer benefits that can be used anywhere Medicare is used – there is no restricted network of providers.
People who are on traditional Medicare and who have supplemental or Medigap coverage can switch to a Medicare Advantage plan during the open enrollment period, and vice versa, says Erica Bowman, public benefits paralegal with Legal Aid of the Bluegrass. However, she warns that persons who move from Medicare into Medicare Advantage and discontinue their supplemental coverage might have difficulty getting that coverage again at the same price if they decide to change back to traditional Medicare in the future.
How can seniors avoid fraud when enrolling in Medicare or when changing their plans?
Scott Wegenast, communications manager for AARP Kentucky, says the annual open enrollment period often brings increased activity by scammers intent on deceiving senior citizens on the phone or through other means of contact. He offers three pieces of advice to viewers.
“Number one: Medicare is not going to call you – you’re not going to have a call from Medicare, and they’re not going to text you,” he says. “Number two: if you get a suspicious call, do not give out your personal data. And number three: be wary of any emotional push (by a caller) such as your policy is going to be terminated or you’re going to be charged extra because you didn’t do X, Y, or Z.”
Wegenast encourages Medicare enrollees to discuss any suspicious activity with family members and friends, and to remain calm and patient during what can be a confusing time as they compare and choose plans. He adds that Medicare’s official website has a page for reporting fraud.
“The best thing you can do is talk with folks,” he concludes. “Let them know that, ‘Hey, I got this call, they said they’re going to send me a free gift card if I pay them… There’s a lot of different approaches to these scams.”
What steps should people take during open enrollment if they want to make changes to their Medicare plan? Where can they get help?
“This is the time for people to review all their options and decide whether they want to keep the coverage they have or make a change,” Neuman says. She explains that those with a Medicare Advantage plan that combines policies can use the open enrollment period to try to find a different plan with coverage that better suits their health needs, lower monthly premiums, or both.
“The Medicare Advantage plans and the drug plans will always send out an annual, notice-of-change document, and you need to make sure you’re aware of that document… That’s going to give you all of the changes going into next year,” says Justin Aulds, health insurance specialist with Trucordia Health Insurance. “You may see something that’s in there that’s alarming, that’s important to you, whether that could be a medication, a maximum out-of-pocket (cost) in a plan, or an extra benefit that you used to have that might not be there next year.”
Bowman says those needing assistance researching plans should visit Medicare’s website or call Medicare at 1-800-633-4227 (1-800-MEDICARE) for general information. Individual counseling is also available through Kentucky’s State Health Insurance Assistance Program (SHIP).
“We are able to answer just about any question about Medicare, offer Medicare counseling, speak to beneficiaries about supplemental coverage – all things Medicare,” Bowman says.
Other resources to access include local senior citizen centers, Area Agencies on Aging and Independent Living, and the AARP Kentucky website.
Lindsay Medley offers a simple recommendation for selecting a plan, be it traditional Medicare plus a supplement or one of the Medicare Advantage bundled plans. “Focus on what’s going to give you the most peace of mind – whether that’s something that offers more hospital coverage, or more dental and vision coverage,” she says.
