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Congratulations, you made it. With birthday candles coming 24 candles to a pack, you and I both now need 3 packs of candles. Lucky you, you’re now also part of the Medicare Club. And, as a member of the club myself, “Welcome.” 

The question that so many of our clients begin with is a basic one: “How do I get my Medicare card?”  Some people also ask and another question when it comes to their Medicare card, “Should I get my Medicare card now or wait until I retire?” We will address this second question later in this presentation. 

People usually become eligible to apply for their Medicare card at the beginning of the month that is three months before the month in which they turn 65. So, if your birthday is November 19, then, working backwards, you can apply for your Medicare card as soon as August 1. The latest date to apply is 3 months past your birth month. In our example counting forward three months, your Medicare enrollment period would end February 28th. Your Medicare sign-up period adds up to 7 months in total, three months before your birth month, your actual birth month and then three months after your birth month.  

If, in our November 19th birthday example, you apply for your card at any time prior to November 1 then your Medicare will start on the first day of November. It doesn’t matter what your actual birth date in the month is, everyone starts on the 1st.  

With a strange exception. If your birthday is on the first of a month such as November 1 then your Medicare will start not on November 1 but on October 1, and your sign-up period will also begin a month earlier on July 1. The government, of course, has a very good reason why they set up this strange first-of-the-month birthday rule. But nobody knows what it is.       

Generally, you need to be 65 years old or older to have Medicare. An exception is that people who have been disabled for at least 24 months can join Medicare at any adult age.   

There are two Parts to Medicare. Part A which is mainly hospital coverage and Part B which is doctors and most everything else. Part A has no cost as long as you or your spouse have worked at least 10 years. Part B has a cost of $202.90 a month, in 2026, for most people who are not above the high-income threshold where you pay an extra amount called IRMAA. 

The usual way to sign up for Medicare is through the Social Security website, SSA.gov or at your MySocialSecurity.gov page.  You can also sign up on the phone at 800-772-1213. Expect a long, long hold. You can also sign up by making an appointment at a Social Security office. If you have any complicating circumstances, such as that you are a naturalized citizen, an appointment would be highly recommended. 

If you intend to continue working and plan to keep your Group Health Insurance, then you can still sign up for just Part A, which has no cost, and because you get some benefits, you should probably should do so. It provides secondary coverage to your Group Health Insurance and could help to pay part of your hospital deductible with your Group Health plan. The exception is that people paying into an HSA, Health Savings Account, should not sign up for Part A as doing so will likely trigger tax penalties.  If you don’t know what an HSA is, you most likely aren’t paying into one. 

If you are not in a Group Health Plan you will want to sign up for both Parts A and Part B. You will need both Parts A and B for Medicare to be your primary coverage. Medicare also has another confusing rule impacting those in Group Health plans with less than 20 employees. If there are less than 20 employees where you work then Medicare becomes the primary provider, not your Group Health plan, meaning you will probably need to have Part B. Consult your HR department, or us, if this is the case. 

If you are turning 65 and continuing to work, you should compare the cost and benefits of Group Health with the cost and benefits of a Medicare plan. Medicare often presents the better value. If you are IRMAA high income, or have a spouse under age 65 requiring you to keep with your Group plan, then you will likely however want to delay enrolling into Medicare.      

How does a jet engine propel an airplane o? the ground? Or how does nano technology work? Unless you’re an expert in such matters, I don’t know and you don’t know. Heck, I can’t even figure out how to run my thermostat. 

Here’s another thing to add to the list of ba?ers: Medicare. There are as many rules with Medicare as there are people in government making them. And, because the government likes changes, the rules are constantly, and often drastically, shifting.

After what I estimate is around 25,000 hours of my own life spent talking to my clients, running a healthcare agency, attending conferences and retraining each year, I like to think I am expert in Medicare. But still, just about every day something ba?es me and I need to go to other experts I that know to put our collective minds together.

Medicare is complex. And if there is one thing I have learned from talking to thousands of Medicare clients over the years, is that if you are confused about Medicare, your part of a very big club. The club includes doctors, lawyers, professors. Smart people who just don’t understand Medicare.

That said, I have also gotten pretty good at explaining Medicare. So, let’s go over the basics. Medicare has four parts, each with a letter. These four parts to Medicare are named with the word, “Parts”: Part A, Part B, Part C and Part D.

You get your Medicare card from the government, from the Center for Medicare Services, CMS. There is only one place to get it, from CMS. Amazon Prime does not o?er Medicare cards, at least not yet. We will discuss how to get your Medicare card in the next video.

Your Medicare card gives you both Part A and Part B. Part A is essentially hospital coverage but also includes a few other things such as skilled nursing care. Part B covers essentially everything medical that doesn’t take place in the hospital, including doctor appointments, labs, x-rays and other tests. Part B also covers outpatient drugs such as chemotherapy drugs or even Botox.

Part C is another name for Medicare Advantage. We will discuss that subject in a minute. 

Part D is your prescription drugs.

When you get your red, white and blue Medicare card you have completed step one. It’s like going to the airport though. The airport is not your ?nal destination.  You still have to get onto a plane.

There are two types of Medicare: The first type is Original Medicare, sometimes called Traditional Medicare. And the second type is Medicare Advantage, sometimes called Part C. Once you get your Medicare card you come to a fork in the road where you pick one or the other. You cannot choose both, any more than you can board two airplanes.

With Medicare Advantage, CMS pays a private insurance company such as United, Aetna or Humana to take over and manage all your medical needs. There are usually both HMOs and PPOs to choose from. Most plans include your drug coverage and often other bene?ts as well such as some dental coverage, thus making Medicare Advantage all inclusive. In essence, Part C is all you need.

With Original Medicare, Medicare itself stays in charge of your medical needs. Medicare pays the first 80%. The other 20% Medicare does not pay for under Original Medicare could cost someone an unlimited amount, maybe hundreds of thousands of dollars with bad luck. Because of this, people almost always get a Medigap supplement, most commonly Plan G, that covers the other 20% of costs, after a deductible that is set by the government each year. In 2026 it was $283. With Original Medicare, you will also need a stand-alone drug plan to cover your Part D. 

I often describe Medicare Advantage as being like the Full-Meal-Deal at fast food restaurants> Medicare Advantage includes everything needed medically within one plan. Whereas Original Medicare is alla carte usually needing 2 or even 3 extra plan enrollments.

Which is the better choice? That depends on your own views. Medicare Advantage will often provide better cost value. Original Medicare will generally give you more freedom and ?exibility especially with your doctor choices. A question I often ask clients is, “Which is most important to you? Value or flexibility?”

We will discuss this further in the video on comparing the two.

It is vital, however. to know, that in the ?rst 6 months after you join Medicare with Part B, there is no underwriting to sign up for a Medigap supplement. No matter what your medical conditions are, carriers must issue any supplement to you charging you the normal premiums, and with no medical questions. Once those 6 months are up, in most circumstances you will have underwriting to pass to get a Medigap supplement. This being the case, you may never be able to change to Original Medicare in the future if you cannot pass underwriting. This is an important matter, for the future with your medical treatment options, to consider carefully.

When we get a wedding invitation we are often asked to pick between two choices: Chicken or steak? But if we wished we made the other choice, it’s no big deal. The bride still looks great, we still have all our old dance moves, and heck it’s only a meal.

On the other hand, Medicare Advantage or Original Medicare is not chicken or steak. Our future health, the medical issues we could have now, could have next week, or most likely will have in the future, and how we deal with them, is at stake.

Medicare rules for healthcare agents do not allow me to discuss the extra bene?ts of Medicare Advantage plans in this format but for most people Medicare Advantage plans will often come with extra bene?ts that Original Medicare does not have. Medicare Advantage will usually cost you less in premiums and in your total amount spent. Although, with Medicare Advantage you do have co-payments, which with hospital stays and cancer treatments especially, can get costly. However, you are protected by a maximum-out-of-pocket amount, we agents call it MOOP, after which you have no further copayments to make for the rest of the calendar year. This way, you do know your downside. Medicare Advantage plans, which can be HMOs or PPOs work beautifully for a lot of people. Many people will tell me they saved a lot of money by going with Medicare Advantage.

That said, the most common question I get, in fact I have been asked it hundreds of times is, “Which one am I on, myself?” My own choice, and my reasons for it, may be very di?erent than how others weigh it. But I am on Original Medicare with a Medigap supplement. If it costs me more each year than Medicare Advantage would, then I don’t mind. The car I choose to drive also costs me more than a more economical choice would. Not all my choices are about what gets me the best value. 

There are two reasons I chose Original Medicare with a Plan G supplement. My first reason is that with Original Medicare I can see any doctor, or go to any clinic or hospital, in the USA that takes Medicare.

Maybe, if I get some exotic disease I will want to travel to a hospital somewhere else that specializes in my disease. Chances are I won’t, but my point is I don’t want to be told that I can’t. The majority of doctors and hospitals take a large percentage of Medicare Advantage plans, but there are some doctors and clinics that take only Original Medicare and I don’t want to be restricted.

With Original Medicare I can do my own homework and make my own appointments with specialists with less concern as to whether they will be in network. Because with Original Medicare there are no doctor networks. If a doctor or clinic takes Medicare at all, then I can see them. 

The second important reason for my own choice of Original Medicare, is that Medicare Advantage plans often require pre-authorizations. Medicare Advantage carriers want the right to pre-approve before paying out a lot of money on expensive medical procedures. Original Medicare is not a “ticket to anything medical at all you want” but to the degree there are any authorizations needed, or that may be required by rule changes in the future, these restrictions are much fewer with Original Medicare.

The choice, often comes down to Less Cost on one hand, versus More Freedom and Flexibility on the other. I can’t tell you which should be more important to you. My own clients choose between the two options right around 50/50.

My recommendation is to think about Medicare, and the coverage that you will want, based upon “someday”. Today you may be 100% healthy, or close to it, but that can change at any moment. If you were to have a major medical issue where you could not switch to Original Medicare with a Medigap supplement, would you be happy with Medicare Advantage? Or, would you want the extra freedom and ?exibility of Original Medicare? If your own answer to the “someday” question is Original Medicare my advice is to not play chicken with possibilities, and make that choice now, even if it saves you money to go with Medicare Advantage now with the plan of switching later. 

Medicare loves acronyms and has a lot of them. One such acronym (which took me a while to memorize what it even stood for), is IRMAA. It stands for “Income Related Medicare Adjusted Amount.” If it was me creating the acronym I would have gone with YEMYOM which stands for, “You Earn More, You Owe More.” 

The theory behind IRMAA or YEMYOM, with my acronym, being that when Bill Gates became eligible for Medicare a few years ago why should he only pay the same $202.90 as everyone else?

Here is how IRMAA works: Social Security, which runs Medicare, takes two years of your tax returns and they apply a formula to them called MAGI, which stands for Modified Adjusted Gross Income. MAGI is very similar to your tax returns Adjusted Gross Income so to figure out if you are going to be subject to IRMAA or not you can essentially use that. 

The threshold for IRMAA is $109,000 for a single filer, or $218,000 as a joint filer. That’s for the lowest amount of IRMAA so if your taxable income is below that amount, you can watch this video just to say, “Hah hah” to those who have to pay it, but it won’t apply to you. If you are above the IRMAA amount, then you’ll need to pay this extra amount with an increasing scale based on your income.

If you are IRMAA what will happen is that after you apply for your Medicare card at some point a letter will come in the mail from Social Security saying, “Congratulations, your IRMAA,” and give you your IRMAA level and extra amount you need to pay.  

Two common questions I get from people is one: “Which tax returns will they use?” It’s your last two years tax returns but when they switch over to the latest return is not when you file it, it may be many months later that they make the transition. Even more important people often ask, “My income is going down, especially since I retired, when will my IRMAA adjust?”  

The good news is that the government has form SSA-44. SSA stands for Social Security Administration, form number 44. It is used when you have what is referred to as a Life Changing Event, such as retirement that changes your income. You attach the supporting documents such as a letter from your employer showing that you’re retiring and as a result losing your job income. Then, voila, in theory your IRMAA will come off altogether or it may be adjusted down to a lower bracket. 

I always say to clients be proactive and file the form. You don’t want to wait an extra year for the government to catch up with knowing your income is lower. A really good idea is to make an appointment with your local Social Security office to provide your SSA-44 form and your backup documentation directly to a Social Security agent. You’ll also want to bring your latest tax return.  If you win your IRMAA appeal it will also be retroactive to the date of your life changing event; so, if you have made a few higher payments because of IRMAA since retiring, then you could be getting money refunded back to you.  

Now let’s look at the brackets. This is for 2026 and are based off of the base rate for Part B medical costs of $202.90. Note that most people do not pay anything for Part A and no IRMAA ever applies. 

The first bracket starts at $109,000 filing single and $218,000 joint. It’s $284.10 or around an extra $81 above the normal amount. It works out to a 40% surcharge. 

But wait, as they say in the Ginza knife commercial, there’s more! You also get to pay Part D IRMAA of $14.50. Part D is your drug coverage. People who are not IRMAA payers, pay zero to Medicare for Part D. Only those of us who are designated as IRMAA have the privilege of paying something. So, in the lowest bracket you are paying $298.60 in combination. Or an extra $95.50 in surcharge.

Bracket two begins over $137,000 filing single or $274,000 filing jointly. The cost for your Part B goes up $405.80 plus $37.50 for Part D IRMAA, for a total of $443.30.

Bracket three starts at $205,000 when filing single, and $410,000 filing jointly. Your Part B comes to $527.50 a month, Part D another $60.40, totaling $587.50. 

Bracket five is for those with over $500,000 in income filing single, or $750,000 filing jointly. Your Part B comes to $689.90 a month, Part D IRMAA adds another $91.00, totaling $780.90 a month. 

In conclusion, lots of my clients bemoan, “It’s not fair.  I keep getting hit with more and more taxes simple because I did well and earn a lot of money.” Others shrug and say, “I guess owing a lot of taxes is a nice problem to have.”   

Plan G. Plan N. Plan F. Medigap supplement letter plans are standardized by Medicare. In all, there are 10 different letter plans, some of which are not even available in most states. Some of the letter plans such as the very popular Plan G are everywhere, like Toyotas. Other letter plans are like Peugeots. Basically, not worth talking about it.  

Plan F used to be the most popular, but as of 2020 it was discontinued other than for people who turned 65 prior to 2020. Because everyone who has Plan F is now at least 71 years old and aging, the premium costs of plan F have skyrocketed and will continue to go up even more as the Plan F pools age further. I recommend for those in Plan F, if you can pass underwriting and get out, to make the switch over to Plan G.

Plan F covers both the Part A and Part B deductibles 100% so you have no deductible or any other co-payment costs. Plan G, which is by far the most popular plan, covers the Part A deductible but not the Part B deductible which is set by the government each year. This year the Part B deductible is $283 so that is your only deductible expense for the year. Around 80% of people with Medigap supplements have either Plan F, if they have been on Medicare for a while, or Plan G, if they are more recent to Medicare.

The other two plans we will discuss is Plan N which is the second most popular plan although Plan G is more popular than N by around 4 to 1. We will also discuss a hybrid of Plan G, called a High-deductible Plan G, though I do not recommend what we refer to as a High G.  

Letter plans are standardized by the government. So, a carrier cannot decide let’s make our deductible half-price, only $141 for your Part B deductible, creating a bargain. Or, for each Plan G we sell we will give away a free Plan G to someone needy. It would be nice, but it’s not allowed. 

With a Plan G Medigap supplement between what Medicare contributes, and what your supplement contributes, 100% of both your Part A hospital costs and Part B doctor and other medical costs are covered. But you do pay the first $283 in 2026, as a deductible, yourself.  If all your medical expenses in a year our preventative, you wouldn’t even pay the $283 deductible as there is no deductible charged for preventative health costs.  

Plan G also picks up the 15% excess costs that some medical facilities and doctors can charge, often referred to as balanced billing. In 8 states there is no balanced billing, as state law prohibits it. To better understand excess charges: Some medical facilities do not accept what Medicare is willing to pay them for medical procedures, called assignment. But they do accept Medicare patients with an extra fee of 15% above the Medicare payment amount. A well-known example is Mayo Clinic. Plan G picks up this excess charge amount often giving people further peace of mind of knowing with their Medicare plan they can use the maximum number of facilities.

Because Plan G gives you more benefits than Plan N does, the premiums will be around 20% more than those for Plan N. Plan N, however, does not cover excess charges. The other big difference Plan N has is that with Plan N you pay a $20 copayment for most doctor visits and $50 for emergency room visits. You do not have this copayment with Plan G. 

High-Deductible Plan G, or High G as we call it, has a substantially lower monthly premium. In fact, it’s less than half the cost. But there is a catch. Instead of paying a $283 deductible you pay a much higher deductible with a High G.  In 2026 it’s $2,950 and is reset higher by Medicare each year.  The reason I don’t recommend High G is that you may, with good luck, save for instance $1,000 in premiums this year, but if you have any medical expenses at all to speak of, and it doesn’t take much to be billed $2,950, one small medical incident could end up costing you the full $2,950 deductible,  costing you three times more than you saved. 

Worse though, once you are in a High-Deductible G Plan you can’t change to a regular Plan G down the round unless you can pass underwriting. So, to maybe save $1,000 this year, if you don’t have medical issues, you could end up paying triple that amount every year for 30 years to come. Some bargain that would be! 

Plan G provides you with the most flexibility and cost certainty. That’s why it’s so popular. Popularity tends to come with good reasons.

The answer is, “Not if you are new to Medicare.” Medicare made a deal and every insurance carrier that o?ers Medigap Supplements must go along with that deal. Here’s the deal. There are certain circumstances we will discuss that result in insurance companies providing Medigap with Guaranteed Issue. 

This means that everyone who ?ts one of these circumstances is entitled to any Medigap letter plan they want, with any carrier they want, without any underwriting. There are no medical questions of any kind asked. You cannot be charged a higher premium based on their health. It doesn’t matter what medical issues that someone has, they are approved for their Medigap supplement. Period.

The largest part of that special guaranteed group are those people who ?rst become eligible for Medicare, but there are others as well who are entitled to a Medigap supplement with no underwriting we will come to in a minute.

The key to being considered new to Medicare for guaranteed issue purposes, is being new to the Part B portion of Medicare. 

Many people delay Medicare while they are covered by their Group Health Insurance past age 65. When those people retire, for instance at age 69, or at age 96 for that matter, they are considered new to Medicare and enjoy the guarantee of Medigap coverage without answering any medical questions. Someone will pay a little more for their premium based only on their age, if they are older than 65, but they will not pay more based on their health condition.

Other people that qualify for guaranteed issue, without underwriting, include those who move out of their plan’s service area when they are on a Medicare Advantage plan, those who lose their Group Health coverage, and people on a Medicare Advantage plan that was discontinues. 

Another important guaranteed issue circumstance is Trial Rights. Those who join a Medicare Advantage plan for the ?rst time get one year to change their mind and switch to Original Medicare with a guaranteed Medigap supplement anytime during that ?rst 12 months on a Medicare Advantage plan. However, you only receive trial rights if you enroll in a Medicare Advantage plan at age 65 right at the beginning, in the ?rst month that you are eligible for Medicare.

For anyone who does not fall into the guaranteed issue category they can still get a Medigap supplement but only if they are accepted through underwriting. The good news is there are no blood tests or doctor exams. You do, however, have to answer “No” to a series of questions pertaining to a large number of medical conditions, and if you are currently having treatments or have surgery upcoming this will likely disqualify you, if you’re being underwritten, as well. Another area of concern that carriers will review is your prescription list.

In essence, if you don’t have guaranteed issue, and carriers don’t have to take you, then in this situation insurance companies are making a business decision. That’s why I often say to clients, “If you think you want Original Medicare with a Medigap supplement enroll in one when you first join Medicare and you know that you have Guaranteed Issue.” Too many times, I see clients who really want Original Medicare later on but cannot make the switch from Medicare Advantage because they can’t pass underwriting. Healthy today does not guarantee healthy tomorrow.  

Let’s start with an important comparison. Medigap supplements and milk. When it comes to milk, one brand of 2% milk is basically the same as another brand of 2% milk. Most of us could care less which brand of 2% we buy. 

The same thing is true of Medigap supplements. For instance, the most popular Medigap plan, which is Plan G, is sold by a variety of carriers. As is the second most popular Medigap plan, Plan N. 

The plans themselves are standardized by Medicare. With Plan G you pay the Part B deductible set by Medicare. In 2026 it’s $283. Ater that, 100% of your Part A and Part B medical expenses are covered. That’s what a Plan G is. A carrier cannot say let’s blow away the competition and make our deductible only $100. They have to go by what is standardized for a Plan G by Medicare.

Let’s clear up another common misunderstanding. With Original Medicare there are no doctor, hospital or other medical networks. It does not matter which carriers supplement you have, if a doctor takes Medicare at all, then any carrier’s supplement will be equally taken. The way it works is that doctors bill Medicare the entire amount and Medicare then collects, from your supplement carrier, you carrier’s share of the billed cost.        

So, to summarize: A Medigap Plan G Supplement is the same Plan G supplement with every carrier. Medicare says so.  Every doctor and hospital takes every carrier’s supplement equally. Again, Medicare says so. 

Then how do you decide? I will answer it this way. If two side-by-side gas stations are posting different gas prices you would generally go with the one that has the better price.

With Medigap supplements there are two factors to consider with their cost. One is the current monthly premium of each carrier, which is easy to compare. The second factor is more challenging, which is projecting how much a carrier’s premiums are likely to go up in the future. This can be like projecting a stock, 50% smart analysis combined with 50% guess work.

Each year carriers submit for a rate price increase from the state insurance commission based upon how the costs for their pool increased. Historically, increases have been modest, typically in the 3% to 5% range. In the post covid years, however, we have seen much higher annual cost increases, usually double digit, sometimes even over 20%. Carriers submit for their rate increases at different times in the year so that you are often also comparing carriers who had already taken their cost increase this year with carriers who have not yet had an increase but who are going to. 

Many carriers also offer discounts in their premiums based on their being two people in the same household having a Medigap policy with that carrier. Another very common discount is for simply living with another adult, a spouse or even a roommate. The idea being that their actuaries tell them that people who live with someone else have less medical issues and cost. 

Women also pay around 15% less than men do. My female clients always say, “At last, something women pay less for.” There is one state, however, where women pay the same as men do because that state doesn’t allow gender discrimination by state law, ironically in that state working against woman. You can guess which state it is? Hint, it’s our most populace state.

People also pay higher premiums based upon your age. With most Medigap policies the premium amount will go up as you age, usually starting at age 68 or 69 with age increases being typically around 3% per year of age. This age-based increase is in addition to the inflationary increase. Note, in some states this age increase is not allowed.   

Another item as an agent I take into consideration in choosing a carrier is the age of the member pool. Carriers will often change out their pool every 5-10 years. The newer the pool then, as a result, the younger the average age of the pool members, which results in lower annual rate increases. 

Many people also like to consider the carrier themselves and the carrier’s reputation. How long have they been selling Medigap supplements? Are they a well-known company? What is their financial strength and even what is their Moody rating?  

Much like with picking stocks, there are many factors that go into picking a carrier for your Medigap supplement. This is where the skills of an experienced agent, and agency, come to the forefront. 

Let’s start with a couple of questions. One: Do you have to have a prescription drug plan? No. 

Should you have a prescription drug plan? Probably, yes. 

Even if you don’t take any prescriptions at all now, there is a penalty to consider if you don’t sign up for a prescription drug plan right away. The penalty is one percent of the average cost of a drug plan calculated for each month that you haven’t signed up for a drug plan. The penalty works out to be around 40 cents per month. So, if you don’t sign up for a drug plan for 2 years your penalty will be around 40 cents times 24 months, or around $10 per month added to your premium each month, when you do sign up. I have seen penalties add up to as much as $70 a month for 20 years of not signing up.  

Many prescription drug plans are very inexpensive, so as a practical matter, most people will choose to sign up for a drug plan right away.

Every one of us has a di?erent situation when it comes to our prescriptions. My 97-year-old mother used to brag that she took only one little pill while her friends had trays full of pills.

Now my mother takes two pills. Lots of us are fortune that way. We take a generic drug or two, and the cost is no big deal.

Other people take expensive name brand pills. You know a drug is expensive when it’s advertised a lot on TV. They don’t advertise the cheap ones. Take Humara for instance, probably the most advertised drug. It’s over $1,000 a month. Many of us think, “$1,000 plus for a bottle of pills. They got to be kidding.” But it takes over 100 million dollars to bring a new drug to market. Understandable, to spend that kind of money on R and D, pharmaceutical companies need a return. For those taking expensive drugs, the homework of choosing the right drug plan really matters, and could mean thousands of dollars of di?erence from one drug plan to another.

The ?rst matter of importance to know is that a carrier divides drugs into tiers based on cost. There are usually 5 tiers. Tier 1 is preferred generic drugs. They cost very little.

Tier 2 is non-preferred generic drugs, that cost a few dollars more. 

Tier 3 is Preferred Name brand drugs. These are drugs that do not yet have a generic version for and they cost considerably more. 

Tier 4 is non-preferred name brand drugs where we jump up to a somewhat higher cost. 

Tier 5 are the specialty drugs, such as Humara, which cost a lot.

Every drug plan has a di?erent set of drugs they cover called a formulary. Plans are required to have drugs in every category in their formulary but they are not required to have all drugs. Certain drugs may be in formulary with some plans but not with others. More expensive drugs may also have other restrictions depending on the plan, such as the dosage they will cover, the pill quantity, or they may require step up therapy where you try out a less costly drug ?rst. More expensive drug plans, with higher monthly premiums, will have larger drug formularies than lower cost drug plans do.

Drug plans also have three phases to them. Most plans start out with Phase one, the deductible phase. The maximum deductible is set by Medicare each year. In 2026 it’s $615. With many drug plans, the deductible does not apply to the generic drug tiers, Tier 1 and Tier 2. With more expensive drug plans, they may not have any deductible for any tier at all. 

Phase Two, after the deductible phase, is the Initial Coverage Phase. In this phase you make co-payments which are set amounts such as $5 per prescription, or with some plans they use co-insurance which is when you pay a percentage of the cost such as 30%. How much out-of-pocket cost you will have is based on the tier. Tier 1 and 2 will be very low, or may even be without any copayment at all, depending on the plan.

Tiers 3 through 5 will have higher co-payments which is where your out-of-pocket costs can add up.  

But there is protection. If your own out-of-pocket amount reaches $2,100 then you arrive at a new phase called the Catastrophic Phase. After reaching $2,100 in a calendar year, which takes you into this catastrophic phase, you would have no further co-payments to make for the rest of the calendar year. 

It is however important to know that if a drug is not in formulary with your plan, then the cost will be 100% out-of-pocket so if you take expensive named brand drugs it is very important to check a plan’s formulary before you enroll. If no drug plan covers a drug that you take, you can apply to have it brought into formulary for you, called an exception. Your doctor can likely assist you with this paperwork.

For some people, who are taking only basic generic drugs, choosing a drug plan may only take a few minutes of homework. For others it could be vital to understand exactly how, and even if, their drugs will be covered by their plan.

As healthcare agents, due to a recent cost-cutting measure by carriers, we are no longer paid commissions for drug plans by most carriers. Although we are not compensated, at ItsThatTime we believe that o?ering our knowledge in assisting our clients with their drug plans is an important part of our job. We will therefore run your drugs and make our plan recommendation for you, as a service.

Medicare has rules. Being part of the government: Yup, Lots and lots of rules. As healthcare agents, we especially need to follow these rules in order to stay in Medicare’s good books. This will limit the information I would otherwise provide in this video and if I seem vague on points, or don’t mention any specific carriers by name, you’ll understand why.

      There is something else that is important to know. As of 2026 very few prescription drug plans pay healthcare agents, such as we are, a commission anymore as they did in the past. With new regulations that have been imposed on them by Medicare, drug plan carriers came to the belief that their margins were too tight to pay agents. As a result, most healthcare agents have chosen to leave drug coverage entirely to the client to figure out for themselves. For many people though, especially those taking high-cost drugs, or with many prescriptions, this is where some people need the assistance of an experienced healthcare agent the most.

      With my agency, ItsThatTime, myself and my agents therefore see helping clients with their drug plans as a service. If you need help, or advice, or a quote, we are here to offer this to you, even without a paid commission, as an important service. And before anyone offers, no, we cannot take payment of any kind directly from clients. Not even homemade cookies. That is strictly against Medicare’s rules.

       So, if we do a good job, send us a testimonial, and send any friends you have joining Medicare our way, as your thanks.

       That said, drug coverage can come in a few different forms. First as an included part of Medicare Advantage plans. But if you are viewing this video then the chances are you are going with Original Medicare and a Medigap supplement instead. Second, some people have VA coverage and can get their prescriptions through the VA. But for most people who are choosing Original Medicare, you will need what is called a stand-alone prescription drug plan. 

     There are 4-5 carriers that offer these drug plans with premiums ranging from very little to over $100 a month. The difference in cost comes down to the drugs each plan covers, with more expensive plans having a larger number of drugs they cover which is called their formulary. The more expensive plans also often cover the deductible which can be up to $615 in 2026. The less costly plans don’t cover the deductible, however they usually, but not with all plans, exempt Tier 1 and 2 generic drugs from the deductible.       

       For the majority of people, the less expensive plans work just fine but for those with more expensive drugs it will be important to know which drug plans cover your drugs the best and with the lowest copayment cost.

      We can help research this as a service to you. You can also run your drugs yourself by going to Medicare.gov, and putting in your drugs you take, and the dosages. If you are on simple generic drugs most drug plans may well formulate them the same as Tier 1 and Tier 2 drugs. If this is the case you will likely pick your plan based upon the lowest premium cost. 

      Another factor could be which pharmacies are preferred by a plan, which leads to a smaller co-payment. For instance, if you use Walgreens, Walgreens could be a preferred pharmacy with some drug plans but not others. Medicare.gov will also show you which plans your pharmacy is preferred with. 

        On the Medicare.gov site you will see all the plans that are offered, how much the monthly premium will be and an estimate of your drug costs for each plan based upon the drugs you entered, and their tiers with each plan. The bottom line is you will be able to gauge which plan fits best for you based on overall cost which includes the monthly premiums combined with the drug co-payments for the drugs you take. 

      Of great importance to some people will be whether all their drugs are even in a plan’s formulary. If a drug is not, and you need to take that drug, you can apply for a formulary exception, with your doctor’s help, to have it brought into formulary. There is no guarantee on success.  Experimental drugs and compound drugs are of particular challenge.     

       You will also be able to change your drug plan each year during Annual Enrollment Period. Each year you should also do a review, especially if you take higher tiered drugs, as plans can change their drug formulary from year to year. Annual premiums can also change dramatically from one year to the next.

Here is an interesting statistic. In 2019, 46% of all airplane passengers were 60 years of age and over. And why not? We have grandchildren, bucket lists and we finally have the time to visit those places we’ve always wanted to see. 

It’s no wonder that one of the biggest areas of questions I get about Medicare is how Medicare works with travel. People worry, if I cross the county line and a tree from another county falls on my head, “Am I covered?” Or what if it’s a tree in Greenland falling on a traveler’s head? There are a few. 

So, here is the skinny. Medigap supplements are national. If you live in Pittsburgh but want to see any doctor who takes Medicare in say Casper, Wyoming, go ahead. You’ll be covered the same as if you were in your home in Pittsburgh. The same privilege applies to clinics and hospitals.  

Some people may even seek out medical facilities in other places that specialize in a medical condition which they have. One of the reasons to have Original Medicare and a Medigap supplement in the first place is what I call the Lance Armstrong factor. Lance Armstrong, the famed cyclist, had testicular cancer and went from Texas to Indiana for treatment. The reason why was because the University of Indiana Hospital was the best there was for his kind of cancer. 

With a supplement seeking out specialty clinics in other places is doable. Feel free to travel anywhere in the country to seek out the best medical alternatives, just so long as they take Medicare, as most medical facilities do. Likewise, if you have one of your children living somewhere else and because of this that is where you want to get a surgery done, there’s no issue with doing so.    

Another question I get is on International Travel. Both Plan G and Plan N provide emergency medical coverage for international travel with a $50,000 lifetime. It has to be an emergency though. But then, no one is traveling in Turkey and thinking, “I’m bored today. Why don’t I go see a doctor just as an activity,” if doing so isn’t an emergency.

Note though, that you will probably have to pay the hospital in another country and then seek a reimbursement when you get home. A Medigap supplement also only covers 80% with 20% being your own out-of-pocket cost. There is also a $250 annual deductible. Be aware that the out of country coverage in Medigap insurance is only good for the first 60 days away from the USA. So, if you are planning to go on the Viking Cruises 170 day round-the-world cruise costing a mere $79,000, from a medical coverage standpoint, it isn’t going to sail.

Besides you, guess who has been doing their job for 65 years now. It’s your teeth. And they have to keep on chewing away. They don’t get to go to the tooth HR manager and say, “I retire.” Let’s face facts. At 20 or so chews per each bite taken, after 65 years later it adds to millions of chews. 

Medicare does not cover dental, vison or hearing except under rare instances such as breaking your jaw. There’s a reason for this. It’s because if Medicare did cover such things, Medicare would have gone broke years ago. The fact is, it’s common for people to spend more on their dental in a year then they do on their medical. 

There are however private insurance options for dental coverage. We deal with around 10 different carriers that have dental plans. These plans fall into two general categories. One category are plans that cover only dental. Many carriers also offer a separate vision plan. The other category is called DVH plans which stands for Dental, Vision and Hearing which bundled all three together.

Dental coverage with plans varies in a number of ways. First is the coverage amount itself which can range from $500 to $10,000 depending on the plan. It’s interesting to know that you may only need to pay an extra $20 to $30 a month to jump from $1,000 a year in coverage to $10,000 in coverage. A second way plans vary is in the copayment amount with some plans requiring a higher contribution from you and others being more generous on their end.

A third key consideration is if you might need dental implants at some point. Implants are expensive and some plans don’t cover implants at all whereas other plans will only cover a small contribution. On the more encompassing end are plans which offer up to $3,000 a year for implants. 

A question that is foremost for many people is whether their dentist is in network with a dental plan they are considering. People are often even more loyal to their dentist than they are to keeping their doctor. Most dental plans are PPOs allowing you to go out of network but if you do leave network you will have a higher out-of-pocket cost. 

Dental plans negotiate a lower rate with dentists who are in network. These dentists have agreed to accept a discounted amount because of the volume of business these dental plans bring their way. If a dentist is in their network costs for various procedures are often cut in half. All plans will have a dental search where you, or we, can check to see if your dentist is in network.  

With a DVH, you can use a portion of your benefit for eye exams and eye glasses or contact lenses. 

Speaking of eyes, a common question I often get is whether Medicare, which doesn’t cover vision, covers cataract and other such surgeries. The answer is that when you see an ophthalmologist, who is a medical doctor specializing in the eye, it is covered by Medicare no different than seeing a doctor for your back or your kidneys is. However, laser surgery for vison correction won’t be covered. 

A DVH, or a vision plan add on with a dental plan, will give you limited coverage, usually just a few hundred dollars each year in benefits. Likewise, the hearing portion of a DVH will be very limited. Hearing aids can be very expensive and with a DVH plan coverage is usually capped at a $500 contribution for the hearing portion.    

Note that there are pre-existing condition limitations on dental plans. You can’t expect to break a tooth needing an expensive crown, and sign up for a dental plan the day after it happens, and expect your new plan to pay for the cost. Plans will have a waiting period. For many plans your benefit percentage also increases when you have been on the plan 2 or 3 years. For instance, you could start out at the plan paying 20% of major dental procedures and then increasing their contribution to 60% after 2 years.  

We are experts at dental plans and are happy to send you a quote and answer any questions that you have.

Dave “Tiger” Williams of the Toronto Maple Leafs holds the NHL hockey record of most time in the penalty box: 3,971 minutes. 

This has nothing, of course, to do with Medicare penalties but if you are ever on a game show and are asked who holds hockey’s penalty box record and the prize is a million dollars. You’re welcome!  

Many, many people worry about penalties with Medicare. I get a lot of people phoning me just to be reassured that they won’t get a penalty in their situation. So, let’s understand when there are penalties. Medicare has two penalties that you need to know about.   

The first penalty is for not having your Medicare Part B when you should. Turning 65 puts you into that “should” category. The penalty for not having your Part B is having an extra 10% tacked onto your Part B premiums for each year you do not have Part B when you should. So, if you simply don’t get around to enrolling until you are 68, the penalty is an extra 30% added on.

If you enroll into Medicare late, meaning outside of your 7-month window when you turn 65, the only time you can then enroll is during General Enrollment Period which is January 1 to March 31 each year. The rest of the year you are out of luck and have to wait.   

There is a big exception though to being required to enroll into Medicare penalty free at age 65.  People who are still working and have credible group healthcare coverage, or are the spouse of someone who has group coverage, can defer their Medicare until they retire and they lose Group Health Coverage, deferring without any penalty at all. Your insurance must be considered credible by Medicare as almost all Group Health coverage plans are. Credible means it is at least equal to Medicare in what it covers. If you are not sure about this then consult with your HR department.

The second penalty is a Part D penalty, for not having in place drug coverage after you become eligible for Medicare. This penalty is 1% of the average cost of a drug plan added to your cost when at some point you do sign up for a drug plan. The penalty works out to around 40 cents per month. So, let’s say you wait 2 years to sign up for a drug plan, at 40 cents times 24 months, it will add around $10 each month to your drug plan premium cost.

Once again, if you have Group Health Coverage you won’t have to worry about this penalty either as long as you are working and keep your coverage. Many people who have VA benefits will get their drugs through the VA. VA drug coverage is also allowable by Medicare and you won’t have to worry about the Part D penalties. 

But, let’s say you signed up for a free GoodRX card. That’s not going to fly with Medicare!  

Loren Wade holds an interesting American record. He was America’s oldest employee, ever, when he celebrated his 103rd birthday while still working in his 33rd year greeting people at a Wal-Mart in Kansas. This may not be how you and I want to celebrate turning 103, but many people do choose to work past age 65.

      As discussed further in the video on penalties, and the video on enrolling in Medicare, as long as you actively work for a company with over 20 employees, if you decide to stay on Group healthcare coverage instead of applying for Medicare it should not result in any penalties.  You can apply for your Part A when you are turning 65 which is without any cost for most people, or you can delay Part A, too. As for Part B, you will want to delay Part B if you are keeping your Group health coverage and there is more than 20 employees in your Group, as having Part B will duplicate what you already have with your Group health coverage and you’ll be paying for Part B with no meaningful added benefits.

      Note, though, that you must keep actively working. Retirement plans, or COBRA, do not provide a basis for a Medicare deferral after you turn 65. 

      When you reach 65 and continue to work you will generally have a choice between staying with your Group healthcare coverage or surrendering it to go onto Medicare. You will want to compare the cost and benefits differences both ways. For many people Medicare is the better deal, after all you have been paying into Medicare for 40 years so it should be a great deal. Of course, every group plan is different and some are more generous than others. The other issue you will want to weigh is if you are paying into an HSA. If so, delaying Medicare will allow you to continue contributing to your HSA further. You must, however, stop making HSA contributions 6 months before you do enroll into either Part A or Part B of Medicare in order to avoid tax penalties. You will want to calculate your retirement accordingly.

     Those who have a spouse who is not yet 65 themselves, and is on their Group Health plan tend to stay put with group health coverage so that their spouse can retain coverage.

      When you are getting ready to retire is when you will want to enroll into Medicare Part B giving yourself 2 to 3 months for approval of your application. I recommend doing so through an appointment with your local Social Security office where an agent there can take your paperwork, sometimes shorten the approval process, and work with you on a timeline for beginning Medicare. Appointments can take 2-4 weeks to get. You can apply for Part B online instead, but there will be less control of timelines that way. 

      You will need some very important paperwork in order to apply for your Medicare Part B if you are past age 65 which is referred to as a delayed enrollment. These Medicare forms are referred to as Evidence of Credible Coverage. They show Medicare that you have had healthcare coverage through work from when you turned 65. The bottom line is that you get these forms from your HR Department who will know exactly the paperwork that you need.

      Once you get your Part B approved by Medicare, you will have essentially the same options as someone has when they’re turning 65. You will be able to sign up for a Medigap supplement with no underwriting and have a Special Enrollment Period to sign up for a Part D drug plan as well. If you prefer a Medicare Advantage plan you will have that option as well.

     While you wait for your Part B to be approved, we are happy to go over all of your plan options with you.  

You did it. You enrolled first into Medicare itself and you have your red, white and blue Medicare card to prove it. And, now you also have added a Medigap supplement and probably a drug plan as well to the mix. You are now officially one of us, a senior.

Here is some important information to know now that you are enrolled. Your plans will start on the first day of the month that you enrolled in to begin your Medicare coverage. Even if your card hasn’t arrived yet, you will still be enrolled and covered as of your start date.

You will receive a welcome kit in the mail from the carriers you enrolled into including a membership card. You will also have a portal for those carriers where you can view a lot of important information online.

We at ItsThatTime also know people have only so many slots in their wallet and don’t like having to carry around a paper Medicare card, that soon rips, along with paper cards from all the other medical plans they are enrolled in. That’s why we created what we call “The Convenience Card”. It has your Medicare card number, and the names and member numbers for each of your medical plans, along with contact phone numbers for them, and we put it all onto the same credit card style card. This is something we put together and send to you as a service to you. If you ever need a replacement card, just ask.    

Should you ever move to a different county please notify your carrier as they will handle a move and any changes they need to make on their end. 

A very important area I like to talk about is Preventative Health. Medicare has a list of preventative measures that falls into the preventative health category. These items are not subject to the annual deductible. If something is on the preventative care list, you should not have any out-of-pocket copayment costs. 

The most important item on the list is called a “Welcome to Medicare visit.” You make this appointment with your primary care doctor. It is a head to toe physical with lab work that will screen you for a large variety of concerns. Your Welcome to Medicare visit is extremely thorough and gives you a baseline for moving forward with any health concerns. When you call your primary care office just say you want a ‘Welcome to Medicare’ visit scheduled and they will know exactly what you mean. After that, each year you are entitled to an Annual Wellness exam which is not as all-encompassing but is designed to keep you healthy and find any potential medical issues at the earliest point. 

Other items that fall into the preventative health category include prostate exams, mammograms, and the colonoscopies that we all look greatly forward to. In addition, various vaccines are covered including covid, flu, pneumonia and shingles. You typically get these at your pharmacy

As long as you continue to pay your Medigap plan premiums, and pay Medicare itself for your Part B premiums, your Medigap supplement plan can not be cancelled by the carrier based on the cost of your claims. Nor can your premium be increased because of claims. Premiums do however increase over time as costs go up, and in some Medigap plans because you age, which I discuss in other videos.            

Your prescription drug plan can be changed each year during Annual Enrollment Period (AEP) which is from October 15 through December 7. You will get a letter in September from your carrier each year letting you know the premium for the following year and if there are any other changes, most especially to the drug formulary. Generally, if you take no action to make a plan change during AEP, your plan will roll over.

What follows is not intended in any way to offer medical advice and, of course, you should always consult with your doctor. That said, with being in the healthcare industry, studying ways to better achieve health and longevity has become a hobby of mine.  

I wanted to offer my ten favorite health tips. All these tips are based upon multiple credible studies. But I won’t bore you with study details which, if you like, you can google on your own. 

It goes without saying that getting good sleeps, plenty of exercise, and eating a healthier Mediterranean style diet will contribute greatly to one’s health and longevity. These ten tips, that are favorites of mine, may be less known: 

Tip One: Eat Lots of Mushrooms: I always tell people that me and mushrooms have something in common. Were both fungis (fun guy, get it!). Okay, bad jokes aside, mushrooms are delicious, at least I think so, and all that deliciousness has only 4 calories per mushroom. Mushrooms are a tremendous source of bioactive compounds that have anti-toxin and anti-inflammatory benefits. Mushrooms reduce triglycerides in blood which are major factors in strokes and heart attacks. Mushrooms can also reduce cholesterol levels and blood pressure.  

One to two cups of mushrooms a week have been found to significantly reduce various types of cancer including breast and prostate. Mushrooms, especially Lions Mane, help stimulate nerve growth which improves cognitive function. Reishi mushrooms are sometimes called nature’s Xanax because they both reduce stress and improve sleep. Finally, mushrooms are a key source of pre-biotics for gut health.  Mushrooms can of course be eaten cooked, or raw if you like, or are available combining a variety of mushroom types in capsule form.  

Tip Two: Eat Wild Blueberries. We all know that 1950s classic, “I got my thrills on Blueberry Hill.” Maybe the reason the hill was so thrilling was because of all those wild blueberries. Blueberries themselves are on just about every list of the 10 best foods for you. But, did you know that wild blueberries have 2 times more antitoxins and 30% less sugar than regular blueberries do? They are an anti-toxin powerhouse, high in fiber and linked to improved cognitive skills and cardiovascular function including lowering blood pressure and improving blood vessel function.

I am not suggesting you go out wild blueberry picking every weekend, although that does sound like a fun activity. But look for wild blueberries that have been flash frozen to keep nutrients locked in, available at grocery stores or online. Just tell them Tom sent you. Just kidding, they won’t care.   

Tip 3:  Get the Shingles Vaccine: Here is an interesting question that could come up if you’re ever on a game show. What percentage of seniors have gotten the shingles vaccine as is highly recommended for us seniors to do. Is it 35%, 48%, 61% or 73%? If you answered 35%, you are game show ready. 

The shingles vaccine is free when you have Part D drug coverage. We all know what the shingles vaccine is primarily for, shingles. Around 50% of seniors will get shingles, with the risk increasing greatly as you age. People who have had shingles will all tell you the exact same thing, “Don’t get shingles.” 

It’s painful and uncomfortable, and at its worst can last months or years and can lead to blindness, heart attack, strokes and facial paralysis. The shingles vaccine reduces the risk of getting shingles by 90%.   

But here’s what you probably don’t know. A new major study showed that the shingles vaccine does more than just protect us from shingles. It reduces the risk of developing vascular dementia by half in a study of 170,000 people. The shingles vaccine is also associated with significant decreases of risk from cardiac events and death, with heart attacks being lowered by 25%.  

Tip Four: Take Creatine: As we age, we lose muscle. That is as inevitable as the hair on our head, and many of us lose that, too. When we were young, we wanted lots of muscles because, for men anyways, we all wanted to look like, if not Arnold Shwartsneiger, at least Silvester Stallone. As seniors, growing older, muscles are even more important because they keep us active and protect us against dangerous falls.  

Creatine supplements, in a variety of forms including tasty gummies, can be a key aid in combating muscle loss, increasing lean body mass and adding to endurance. Creatine also aids the brain and is shown to slow down brain aging. Low amounts of creatine are found naturally in red meat and shellfish especially. In order to get 3-5 grams daily of creatine as recommended, most people will need to take a creatine supplement. Hello, delicious creatine gummies. 

Tip Five: We Need Protein: And speaking of muscle, just like the main ingredient in bread is flour, the main ingredient in muscles is protein. In our senior years we actually need more protein than we did when we were younger. There are two reasons for this. One, our bodies become less efficient at converting protein to muscle and so most of it goes to waste. 

Second, more than ever, we need as much muscle as we can get because we will be losing muscle rapidly and the muscle mass we do retain both protects us against injuries and infections and having enough muscle strength adds to our vitality and life enjoyment. The recommendation for seniors is around 50 grams of protein daily per hundred pounds you weigh, so for a 150-pound person, it’s 75 grams. 

It’s best to spread protein out over three meals, so for instance, 75 grams of protein would be 25 grams per meal. In chicken terms a 6-ounce chicken beast has around 50 grams of protein, an egg 6 grams. So, the chicken comes first when it comes to protein. Meat, yogurt, oatmeal, cottage cheese, nuts and beans are other excellent protein sources.    

Tip Six:  Get Your Fiber: What is fiber? For many of us it’s a mystery. We know it’s something that good for us. We kind of know that bananas have fiber. And after that, the mystery begins.

Another name for fiber is roughage. We can all remember our mothers telling us, “You have to eat your roughage.” Fiber is the portion of food derived from plants that you can’t digest and absorb. Your body digests the other parts of food such as fats, proteins and carbohydrates, but fiber simply passes through your body intact taking the journey through your small intestines and colon and then making its way back out into the world. Yes, as number two. 

Most people don’t know that there are actually two types of fiber: soluble fiber dissolves in water and insoluble fiber does not. Soluble fiber passes through our body but while it is there it does good things. It’s kind of like the houseguest who washes the dishes. Soluble fiber helps lower your levels of blood sugar and your bad cholesterol.

Insoluble fiber does not dissolve in water. Because it doesn’t dissolve it becomes the locomotive for your digestion system and forms into the bulk of your stools. As such, getting plenty of insoluble fiber hopefully keeps you from becoming constipated.  

Most plant-based foods contain both types of fiber. But the ratios are different. Some foods lean heavily towards insoluble fiber content while others focus their attention more to the soluble side. The bottom line though is we need a good deal of both types of fiber for different purposes. So, get a variety of fiber sources.  

When it comes to fiber, the proof is in the pudding, as they say. Harvard Medical School did an analysis of over 250 studies on the benefits of added fiber and concluded that those who ate more fiber in their diet reduced their risk of dying from heart disease, stroke, type 2 diabetes and colon cancer by 16% to 24% when compare to people who ate less fiber. 250 studies are a lot of pudding proof! Ideally banana pudding for the fiber.  

Fiber also helps to keep your weight down and your appetite suppressed.  

Senior men should get at least 30 grams of fiber a day, women at least 21 grams. Some of the best ways to accomplish this is with a high fiber breakfast cereal, around 10 grams, an apple or banana 5 grams, and beans and peas are high in fiber as well. Follow the fiber content on labels and mix up your fiber sources to get plenty of both kinds.    

Tip 7. Flavanols Especially for Sitters: As we get older our blood vessels do not transport blood as well as they once did. This is especially a problem when you sit a lot, as when sitting we reduce the efficiency of how well our blood vessels are able to do their job. 

A major study of Britain, found that cocoa which is high in flavanols, and which the British happen to love, caused the blood vessels to work as well while sitting as they do while standing. So, if you’re going to have a long sit, a cup of cocoa that it high in flavanols could be a good idea. Other foods high in flavanols include nuts, apples, berries and tea. But not doughnuts, darn it.    

Tip Eight:  Vitamin D, It’s The Sunshine Vitamin: What’s the best source of Vitamin D? The sun. So, I certainly would have thought that living in Arizona, the state ranked Number One in sunshine, I wouldn’t have a Vitamin D deficiency. But I did, and I wasn’t alone. A whopping 70% of seniors have a Vitamin D deficiency. The reason is, as seniors our bodies generate only around 1/4th the Vitamin D as we did in our 20s. 

     And who needs Vitamin D protection the most given that it is instrumental in bone health by aiding the absorption of calcium, helps maintain muscle strength, boosts our immune system, regulates blood sugar, and plays a key role in fighting heart disease? It sure sounds like the answer is: seniors.  

     And speaking of heart disease, an exciting game changing study came out in 2025 by Intermountain Health in Salt Lake City. They found, in a large trial, that a Vitamin D3 supplements reduced the risk of a second heart attack in half for those who had suffered one previously. 

     And, imagine that. That’s the kind of results giant pharmaceutical companies tout from a pill they charge a $1,000 a month for. And here we can cut our second heart attack risk in half from something we get free from the sun. Or at worst, a month’s supply of D3 pills cost us only a few dollars.   

     The recommended dose of Vitamin D for seniors is 800 IU though some experts recommend up to 4,000 IU per day can have value, a higher dose should be in consultation with your doctor. Higher doses, especially above 4,000 IU can be harmful. 

Tip Nine: Something to Sing About: Saffron! Some of us might remember the Donovan song Mellow Yellow from 1966, with the opening line, “I’m just mad about Saffron and Saffron’s mad about me.” 

      It turns out that there could be something very “Mellow Yellow” about the spice saffron, which is delicious in rice and many other foods, and available inexpensively as a supplement. 28 different studies have shown that saffron could be as effective with dealing with depression as anti-depressives are. And most “mellow yellow” for us seniors is that saffron seems to also have a positive impact on sexual function and on preserving memory function. A couple of important functions worth preserving, wouldn’t you say?  

Tip Ten: Foodless Evenings:  Oh, to be a kid again. I could eat anything, and I did. Milkshakes to my heart’s delight! And I never gained an ounce of fat. My mom would say she could use my ribs as a washboard. But now that I am a senior, there’s clearly no more clothes getting washed on my ribs. 

Weight control is a tough issue for many seniors as our metabolism changes and it becomes difficult to shed unwanted pounds. Fat around the organs is a big issue for heart health and also impacts many other conditions such as diabetes.  

One of the trends that has come into vogue is intermittent fasting, particularly by not eating for a 16-hour window, limiting eating to from noon to 8:00 pm. For many people this has worked well with weight loss and as well as other health benefits. Of course, other nutrition experts advocate that eating breakfast, and especially getting our protein in the morning, is important. 

Either way, a recent major study at Northwestern University has added a new wrinkle. They found major health benefits by not eating the last three hours before sleep. So, if you go to bed at 10:00 then no more eating after 7:00. The study shows that by doing so we have meaningful drops in both our blood pressure and in our heart rate while we sleep and we also have better daytime blood sugar control. Not to mention that less time for evening snacking means less calories and in so doing controlling weight gain.