Medicare, explained simply
Tom Vaughn has advised on Medicare for over 15 years on the Southern California coast. He explains the parts and helps you choose.
Are you eligible for Medicare?
Nearly everyone qualifies at 65. Income does not matter. Still working does not matter. If you or your spouse paid Medicare taxes for 10 years, Part A is free.
Some people qualify earlier. That means 24 months of Social Security disability payments, ALS, or long-term kidney failure.
Tom's most important advice: Start before you turn 65. What you choose, and when, affects your cover and your costs for life. A 15-minute call with Tom months before you're eligible can save you from costly mistakes.
The 7-month window
What Medicare covers, and what it leaves you
Medicare comes in parts. Each covers something different. Tom helps you match them to your doctors, your medicines and your budget.
Medigap · Medicare Supplement
Medigap pays most of what Original Medicare leaves you: deductibles, coinsurance and copays. See any Medicare-accepting doctor in the country with predictable costs. Tom specializes in Plans G and N, the best balance of cover and value for most clients.
- See any doctor who takes Medicare, with no referrals
- Covers most gaps left by Original Medicare
- Covered anywhere in the country, so it suits travellers
- Predictable monthly premium, minimal surprise costs
- Pairs with a standalone Part D drug plan
Medicare Part A & B
The base everything else builds on. Part A pays for hospital stays, nursing care and hospice. Part B pays for doctor visits and check-ups. Together they cover about 80% of approved costs.
- Part A: hospital, skilled nursing, hospice
- Part B: doctors, outpatient, preventive care
- The 20% gap is why most people add Medigap or Advantage
Medicare Advantage · Part C
An all-in-one alternative that bundles Part A, Part B, and often Part D through private insurers. Often includes dental, vision, and hearing. Lower premiums, but network-based.
- Bundled coverage: medical + drug + extras
- Often includes dental, vision, and hearing
- You have to use the plan's list of doctors
Prescription Drugs · Part D
Standalone drug plans that work alongside Original Medicare and Medigap. Tom runs your specific medication list against every available plan to find the one that minimizes your total cost.
- Covers outpatient prescription drugs
- Tom compares all Part D plans against your medications
- Plans and drug prices change every year, so it's worth a yearly check
- Late enrollment penalty if you go without creditable coverage
Tom works for you, not the insurance company
Some agents sell one company's plans only. Tom is tied to none of them. He compares the major insurers and tells you which plan fits.
His advice is free. The insurance company pays him when you sign up. Your premium is the same either way.
Questions Tom hears every day.
If you don't see your question here, Tom is happy to answer it directly.
Ask Tom directly →The sign-up window is seven months. It opens three months before the month you turn 65. Miss it without an exception and you pay a penalty for life. On Part B that is 10% for each year you waited.
Medigap adds to Original Medicare. Medicare stays primary. Medigap pays most of what Medicare leaves. Any doctor who takes Medicare will see you. Medicare Advantage is different. A private plan replaces Original Medicare. You often pay less each month. You must use that plan's doctors.
Yes. The insurance company pays Tom when you sign up. You pay nothing. Your premium is the same either way.
It depends on the size of your employer. 20 or more employees: your work plan stays primary and you can wait. Fewer than 20: Medicare becomes primary at 65, so sign up then.
They are the two most complete Medigap plans. Plan G leaves you one bill: the yearly Part B deductible, about $240. Plan N costs less each month. You pay small copays at office and emergency visits.
Ready to find the right plan?
Talk to Tom for free. By phone, on Zoom, or in person.
Get in touch
Tom responds the same day, Mon–Fri.
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