It's not the greatest.

First, you have a window of opportunity for enrollment - 3 months before the month you turn 65, and 3 months after the month you turn 65. Once you select a plan and enroll, stay on top of it. Don't assume the paper work will be processed in a timely fashion. My husband and I enrolled at the exact same time (months ahead of our individual deadlines) - his application was processed, mine wasn't. I had to chase them and my application still wasn't processed until one day before my deadline.

If you have enough work credits (which I imagine you do), Part A/Hospital has no premium charge.

Part B coverage is for medical/doctors. You have to pay for Part B. My husband and I are each charged $179.00 per month. Premium rate is based on income (which you made mention of in your post). It doesn't pay for medications, dental, vision. Also, be aware that each year, premiums have risen. When we first signed up for Medicare, our premium was $140.00 each month. Yes, once you collect Social Security, you will get COLA/cost of living adjustment each year. That is typically swallowed up by the rise in the Medicare premium. If there is anything left of your COLA after Medicare gets its hands on it, it generally will only buy you a cup of coffee and a buttered bagel.

You can choose either Original Medicare or Medicare Advantage. (I don't know if there are any other options other than these two routes).

Original Medicare only pays a percentage of the total charge (and that charge is what is considered a 'reasonable charge' if I understand correctly) - I think something like 80% (but don't quote me on this). Many people select to supplement Medicare with a medigap insurance policy, such as United Health Care. If you want drug coverage, you need to also sign up for Part D. If you don't want to sign up for Part D, you can select to sign up for it at a future date but be forewarned - if you don't sign up for it when you first sign up for Medicare, you will be charged a fine. That fine/charge will remain with you until you are no longer on Medicare - that is, until you die. The fine, to the best of my knowledge, is based on the length of time you went without drug coverage - the longer the time frame, the higher the fine.

Original Medicare with a Medigap insurance plus Part D is the more expensive way to go. My mother had it. It offered the best coverage, but believe me she paid for it.

The other plan you can select is Medicare Advantage Plan. (I think its called Part C.) It is essentially Medicare that is 'enhanced' by an outside insurance carrier plan. Its somewhat better coverage. We currently have this plan as we couldn't afford Original Medicare with Medigap and Drug Coverage, though we wanted it. If you opt for an Advantage plan, you may not add a medigap policy to it. The Advantage plan you select will determine what your drug coverage will be - it is, to the best of my knowledge, included.

Some Advantage plans do not charge an additional premium (the rock bottom plan quite often), but then the coverage is rather limited. The next step up from the bottom, so to speak, is the Advantage plan my husband and I selected. It comes with better medical/doctor coverage, drug coverage, and some meager coverage for dental and vision (and I do mean meager). Not all plans offer the same coverage, so you have to do comparison shopping.

Advantage plans are not without problems. Generally speaking, they do not pay for any medical problems you may encounter while traveling out of your 'area'. They only cover emergency services (and sometimes they limit that). The Advantage HMO plans will only pay for in-network providers. They will pay nothing for out of network, so you are on your own with that. We selected a PPO plan, which pays in-network providers and a rather reduced amount for out of net-work. I could be wrong, but I think the PPO requires a referral to see a specialist. I always ask for a referral to shut the insurance company up before it even thinks of opening its mouth. Again, all of the is dependent on the plans offered by the insurance carrier you go with.

We each pay $70.00 per month for the Advantage coverage. So, between the both of us, our Medicare Advantage plan is costing us $498.00. Since this isn't enough coverage, my husband (who still works full time), has taken out additional coverage with his company for dental, but we still end up paying a hefty bill if we need work beyond the typical routine care.

I always use in-network providers and generic drugs whenever possible. My husband avoids doctors at all costs. Drugs are assigned 'tiers'. The higher the tier the drug has been assigned to, the less the plan will pay for it. So make sure you know what tier your scripts (if you take any) are assigned to and how much you will be responsible for paying before you sign up for a plan.

Not all plans are the same - coverage varies according to the plan you select, the area you live in, your income, and the insurance carrier you sign up with (for either the Advantage Plan or the Medigap insurance).

It's complicated, and to add on top of it, plans change. Insurance companies are notorious for changing coverage. Our original plan was discontinued. My husband and I had to not only find a new plan but a plan that had in-network providers in our area. It takes me 1 1/2 month to see my primary, specialists can take anyway from 3-12 months.

Finding in-network providers has become a problem around here. Medicare pays around 30-50% less than what private insurance policies pay. More and more providers are dropping out of network. Providers that are still in the network quite often no longer take new patients as their practice is over-flowing with patients. The problem continues to get worse around here.

Each year there is an open enrollment period, when you can switch plans. There are also rules that apply to switching plans, so make sure you are familiar with them too.

When we originally signed up, we did all the work ourselves. When our Advantage insurance carrier discontinued our plan, we used an insurance agent to help us navigate the new waters and find a plan. So far, our plan 'will do'. It could be better. I've already been denied coverage for a drug I need. I appealed it, but as I suspected, it was a wasted endeavor. I can't afford the drug, so I go without. Also, be aware that I have heard claim of Advantage plans being sued for refusing coverage on claims that they should have. I think United Health Care has also been hit with law suits, but I don't know the details as we are not insured through them. Such is the state of healthcare today - access to care is crappy if you are someone of limited financial means.

I am not an insurance agent, nor am I an expert on this. What I wrote is based on my personal experience and understanding. Policies and coverage can change yearly, so my advice is to be on your toes with this and start planning well in advance.

Good luck!!