Your Medicare Starting-Point Report

Where are you with Medicare right now?

Choose the answer that is closest to your situation.

I’m not on Medicare yetI’m turning 65 or getting close to Medicare. I’m already on MedicareI want to understand or review what I have. I’m over 65 and still covered through workMy coverage may be through my employer or my spouse’s employer. I’m not sure where I fitThat’s fine. The report can help identify what to verify.

What does your timing look like?

This helps Max identify enrollment and employer-coverage questions that may matter.

When do you turn 65? (month and year) Will you or your spouse still have employer health coverage then? If yes, about how many employees does that employer have? Are you currently contributing to a Health Savings Account (HSA)?

What kind of coverage do you have now?

If you are not sure, choose “I’m not sure.” That is useful information too.

Original Medicare onlyParts A and B without a Medigap policy. Original Medicare + MedigapI also have a Medicare Supplement policy. Medicare AdvantageI receive Medicare benefits through a private Medicare Advantage plan. Employer, retiree, or union coverageIt works with or alongside Medicare. VA, TRICARE, or other coverageI have another government health benefit alongside Medicare. I’m not sureI’d like help figuring out what I have.

How does your work coverage fit with Medicare right now?

These details can materially change what you need to verify before changing coverage.

Are you enrolled in any part of Medicare now? Is your health coverage tied to current active employment? About how many employees does that employer have? Are you currently contributing to a Health Savings Account (HSA)?

That’s okay. What best describes why you came here?

I’m approaching 65I know Medicare is coming, but I’m not sure what I need to do. I already have some Medicare-related coverageI’m not sure exactly what type it is. I’m working past 65I’m trying to understand Medicare and employer coverage. I just have Medicare questionsI want a starting point before talking to anyone.

What matters most to you?

Choose every item that genuinely matters. There is no “right” answer.

Keep my current doctors and hospitals Keep the monthly premium low Predictable out-of-pocket medical costs Strong prescription-drug coverage Freedom to use providers across the country Coverage that works when I travel or live in more than one place Dental, vision, hearing or other extra benefits Keep things simple and easy to manage

Which tradeoff sounds more like you?

This is not a plan recommendation. It helps the report understand how you think about cost and flexibility.

I prefer more predictability and flexibilityI may be comfortable paying more each month if that reduces uncertainty when I need care or gives me broader provider choice. I prefer to keep the monthly premium as low as practicalI can accept provider networks or more cost-sharing when I use care if the overall fit makes sense. I don’t know yetI want the report to explain the tradeoff before I decide what matters more.

Tell us a little about how you use healthcare.

We do not need diagnoses or medical records.

How important is it to keep your current doctors? How much do you travel or spend time away from home? How important is prescription-drug coverage in your situation?

What are you actually trying to figure out?

Choose any that apply, then tell Max anything else in your own words.

What should I do as I approach 65? Can I delay Medicare while I keep working? Original Medicare + Medigap versus Medicare Advantage Am I still in the right coverage? My plan or benefits are changing Doctors, networks or prescriptions What might cost me more or less? I just want Medicare explained in plain English

What is the main question you want your report to answer? (optional)

Please do not include diagnoses, Social Security numbers, Medicare numbers, member IDs, banking information, or other sensitive records.

Where should we send your report?

This is the only reason we ask for your email address.

First name Email for your report ZIP codeWe use this only to understand the geographic context of Medicare options. It is not a street address.

I want the report, not a sales call. SafeFare may use this email address to deliver the report I requested. Do not add me to a marketing list and do not call me because I used this tool. If I want to speak with Roderick after reading the report, I will contact SafeFare myself. I understand this pilot report is educational decision support, not a plan enrollment or guarantee. Specific plan availability, eligibility, networks, formularies, premiums and benefits must be verified before I make a decision.

Before you send it

Tell Max enough to help. Keep your phone number.

We ask only what can change the report.

Review what Max will receive.

You decide what happens next.