Should you (when) sign up for Medicare A Hospital, Part B Doctor & Outpatient, Medicare Advantage, Medi Gap, Part D Rx?
Should You Sign Up for Medicare? Avoid Costly Mistakes
Turning 65 or leaving employer coverage?
Knowing when to enroll in Medicare can save you thousands in penalties and help you avoid gaps in coverage.
Get clear answers and compare your options in minutes.
Start Here: What Situation Are You In?
Select the option that best fits your situation.
- Turning 65 soon
- Still working past 65
- Losing employer coverage
- Already on Medicare and reviewing options
Do You Need to Sign Up for Medicare?
Here is the simple version:
- If you are turning 65 and do not have employer coverage, you will usually want to enroll in Medicare on time.
- If you are still working and have employer coverage, whether you can delay Part B may depend on the size of the employer.
- If the employer has 20 or more employees, you may be able to delay Part B without penalty.
- If the employer has fewer than 20 employees, Medicare may become primary and you may need Part B.
- If you are losing employer coverage, you may qualify for a Special Enrollment Period.
- Visit our webpage on Employer vs Medicare
Do not guess. A Medicare enrollment mistake can lead to late enrollment penalties or gaps in coverage.
📞 Talk to Steve About My Situation
Quick Medicare Decision Flow
Are you turning 65?
→ Yes
Do you have employer coverage?
→ No: You likely need to enroll in Medicare.
→ Yes
Does the employer have 20 or more employees?
→ Yes: You may be able to delay Part B.
→ No: You likely need Medicare Part B.
→ No
Are you losing employer coverage?
→ Yes: You may have a Special Enrollment Period.
→ No: Your next step depends on your current coverage and Medicare status.
- Visit our webpage on Employer vs Medicare
Avoid These Expensive Medicare Mistakes
- Missing your Initial Enrollment Period
- Assuming employer coverage automatically lets you delay Medicare
- Missing Part D enrollment and getting hit with a late penalty
- Choosing the wrong Medicare Medi Gap supplement or Advantage plan
- Waiting too long after employer coverage ends
- Visit our webpage on Employer vs Medicare
These mistakes can be expensive and in some cases the penalty can last for years.
Compare Your Medicare Options
Original Medicare + Medigap
- Freedom to see any doctor who accepts Medicare Provider Finder
- Predictable coverage with fewer surprise costs
- Popular with people who want flexibility
Medicare Advantage Plans
- May have lower upfront monthly premiums
- Often includes additional benefits
- Usually uses provider networks
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Employer Coverage After 65
- Sometimes you can keep it and delay Part B
- Sometimes Medicare needs to be primary
- The details matter
Common Medicare Situations
- Turning 65 Soon
- If you are approaching age 65, this is the time to find out whether you should enroll in Medicare Part A, Part B, Part D, or a Medicare supplement plan.
- Still Working Past 65
- If you are still working, Medicare may or may not need to start now. Employer size and the type of coverage can make a big difference.
- Losing Employer Coverage
- If your employer coverage is ending, timing matters. You may qualify for a Special Enrollment Period, but you do not want to miss the deadline.
- Already on Medicare
- If you are already on Medicare, you may want to review your supplement, drug plan, or Medicare Advantage coverage.
Not Sure What to Do? Get Personalized Help
You do not have to figure this out alone.
- Licensed California insurance agent
- One-on-one guidance
- No-cost consultation
Related Medicare Topics
Disclaimer: This page provides general information and is not legal or tax advice. Medicare enrollment decisions depend on your specific situation, including your current coverage, employer size, and eligibility rules.
Child Sub Pages
- What’s on this page?
Wed, 24 Dec 2008
Steve,
I was looking for some specific Medicare information and found your site on Google.
You have a great site. It is very informative without a lot of meaningless information.
I thought I’d tell you that. I think I am glad you are not in my area. I’d hate to have you as a competitor.
Best regards,
Mark A. Squires.
Principal
Squires. and Associates
Independence MO
Enrollment Details – How to
FAQ's
Open up FAQ’s below for answers
I went to Social Security and got all signed up. Now they say they have a record of me being there, but no record of signing up. What do I do?
disability secrets.com/social-security-office-lost-my-appeal-paperwork-what-do-i
We did have a client who reported that her local Congressperson helped her out and got the problem resolved.
- house.gov/find-your-representative
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nytimes.com/how-senators-and-representatives-can-help-constituents
I won’t have 40 quarters until I’m 68. When is my initial enrollment period? I don’t want any penalties.
Use this tool to determine when you are eligible for Medicare.
Your Initial Enrollment Period based on your age
Your Initial Enrollment Period based on your age contextual help
October 1, 2019 – April 30, 2020
Am I eligible to enroll?
Medicare is for people age 65 and older and those who have special condition or disability. You’re not eligible to enroll in Medicare now because you don’t meet the special condition/disability requirements.
If you’re a U.S. citizen or you meet the lawful presence and residency requirements, the Initial Enrollment Period (IEP) is your first chance to sign up for Medicare. It starts 3 months before your 65th birthday, includes the month you turn 65, and ends 3 months after the month you turn 65.
Sign up for Medicare
Costs for Medicare since you won’t get it for free…
Costs for Medicare… How does that compare to the under 65 plan you have now?
What if I have Employer Coverage?
See our webpage on that
- Medicare enrollment, if covered by Employer Plan? Retiring?
Just to make sure, is renewal automatic?
Yes, everything Parts A Hospital, B Doctor Visits, Medi Gap, Medicare Advantage and Part D Rx automatically renew.
I’m having trouble finding citable sources. I don’t count other agent websites, as it seems I’m the only one, who cites a source.
https://www.medicare.gov/pubs/pdf/10050-medicare-and-you.pdf
Didn’t you get a January bill for Parts A & B? Just pay it.
Does your prior coverage before enrolling in Parts A & B have anything to do with the coverage you will receive?
Part B Doctor Visits is exactly the same for everyone.
To get the “best” greatest selection of MD and providers you would want to sign up for a Medi Gap plan. Plan F has the most comprehensive benefits. This would be most similar to PPO and not the restrictive provider lists in a Medicare Advantage Plan (MAPD). MAPD though generally has zero premium.
If you are thinking of keeping your COBRA beyond age 65 and not getting Part B, that won’t work, see Medicare Publication 11036 Enrolling in A & B page 13.
See link above to use our Blue Cross and Blue Shield affiliate sites to view benefits, pricing and enroll online. We also have tons of detail on each page in our website.
Where and how do I shop all the Insurance Companies to get the best coverage and premium for Part B Doctor Visits?
The Federal Government – Medicare is the ONLY place to get Part B Dr Visits. I guess one could argue though that if they have employer coverage available, that would be “Part B.”
Some people might get confused though, thinking Medicare Advantage is giving them their Parts A & B…
The decisions on getting Part D Prescriptions, Medi Gap or Medicare Advantage are separate and give you additional coverage on top of Medicare Part A Hospital and Part B Dr. Visits.
Probably the first decision is if you want a Medi Gap Plan which allows you to go to any MD or Hospital that accepts Medicare, which most do or a Medicare Advantage plan with oftentimes zero premium.
Here’s our web page on helping you make that decision
Our page on how most all doctors take Medicare and if they don’t the limit on what they can charge over Medicare allowance and how if they don’t take Medicare at all, they must have you sign a form that you understand that.
Resources & Links
Medicare has done an excellent job of explaining how and when to enroll in their:
- Guide Medicare & You,
- Publication 11036 Enrolling in Parts A & B,
- CA Health Line 10.27.2016
- Washington Post on how to figure out Medicare and choose the correct plan
- Information you need to have to apply for Medicare or Social Security
- What Documents Do You Need to Apply for Retirement Benefits?
- Seniors Find Medicare Enrollment Confusing, Avoid Changing Plans
BROKER ONLY
Medi-Cal & Medicare Lookup Jarvis
- Official Medicare Brochures
- Introduction to Medicare
- How to purchase Medi Gap
- Part D Rx
- Understanding Medicare Advantage
Why isn’t it Free?
I paid taxes all my life!
FAQ’s, Misc and Historical
FAQ’s
- I am trying to get my Mom on Medicare part A. She is on part B but not part A. How can I get this done?
. - Did your Mom or Dad work over 10 years in the USA and pay into Medicare?
- Here’s our webpage on the rules if they have to pay a premium, if they don’t have enough credits
- Why didn’t your Mom sign up for Part A previously?
- When was she first eligible for Part A?
- There are monetary penalties for late enrollment.
- Please send the details to the questions above, the answer is not as simple as the question seems. Let us get you the correct information, based on your situation.
- You might have to wait for the General Enrollment Period, if you have to pay for Part A Hospital?
- How about checking our website and getting information on Medicare Advantage or Medi Gap. We can help you enroll with no extra charge for our expertise.
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- My husband turns 65 in November. I’m 61. How does that affect my Covered CA coverage and subsidies? How does that affect our MAGI income? All the income is in his name! Does that mean I’ll have to be on Medi Cal as I won’t show any income?
. - Covered CA rules mandate that married people file jointly.
- Thus, your MAGI income doesn’t matter whose name it is in.
- Web visitors can get quotes here.
- I’ll send you a private email with quotes, just for you with Covered CA
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- Because my 65th birthday is 10/17/2019, today I submitted an online application for Medicare. What’s next?
. - Thank you so much for submitting your enrollment in Medicare A & B on the very first day that one is able too. 3 months before the month one turns 65. See our webpage above for more explanation. There are often SNAFU’s – Situation Normal All Fouled Up that can cause a lot of grief, worry and delays.
- Did you get a receipt or confirmation that you submitted your application?
- Click here to the links and instructions to get an ONLINE Social Security and Medicare Account so that you can track your progress of getting enrolled into Medicare A & B.
- One can always just wait till Medicare sends your ID card…
- Once you have your Medicare ID #, then we can submit applications for Medi Gap, Part D Rx & Medicare Advantage. See those pages on our website for more detail. Email us with any questions, visit our scheduling page to make a phone, Skype, What’s App or face to face meeting. Please note that for Part D or MAPD Medicare Advantage Federal Law requires you to sign a form to allow us to discuss those plans with you.
- Here’s our page to better explain the advantages – disadvantages of MAPD vs Medi Gap and what the plans add to cover the gaps in Medicare A & B.
- This page has a chart on what Medicare Pays, then Plan F Medi Gap, then what is still left for you to pay. Most of the time zero. Note that after 1.1.2020 Plan G will be the most comprehensive. Those that have Plan F, Extra or Innovative can keep Plan F forever!
- Here’s one way of knowing in advance of your approval for Medicare A & B so that we can proceed with getting Medi Gap or Medicare Advantage.
- See also our webpage on getting a Social Security Account.
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- I turn 65 in July. I just applied for Social Security and have received two checks so far. Will I be automatically enrolled into Medicare?
. - Some people get Part A and Part B automatically
- If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), you’ll automatically get Part A and Part B starting the first day of the month you turn 65. (If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.) https://individuals.healthreformquotes.com/medicare/sign-medicare/#medicare10050
- If you’re getting these benefits, in most cases,
You’ll get the “Welcome to Medicare” package that welcomes you to the program. This package is mailed about 3 months before your 65th birthday. In this package, you’ll get your Medicare card. https://www.medicare.gov/publications/10050-Medicare-and-You.pdf - I suggest you double check and make sure Social Security does it. Do you have an ONLINE account with them? https://www.ssa.gov/myaccount/
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- I applied for Medicare, but they are asking for tons of extra paperwork. Will my effective date still be my birthday month or will their scrutiny make it take longer?
. - Here’s the reply from CA Health Care Advocates:
- I imagine the effective date would be retroactive to the original date of entitlement if the person is deemed to be eligible. But I’ve never faced this situation. Region 9 https://www.ssa.gov/sf/contact.htm would be the place to call about that.
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- I imagine the effective date would be retroactive to the original date of entitlement if the person is deemed to be eligible. But I’ve never faced this situation. Region 9 https://www.ssa.gov/sf/contact.htm would be the place to call about that.
- My wife needs health insurance from Medicare.
- She’s 65 years old us citizen but still working.
- Social security can’t support her due to over the limit income.
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- If you or your wife have worked in the USA for more than 10 years, go ahead and use the enrollment link above.
- Here’s the rules about qualifying for no Charge Part A
- If you don’t qualify for no cost Part A Hospital, scroll down and view the sub or child pages. If you still have questions post them on the most relevant page. You do not have to put in your name.
- What do you mean Social Security can’t support her, your over the Income Limit?
- Do you mean Medi Cal, Medicaid? Obamacare/ACA subsidies?
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- I’m interested in getting Medicare at 63 years old. I have MS and have been told I’m eligible at 63. Is that true?
. - Yes, if you qualify for SSDI, after two years you automatically get Medicare.
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. - Medicare was enacted in 1965. I first had it deducted from paychecks starting in 1966. I retired in 2016 so Medicare was deducted from all my earnings for 50 years.
- I finally had occasion to use my Medicare benefit getting a doctor ordered blood test in order to continue receiving medication for high blood pressure. Medicare paid a whopping $2.94. My share was only $241.84.
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- I finally had occasion to use my Medicare benefit getting a doctor ordered blood test in order to continue receiving medication for high blood pressure. Medicare paid a whopping $2.94. My share was only $241.84.
- See the chatter between high school friends on facebook to respond to this issue.
History of Medicare
on cms.gov
cms.gov/History cms.gov/KeyMilestones.pdf
govbooktalk.gpo.govhappy-birthday-medicare/
Consumer Resources & Links
- Medicare.Gov Eligibility Tool
- Privacy… having a friend talk to your MD # 11441
- CBS News 10.2015 How will you get Health Insurance in Retirement?
- Calif. Department on Aging
- 2015 Costs to remain the same CA HealthLine
- Law Help.org Medicare
- medicare.gov/cost/ deductibles, co pays, premium
- Reforms to the Medicare payment system are meant to promote greater efficiency in the healthcare delivery system by restructuring Medicare reimbursements from fee-for-service to bundled payments.[44][45] Under the new payment system, a single payment is paid to a hospital and a physician group for a defined episode of care (such as a hip replacement) rather than individual payments to individual service providers. In addition, it has been asserted that the Medicare Part D coverage gap (commonly called the “donut hole“) will shrink incrementally, closing completely by January 1, 2020.[46] Wikipedia
- The CBO averred that the bill would “substantially reduce the growth of Medicare’s payment rates for most services; impose an excise tax on insurance plans with relatively high premiums; and make various other changes to the federal tax code, Medicare, Medicaid, and other programs”[216]—ultimately extending the solvency of the Medicare trust fund by 8 years.[249]
- Q & A on Medicare’s Website ♦
- Health Affairs.org ♦
- AHIP info ♦
- See our Medicare Advantage Page
- insure me kevin.com/creating-a-spreadsheet-to-compare-medicare-advantage-plans