Medicare Quick Facts

WHAT IS IT?

Medicare is a federal health insurance program for people 65 and older, as well as certain disabled individuals.

DO I HAVE TO ENROLL?

Yes. If you have not been receiving Social Security benefits for at least four months prior to turning 65, you must enroll in Medicare.

WHEN DO I ENROLL?

During the Initial Enrollment Period, which starts three months prior to your 65th birthday and extends three months past your 65th birthday. If your 65th birthday is January 1st, 2026, then you will be able to enroll in Medicare coverage September 1st, 2025 – March 31st, 2026.

This is the link for the website to enroll – https://www.ssa.gov/medicare/sign-up.

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IS THERE A REASON I WOULDN’T ENROLL AT 65?

The only other reason you would not enroll at this time would be because you or your spouse are still working and you are covered by an employer’s policy. However, you can go ahead and enroll. Or, if you choose not to do so during the Initial Enrollment Period, then you must do so eight months prior to the last day of work or risk facing a life-long penalty.

WHAT HAPPENS IF I MISS THE INITIAL ENROLLMENT PERIOD?

If you miss the Initial Enrollment Period, you can always enroll during the General Enrollment Period annually, which is January 1st – March 31st, but you will typically face a life-long penalty for not signing up during your Initial Enrollment Period.

WHAT ARE THE DIFFERENT PARTS OF MEDICARE?

Medicare Part A – HOSPITAL INSURANCE

Part A covers inpatient hospital care, some nursing home care, post-hospital home health care, and hospice care.

Premium – There is no premium for Part A so long as you are fully vested in Social Security. If you are not fully vested, there is a premium associated.

Medicare Part B -MEDICAL INSURANCE

Part B covers physicians’ services, outpatient hospital care, physical therapy, ambulance trips, medical equipment, and some preventive services.

Premium – You cannot register for Part B without Part A, and there is an income-based premium associated with Part B.

Note – You do not have to register for Part B when registering for Part A. If you are still covered under an employer’s health plan, then you would wait to register for Part B.

Medicare Part C – MEDICARE ADVANTAGE

Part C gives you access to Part A and Part B coverage through managed care plans, such as PPOs and HMOs, with Medicare sanctioned providers. If you need more coverage for dental, vision, and prescriptions, Part C can provide that flexibility.

Premium – You will pay a premium set by the Medicare-approved provider.

Medicare Part D – PRESCRIPTION DRUG COVERAGE

Part D is prescription drug coverage. If your Medicare Advantage plan (Part C) does not cover prescription drugs, then you may want to add Part D coverage.

Premium – You will pay a premium set by the Medicare-approved provider.

DO I HAVE TO REGISTER FOR ALL PARTS OF MEDICARE DURING THE INITIAL ENROLLMENT PERIOD?

You must enroll in Medicare Part A and Medicare Part Be during the Initial Enrollment Period or risk a life-long penalty (unless you are currently employed and covered under an employer’s plan). You may opt to enroll in Medicare Part C and Medicare Part D during a General Enrollment Period. Additionally, if you want to change Medicare Part C providers, you may do so during a General Enrollment Period.