6 to 12 months
(Time to Learn)
After
You Enroll
COST you
Should know about
Penalties
To Avoid
Missed IEP
( You have a time)
Still Working
( Need to Know)
During IEP
(3 months Before)
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Learn about: Original Medicare (Parts A & B) vs Medicare Advantage (Part C); most people also add drug coverage (Part D) and may consider Medigap to reduce out-of-pocket costs.
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Mark the key dates you can change coverage each year (MA Open Enrollment in Jan–Mar; Fall Open Enrollment Oct 15–Dec 7).
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If you have other insurance, learn how it coordinates with Medicare (who pays first) so you time enrollment correctly
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Your Initial Enrollment Period (IEP) is 7 months: the 3 months before, your birth month, and the 3 months after. If your birthday is on the 1st, the window shifts one month earlier.
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When coverage starts depends on when you enroll:
– Enroll in the first 3 months → coverage usually starts the first day of your birth month (or the prior month if your birthday is the 1st).
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You may delay Part B without penalty if you have group coverage based on current employment. After that coverage ends, you get an 8-month Special Enrollment Period (SEP) for Part B. Coverage generally starts the first day of the month after you sign up.
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Important employer-size rule (age 65+): – Employer ≥20 employees → your employer plan usually pays first.
– Employer <20 employees → Medicare pays first (so you typically should not delay Part B).
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Special Enrollment Periods (SEPs):
You may qualify if you delayed Medicare because you had other creditable coverage (like employer or union insurance), or in certain cases like moving, losing Medicaid, or being misinformed by a plan. Rules and timing depend on the situation. -
General Enrollment Period (GEP):
If you don’t qualify for an SEP, you can enroll January 1 – March 31. Coverage starts the first day of the month after you sign up.
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Part B late-enrollment penalty: your premium may rise 10% for each full 12-month period you could’ve had Part B but didn’t—for as long as you have Part B. (SEPs usually avoid this.)
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Part D late-enrollment penalty: if you go 63+ days without Part D or other creditable drug coverage after your IEP, a permanent penalty is added to your drug plan premium (calculated using the annual “base beneficiary premium”).
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Part B standard premium: $185/month; higher-income enrollees may owe IRMAA.
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If you must buy Part A: 2025 premium is $285–$518/month (10% penalty if you delay).
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Part D out-of-pocket cap: $2,000/year maximum on covered drugs in 2025; after you hit it, no copays/coinsurance for the rest of the year. You can also opt into the Medicare Prescription Payment Plan to spread drug costs across monthly bills.
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Watch your Medicare card in the mail and bring the correct card to each visit (plan card if you join Medicare Advantage).
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Schedule your “Welcome to Medicare” preventive visit in your first year, then yearly Wellness visits. (Covered under Part B.)
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Each fall, review your coverage and costs; compare plans at Medicare.gov/plan-compare or call your SHIP for free one-on-one guidance.
Extra Help (LIS)
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Lowers Drug Costs
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Based on Income/Resources
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No Late Penalty
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Flexible Plan Changes
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May reduce or eliminate premiums, deductibles, and copays for Part D
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SOCIAL SECURITY
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Track your Medicare enrollment
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Apply for Medicare online
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View and manage your benefits
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Download important documents instantly
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Update your info anytime
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