Most people must enroll in Original Medicare (Part A and Part B with the SSA) when turning 65
if NOT working and receiving Large Group Coverage (or Spousal Large Group Coverage) including having any of the plans below, in order to avoid a possible 10% lifetime Part B Late Enrollment Penalty, as the plans below are NOT considered “creditable coverage” after turning 65.
* Most Retiree plans
* Cobra insurance
* ACA plan (Affordable Care Act)
* Small Employer Group Ins. (19 employees or less)
** NOTE: If you have large group coverage from an employer with 20+ employees (or on your spouse’s large group coverage), you likely can “delay your Medicare Part B enrollment”. You always want to check with the company’s HR department to confirm their dependent spouse coverage is still considered “creditable coverage” after turning 65. (You will need CMS Form L-564 “proof of insurance after 65” when you enroll in Part B in the future).
** IMPORTANT ** If you work past 65 and contribute to an HSA (Health Savings Account), you can NOT be enrolled in Part A or Part B.
If you’re already drawing Social Security retirement benefits when turning 65, you likely will automatically be enrolled in Medicare. They will send your Red, White and Blue card
approximately 90 days prior to your 65th birthday. Your Part A and Part B effective dates will generally be the 1st day of your 65th birth month. *Note: If your birthday falls on the 1st, your effective date will be on the 1st of the previous month. (Example: if your birthday is July 1st, your effective date will be June 1st.) Medicare will start deducting your Part B monthly premium. In 2026, the Standard Part B premium for most people is $202.90/mo. People with higher incomes reported on their MAGI (tax return – two years prior) may pay additional for their Part B and Part D premiums.
If you are NOT drawing Social Security yet, you will need to “manually enroll” in Original Medicare. Go to SSA.gov or contact Social Security at (800) 772-1213. Social Security Administration will send you a quarterly paper billing for your Part B premium. You can setup monthly auto-draft “Medicare Easy Pay” with the SSA.