Most people must enroll in Original Medicare (Part A and Part B) with the SSA when turning 65
if they are NOT working and receiving Large Employer Coverage (LEC) or Spousal Large Employer Coverage. None of the insurance plans below are considered “creditable coverage” after turning 65, and will not prevent a 10% lifetime Part B Late Enrollment Penalty.
* Small Employer Group Ins. (19 employees or less)
* Most Retiree plans
* COBRA insurance
* ACA – Affordable Care Act (formally Obamacare)
* FEHB – Federal Employees Health Benefits
** NOTE: If you have Large Employer Coverage from an employer with 20+ employees (or you’re on spouse’s Large Employer 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 with the SSA in the future – to avoid being charged a Late Enrollment Penalty).
** IMPORTANT ** If you contribute to an HSA (Health Savings Account), you MUST stop contributing at least SIX months prior to enrolling in Part A or Part B (IF DELAYING MEDICARE AFTER 65) otherwise, there will be a 6% IRS excise tax penalty.
If you’re already drawing Social Security retirement benefits when turning 65, you likely will “automatically” be auto-enrolled in Medicare. They will send your Red, White and Blue card
approximately 100 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. Medicare will start deducting your Part B monthly premium from your Social Security check/direct deposit. 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 surcharges (IRMAA) added to 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 (3-mos.) paper billing for your Part B premium. You can setup monthly auto-draft “Medicare Easy Pay” with the SSA.