Do I Need to Enroll In Medicare?

Penalties for Not Singing Up for Medicare 

Yes!  You are reading that right, there are PENALTIES for not singing up for Medicare at the right time. And to make matters worse, these penalties stick around for a life time.  Understanding when to enroll in Medicare and how to navigate the process will keep your hard money where it belongs.

The Rules ~ (Ifs, And & Buts)

You'll basically get one shot at getting your Medicare enrollment right.  Many of us go into this thinking the process should be simple and straight forward, Right? We'll that's really not the case.  Determining your Medicare eligibility is sometimes tricky. 

There are several types of eligibility, enrollment periods  and penalties. The number one mistake that people make is confusing Medicare eligibility date at age 65 with their full Social Security retirement date.  These dates are different. Most people qualify for their full Social Security retirement benefit at age 66.  

Almost everyone is eligible for Part A and Part B at age 65, if they or their spouse has paid Medicare taxes for 40 quarters ( 10 years).  This is where things get tricky.

Is it mandatory to sign up for Medicare at age 65?

The crazy answer is YES and NO!  Here why, Medicare eligibility may vary based on your specific situation.  Your specific situation affects the answer to the Medicare at 65 question.  For a more precise answer you need to answer a few questions to determine your situation.

  1. Are you retired or retiring soon after your 65th birthday?
  2. Are you Still working and plan to do so for some time after your 65th birthday?
  3. If working how many employees dose the company have?
  4. What does your employer coverage look like and how much dose it cost?   


Did you answer "YES" to question 1?  You most likely need to sign up for Medicare:  Turning 65 and retiring in your Initial Enrollment Period* or already retired or you are paying individually for your current health coverage.

You should enroll in Medicare 3 months prior to your 65th birthday if you would like coverage to begin the month of your 65th birthday.  Your IEP ( Initial Enrollment Period) is actually a 7 month window that begins 3 month prior to, the month of, and three months following you 65th birthday. If you enroll into Medicare the month of, or the 3 months following your birthday you could wind up with out coverage for several month even though you signed up WITHIN  your enrollment period. So sign up early!

What if I have a retiree health plan? 

If you are a retiree who has a retiree heath  plan provided by a former employer, then you need to sign up for Part A & Part B.  Medicare is primary to the retiree plan, so if you do not sign up you be penalized for not singing up.


Did you answer "YES" to question 2?

If so, we need to answer question 3, how many employees?

If your answer is less than 20, you will need to sign up for Medicare as soon as your eligible. If you fail to enroll in Medicare when you become eligible while working for a company with less than 20 employees, you will incur late enrollment penalties. 


If your to answer to question 3  is more that 20, you may be able to delay your Medicare part B enrollment. Most group health plans meet the definition of “creditable coverage”, so all you need to do is enroll in Part A.  To be on the safe side, check with your employer to get confirmation the plan meets Medicare’s requirements...oh, and make sure to get that in writing.

What if I have a retiree health plan?

If you are a retiree who has a retiree health plan provided by a former employer, then you need to sign up for Medicare Part A and Part B. Medicare will be your primary, the retiree benefits will be secondary. If you fail to enroll when first eligible, you will incur a penalty.

Budgeting tip: If you’re your situation requires you enroll in Medicare, we always recommend you comparing cost and coverage options. Many people are surprised to learn how much they can save with a good Medical plan vs their employer options

A couple quick notes on the Penalties:

Part A Penalty: If you’re not eligible for premium free Part A, and you do not enroll when your first eligible, you monthly premium can go up 10%.

Part B Penalty: For each 12-month period you delay enrollment in Part B you will have to pay a 10% penalty and in most cases that for as long as you have Medicare. So, you delayed enrollment for 4 years, your penalty would be 40% of your Part B premium.

Meet Denise

Hi, I’m Denise Anderson

Medicare Donut Hole Changes in 2019

Medicare Supplement Accredited Advisor

Your Medicare Guru & Concierge

I am a mother, a daughter and a caregiver. I believe in treating others as you want to be treated. In our agency everyone is treated like family. 

I’m the Managing Broker at Make Medicare Work (a division of J. Johnston Ins. Svc, Inc.) and a Medicare Supplement Accredited Advisor.

My agency has helped thousands of Medicare beneficiaries properly enroll in Medicare and understand their benefits options at no charge. Collectively, my team has nearly 100 years of experience.

Medicare Donut Hole Changes in 2019

I am a member of the Medicare Benefits Association as well as California Health Underwriters and National Health Underwriter association.

These organizations work tirelessly to help protect and improve Medicare.