Medicare is a federal health insurance program for Americans aged 65 and older, as well as younger individuals with specific disabilities. It is divided into four parts: Part A (hospital insurance), Part B (medical insurance), Part C (private Medicare Advantage plans), and Part D (prescription drugs).
When you elect to enroll and what types of Medicare coverage you opt for can impact you more than you may know.
While the federally recognized retirement age is now 67, Medicare begins for most people when they turn 65. You may begin to see letters in the mail before this milestone birthday regarding your coverage options. It is important not to ignore those messages.
Unless you are already drawing early Social Security benefits, assuming your Medicare coverage will automatically begin at 65 is a costly mistake. You have a 7-month window to enroll without penalties: the month of your 65th birthday, 3 months before your birthday month, and 3 months after your birthday month.
3 Penalties to Look Out For:
- Part B: You can receive a 10% penalty for every year that you do not enroll.
- Part D (Prescription Drugs): For every month without coverage, you will receive a 1% penalty.
- Part A: If you do not qualify for a premium-free Part A, the penalty is 10% for twice the number of years you don’t sign up. (For example, if you’re 2 years late, you’ll have the penalty of 4 years.)
The Exception – Special Enrollment Period
If you’re still working at 65 and have employer health insurance, you could quality for a Special Enrollment Period (SEP) if you choose to move to a full Medicare plan.
Employer insurance is one of the most widely accepted exemptions available. If you have prescription drug coverage, this can also make you exempt from Part D penalties. If your employer has fewer than 20 employees, Medicare may become the primary payer when you are eligible for Medicare. It is important to verify how your employer coverage coordinates with Medicare before delaying enrollment.
In most cases, individuals have an 8-month Special Enrollment Period to enroll in Medicare Part B after active employment or employer coverage ends without incurring a late enrollment penalty.
3 Steps to Take Before You Turn 65:
- Mark out your 7-month window so you know when to enroll.
- Check if your current insurance meets the special enrollment period qualifications.
- Don’t wait until you retire, contact Social Security or Medicare directly to confirm.
Missing certain Medicare enrollment deadlines may result in long-term or permanent premium penalties, depending on the coverage involved. Luckily, this is completely avoidable. Make sure you know your enrollment dates and any qualifying exemptions. If you’re aware of your timeline, you should be just fine.
Please know that if you are working past 65, you may find that taking full Medicare may offer better coverage options at a lower cost than an employer sponsored group plan, which is why it is always a good idea to review your options in this situation.
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Medicare Open enrollment runs from October 15th, 2026, to December 7th, 2026, with new plans taking effect on January 1st, 2027.
Connect with our Gallagher Association Team by phone at 866-732-3028 or fill out a short form at ahs-member-us.ajg.com/americanbooksellersassociation, and we'll call you back at a convenient time.