Medicare has deadlines, and missing one can cost you a penalty for life. This guide explains who qualifies, when to sign up, and how your choices work, step by step.
Who Qualifies for Medicare
- People 65 or older.
- People under 65 who have received Social Security disability benefits for 24 months.
- People with End-Stage Renal Disease (ESRD) or ALS.
When to Sign Up
Initial Enrollment Period
Your Initial Enrollment Period is 7 months long: the 3 months before the month you turn 65, your birthday month, and the 3 months after. If you sign up before your birthday month, coverage starts the first day of your birthday month. If you sign up during or after it, coverage starts the first day of the month after you sign up.
If you already get Social Security benefits, you are usually enrolled in Parts A and B automatically. Otherwise, you sign up through Social Security at ssa.gov.
If You Are Still Working
If you or your spouse are still working and have health coverage through that current job, you may be able to delay Part B without a penalty, and then sign up later using a Special Enrollment Period. Retiree coverage and COBRA do not count. Check with your employer’s benefits office before you delay.
Every Year: Fall Open Enrollment
From October 15 to December 7, anyone with Medicare can join, switch or drop a Medicare Advantage or Part D plan for the next year. People in a Medicare Advantage plan can also make one change from January 1 to March 31.
The Parts of Medicare
- Part A (hospital): $0 premium for most people. 2026 deductible: $1,736 per benefit period.
- Part B (medical): 2026 standard premium: $202.90 a month, with a $283 yearly deductible, then usually 20% coinsurance.
- Part C (Medicare Advantage): private plans that provide your Part A and B benefits, usually with drug coverage.
- Part D (drugs): prescription coverage from private plans. In 2026, out-of-pocket drug costs are capped at $2,100 a year.
Most people then choose either Original Medicare with a Medigap policy and a Part D plan, or a Medicare Advantage plan. See our Medicare Advantage vs. Supplement guide.
How to Avoid Late Penalties
- Part B: if you do not sign up when first eligible and do not have qualifying job-based coverage, your premium can go up 10% for each full 12-month period you could have had Part B, for as long as you have it.
- Part D: if you go 63 days or more in a row without Part D or other creditable drug coverage after your Initial Enrollment Period, you may pay a penalty for as long as you have drug coverage.
- Medigap: your best chance to buy a Medigap policy without health questions is the 6 months after you are 65 and enrolled in Part B.
Help With Costs
If your income and savings are limited, you may qualify for Extra Help with drug costs or a Medicare Savings Program that helps pay Part B premiums. Medicare.gov and Social Security explain how to apply.
A Simple Checklist
- Put your Initial Enrollment Period dates on your calendar.
- List your doctors, hospitals and prescriptions.
- Decide whether you are delaying Part B because of current job coverage, and confirm it counts.
- Compare Medicare Advantage and Medigap before your Medigap window closes.
For official information on all of your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
Compare Medicare plans
To compare Medicare Advantage and Part D plans, call our Medicare partner line at (833) 631-7640. Calls to this number are answered by licensed Medicare agents at our enrollment partner, not by Brilliant Insurance.
About Brilliant Insurance
Brilliant Insurance is an independent agency in Plano, Texas. David Gustafson (Texas License #2116912, NPN 18037219) helps with life insurance and supplemental plans such as hospital indemnity. For those, book a free 30-minute call or call (972) 750-3031.
This article is general information, not advice for your situation. Medicare costs shown are 2026 figures from CMS and change every year. Plans, benefits and availability vary by plan and location.
