Turning 65 is an important milestone, but figuring out how to apply for Medicare can feel overwhelming. When can you enroll? Do you need to apply for Part A and Part B? What if you are still working? How much will Medicare cost? And what other coverage might you need?
The good news is that you do not have to navigate these decisions alone. A licensed insurance agent can help you understand your Medicare options, review your existing coverage, compare plans, and explore additional insurance products that may help with expenses Medicare does not cover.
This guide walks you through the Medicare enrollment timeline, how to apply, how Medicare costs can be affected by income, ways to pay your premiums, financial assistance programs, and additional coverage options such as Medigap, hospital indemnity, and final expense insurance.
Important: Medicare enrollment is handled through Social Security. An insurance agent can help you understand the process and your coverage options, but an agent does not replace Social Security as the enrollment authority.
When Can You Apply for Medicare?
For most people, Medicare eligibility begins at age 65. Your first opportunity to enroll is called your Initial Enrollment Period (IEP).
Your Initial Enrollment Period generally lasts 7 months:
- 3 months before the month you turn 65
- The month you turn 65
- 3 months after the month you turn 65
For example, if you turn 65 in June, your Initial Enrollment Period generally runs from March through September.
The timing of your enrollment can affect when your Medicare coverage starts. If you wait until after your Initial Enrollment Period and do not qualify for another enrollment opportunity, you may also face a late enrollment penalty.
Your Medicare Timeline at a Glance
3 months before turning 65: Your Initial Enrollment Period begins. Start reviewing your Medicare options and determine whether you need to actively enroll.
1 to 3 months before turning 65: Review your current health coverage, expected Medicare costs, and coverage options.
The month you turn 65: You become eligible for Medicare if you meet the eligibility requirements. Your coverage start date depends on when you enroll and your individual circumstances.
3 months after turning 65: Your Initial Enrollment Period ends. If you did not enroll and do not qualify for another enrollment opportunity, you may have to wait for another enrollment period and could face penalties.
After your Initial Enrollment Period: Depending on your situation, you may qualify for a Special Enrollment Period or may need to use the General Enrollment Period.
The official Medicare Get Started With Medicare resource can help you determine which enrollment path may apply to you.
Step 1: Determine Whether You Need to Apply
Not everyone enrolls in Medicare in exactly the same way.
If you are already receiving Social Security benefits before turning 65, you may be automatically enrolled in Medicare Part A and Part B. If you are not receiving Social Security benefits yet, you generally need to actively enroll in Medicare when you become eligible. Your situation may also be different if you qualify for Medicare before age 65 because of disability, End-Stage Renal Disease (ESRD), or ALS. If you are still working at 65, your Medicare enrollment situation may also depend on your employer coverage.
What If You Are Still Working at 65?
If you or your spouse is still working when you turn 65 and have health coverage through current employment, do not automatically assume you should enroll in every part of Medicare or delay Medicare altogether.
Employer size, the type of health coverage you have, and your individual circumstances can affect how Medicare works with your existing insurance.
Medicare recommends reviewing your situation before deciding whether to delay Part B.
This is one area where working with an insurance professional can be helpful. An agent can help you understand what questions to ask about your current coverage and what Medicare options you may want to consider.
Step 2: Gather the Information You Need
Before applying, gather important personal and insurance information.
Depending on your situation, you may need information such as:
- Your Social Security number
- Your date and place of birth
- Information about current employer health coverage
- Dates of current or previous employer coverage
- Your Medicare number if you are applying for Part B only
Social Security provides the current requirements and enrollment options through its Medicare enrollment page.
An agent can also help you prepare a list of questions to consider before selecting additional coverage.
Step 3: Apply for Medicare Through Social Security
If you need to actively enroll, you can apply through Social Security.
Social Security allows eligible individuals to apply online for Medicare Part A and Part B, or Part A only. You can also contact Social Security if you need assistance with your application.
You can begin through the official Social Security Medicare enrollment page or use the online Medicare application.
What Can an Agent Help With?
An insurance agent cannot replace Social Security for your Medicare enrollment application. However, an agent can help you understand what happens after enrollment and evaluate coverage options such as Medicare Advantage, Medicare Supplement Insurance, prescription drug coverage, and supplemental products.
That guidance can be especially useful because Medicare is not one single insurance plan.
Step 4: Understand the Different Parts of Medicare
Medicare has four main parts:
Part A: Helps cover inpatient hospital care, skilled nursing facility care, hospice care, and certain home health care.
Part B: Helps cover medically necessary doctor services, outpatient care, preventive services, and certain medical equipment.
Part C: Also called Medicare Advantage, Part C is offered by private insurance companies approved by Medicare.
Part D: Helps cover prescription drugs.
If you choose Original Medicare, you may also consider Medicare Supplement Insurance, commonly called Medigap, along with prescription drug coverage.
If you choose Medicare Advantage, you generally receive your Medicare-covered Part A and Part B benefits through the Medicare Advantage plan.
Step 5: Understand How Much Medicare Will Cost
Medicare is not necessarily free.
In 2026, the standard Medicare Part B premium is $202.90 per month, although some people pay more based on their income. The 2026 Part B deductible is $283.
Your income can affect what you pay. Medicare uses income information from your tax return to determine whether some beneficiaries must pay an additional amount called an Income-Related Monthly Adjustment Amount (IRMAA) for Part B and Part D.
This means Medicare planning should involve more than asking, “What is the monthly premium?”
Consider:
- Your Part A costs, if applicable
- Your Part B premium
- Your Part B deductible and coinsurance
- Prescription drug costs
- Medicare Advantage or Medigap premiums
- Dental, vision, and hearing expenses
- Other health-related out-of-pocket costs
An agent can help you compare coverage options and understand the premiums associated with different plans.
Step 6: Know How to Pay Your Medicare Premiums
If you receive Social Security benefits, your Medicare Part B premium is generally deducted from your Social Security payment.
If you are not receiving Social Security or Railroad Retirement Board benefits, you may receive a Medicare Premium Bill.
Medicare offers several ways to pay, including online payments through your Medicare account, Medicare Easy Pay, and payment through your bank. You can review the options on Medicare’s online bill payment resource.
UnitedHealthcare also provides a helpful overview of different ways to pay your Medicare Part B premium in its 5 Ways to Pay Your Medicare Part B Premium resource.
If you receive a Medicare bill, make sure you understand the amount due and keep track of your payments.
Step 7: See If You Qualify for Help With Medicare Costs
If your income and resources are limited, you may qualify for programs that help with Medicare costs.
People who have both Medicare and full Medicaid benefits are commonly referred to as dual-eligible beneficiaries. When someone is dual-eligible, Medicare generally pays first for Medicare-covered services, while Medicaid can help with certain remaining costs and services depending on the person’s eligibility.
You may also qualify for a Medicare Savings Program, which can help eligible beneficiaries pay Medicare premiums and, depending on the program, other Medicare costs.
If you have limited income, do not assume Medicare is unaffordable. Review whether you qualify for assistance.
Your insurance agent can help you understand the questions to ask and the coverage options available to you, while Social Security and your state Medicaid office determine eligibility for government assistance programs.
Step 8: If You Can Afford Additional Coverage, Consider Medigap
If you choose Original Medicare and can comfortably afford an additional monthly premium, you may want to consider a Medicare Supplement Insurance plan, also called Medigap.
Medigap is designed to help pay some of the out-of-pocket costs associated with Original Medicare, including certain deductibles, copayments, and coinsurance. You generally need Medicare Part A and Part B to purchase a Medigap policy.
Why Your First 6 Months Can Be Important
If you are 65 or older and have Medicare Part B, you generally get a one-time 6-month Medigap Open Enrollment Period beginning the first month you have Part B.
During this period, insurance companies generally cannot deny you a Medigap policy or use medical underwriting to determine whether to accept your application because of pre-existing health conditions. You can generally choose from the Medigap plans sold in your state.
This makes your initial Medicare enrollment an important time to review Medigap if you are considering Original Medicare.
For example, if you want the additional cost protection a Medigap plan can provide and the premium fits comfortably within your budget, you may want to compare Medigap options while you have your Open Enrollment protections.
What Happens After the 6-Month Period?
Your Medigap Open Enrollment Period is a one-time period. It does not happen every year like Medicare’s Annual Enrollment Period.
After it ends, an insurance company may use medical underwriting, charge you more, or deny you a policy depending on your situation and state law.
However, specific circumstances can provide guaranteed issue rights. These protections can allow you to purchase certain Medigap policies without medical underwriting.
That is why it is important to understand your timing and options before choosing or dropping coverage.
Medicare’s When Can I Buy a Medigap Policy? resource provides additional information about the Medigap Open Enrollment Period and guaranteed issue rights.
Medigap vs. Medicare Advantage
Medigap and Medicare Advantage are not the same thing.
A Medigap policy works alongside Original Medicare to help pay your share of covered costs. Medicare Advantage is another way to receive your Medicare Part A and Part B benefits through a Medicare-approved private plan.
You generally cannot have a Medigap policy and a Medicare Advantage plan at the same time.
Medigap also does not cover everything. It generally does not cover services such as routine dental and vision care, hearing aids, long-term care, or private-duty nursing. Prescription drug coverage is also not included in Medigap policies sold today, so you may need separate Part D coverage.
Talk With an Agent About Your Medigap Options
Medigap plans can have standardized benefits, but premiums can vary between insurance companies. Comparing your options can help you find coverage that fits your budget and needs.
A licensed insurance agent can help you:
- Determine whether Medigap may fit your needs.
- Compare available Medigap plans.
- Review premiums from available insurance companies.
- Explain your Medigap Open Enrollment Period
- Help you understand whether medical underwriting may apply.
- Review guaranteed issue rights if you are outside your Open Enrollment Period.
If you are new to Medicare and considering Original Medicare, talk with a licensed insurance agent about your Medigap options before your 6-month Open Enrollment Period passes.
Step 9: Consider Extra Coverage for Expenses Medicare May Not Cover
Medicare can cover many important health care services, but it does not cover every expense.
Depending on your coverage, you may still have costs related to deductibles, coinsurance, copayments, dental care, vision care, hearing care, prescriptions, hospital stays, and other services.
Additional insurance may help address some of these financial gaps.
Hospital Indemnity Plans
A hospital indemnity plan is supplemental insurance that may provide a cash benefit when you experience a covered hospitalization or another covered event, depending on the policy.
The benefit is generally paid directly to you, allowing you to use the money toward expenses according to the policy terms. This could help with costs that may arise during a hospital stay, such as transportation, household bills, meals, or other out-of-pocket expenses.
A hospital indemnity plan is not a replacement for Medicare or comprehensive health insurance. Benefits, exclusions, limitations, and eligibility vary by policy.
An insurance agent can help you determine whether this type of supplemental coverage makes sense alongside your Medicare coverage.
Step 10: Think About Expenses Medicare Does Not Cover After Your Lifetime
Medicare is designed to help with health care costs. It is not designed to pay for your funeral, burial, cremation, or other final expenses.
This is where final expense insurance may be worth considering as part of your overall financial planning.
Final expense insurance is a type of life insurance designed to provide a death benefit to beneficiaries. Depending on the policy, the benefit can help loved ones handle expenses such as funeral and burial costs, outstanding bills, or other financial obligations.
Planning ahead can help reduce the financial burden placed on your family.
A licensed insurance agent can explain the types of final expense coverage available and help you determine whether it fits your financial goals.
Got Medicare Questions?
We hope that this information on how to apply for Medicare is useful to you. If you want to learn more about extra coverage read our article Accident Insurance: Extra Financial Protection When Life Takes an Unexpected Turn.
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