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Miss your Medicare enrollment window and face permanent premium penalties of 10% per year for life. Here's your complete guide.
7 months
Initial Enrollment
3 before + birthday + 3 after
10%/year
Late Penalty (Part B)
Permanent, for life
$174.70/mo
Part B Premium (2024)
Standard (income-based)
Penalties Are PERMANENT
The 4 Parts of Medicare
| Feature | What It Covers | Cost (2024) |
|---|---|---|
| Part A (Hospital) | Inpatient hospital, skilled nursing | $0 premium (if 40+ work credits) |
| Part B (Medical) | Doctor visits, outpatient, preventive | $174.70/month (income-based) |
| Part C (Medicare Advantage) | Parts A+B bundled, often includes D | $0-$100+/month (on top of Part B) |
| Part D (Prescriptions) | Prescription drug coverage | $10-$50+/month |
Initial Enrollment Opens
Sign up for Parts A and B at ssa.gov. Do NOT wait until your birthday.
Mid-Point
Coverage starts on the 1st of your birthday month if you enrolled in the 3 months prior.
Window Closes
Last chance without penalty. Coverage delayed if you enroll late in this window.
Open Enrollment
Switch Medicare Advantage plans or add/change Part D. Every year.
Choose Your Path
| Feature | Original Medicare (A+B+D+Medigap) | Medicare Advantage (Part C) |
|---|---|---|
| Doctor Choice | Any doctor who accepts Medicare | Network only (HMO/PPO) |
| Monthly Cost | Higher ($200-$400 with Medigap) | Lower ($0-$100 beyond Part B) |
| Out-of-Pocket Max | No cap (unless Medigap) | Capped ($3,000-$8,000) |
| Extra Benefits | None | Vision, dental, hearing often included |
| Best For | Travelers, complex health needs | Healthy, budget-conscious, local care |
Enroll 3 Months Before 65
Go to ssa.gov or call 800-772-1213. Don't wait.
Decide: Original vs Advantage
Original + Medigap for flexibility. Advantage for lower cost.
Choose Part D Plan
Use medicare.gov plan finder. Enter your medications to find cheapest plan.
If Still Working at 65
May delay Part B IF employer has 20+ employees. Get it in writing from HR.
Check for IRMAA Surcharges
Income over $103K (single) means higher Part B/D premiums. Plan Roth conversions accordingly.
Key Takeaways