Medicare Quick Start Guide

If you are turning 65 or retiring soon, you’ll need to decide whether to stay on your employer’s health insurance plan or switch to Medicare. It can be tough to make that decision, so we put together a brief guide to make it simple. We like to break the decision into 3 steps. Read on to discover them.

Step 1: Do I have to enroll in Medicare at age 65?

  • If you currently get health insurance through an employer with 19 or fewer employees: You should enroll in Medicare at age 65 (you have 7 months to enroll, starting 3 months before your 65th birthday and ending 3 months after your 65th birthday). Skip to Step 3.
  • If you currently get health insurance through an employer with 20 or more employees: You have the option to keep your employer health insurance or switch to Medicare. Go to Step 2.

Step 2: If I can delay my Medicare enrollment, should I delay it?

Just because you can delay Medicare doesn’t mean you have to—or should—delay it.

Consider these 3 factors when deciding between keeping your employer plan and switching to Medicare:

  1. Whether you have dependents (a spouse or children) who need your employer plan for health insurance. If so, it’s probably best to delay Medicare enrollment.
  2. The costs of your employer plan vs. Medicare, including premiums, deductibles, coinsurance, and out-of-pocket maximums.
  3. The benefits of your employer plan vs. Medicare.

Step 3: How do I enroll in Medicare?

You will be automatically enrolled in Medicare if:

  • You’re receiving retirement benefits from Social Security or Railroad Retirement Board before your 65th birthday
  • You’ve been receiving Social Security Disability Benefits for 24 months
  • You’ve been diagnosed with ALS

If neither of the above apply to you, you’ll need to enroll in Medicare “manually” through the Social Security Administration.

You can enroll in 1 of 3 ways:

  1. Online: Click here to go to Social Security’s enrollment site for Medicare.
    • Note: you’ll be asked to create a My Social Security account first if you haven’t already done so.
  2. By phone: Call (800) 772-1213.
  3. In person: Go to your local SSA office, which you can find by clicking here.

Online enrollment (option 1) is usually the quickest and most painless option. You’ll need to set up a My Social Security account to enroll in Medicare online, so take care of that first.

Most people also enroll in an Advantage or Supplement plan plus a Part D plan from a private insurance company to cover what Medicare does not. You can enroll in those plans once you are signed up for Medicare Part A and Part B with Social Security.

Want an expert’s opinion first? Request a no-obligation consultation from our Medicare team.