Medicare information reviewed and updated July 2026 · 2026 Part B premium: $202.90/month
What Happens At 65
Three things change when you reach Medicare age. Knowing them in advance keeps you out of penalty trouble.
You Become Eligible
Medicare eligibility begins the first day of your birthday month. If your birthday falls on the 1st of the month, eligibility actually starts the month before.
Your IEP Opens
Your 7-month Initial Enrollment Period gives you a window to enroll without penalty: 3 months before your birthday month, your birthday month, and 3 months after.
Decisions Start
You choose between Medicare Advantage OR Medigap + Part D. These are separate paths with different trade-offs. The choice you make matters long-term.
The 7-Month Initial Enrollment Period
Your IEP runs from 3 months before your 65th birthday through 3 months after. When you enroll within this window determines when coverage starts.
Month -3
IEP opens
First month you can enroll. Coverage starts the month you turn 65.
Month -2
Strong enrollment window
Enroll now for coverage starting the month of your 65th birthday.
Month -1
Last month for birthday-month coverage
Last chance to enroll for coverage starting the month you turn 65.
Birthday Month
Coverage may begin
If you enrolled by Month -1, coverage starts now. Enrolling this month delays start to up to 2 months later.
Month +1
Late enrollment
Coverage starts about 2 months after enrollment.
Month +2
Late enrollment
Coverage starts about 3 months after enrollment.
Month +3
IEP closes
Final month of your Initial Enrollment Period. Miss this window and penalties may apply.
The Four Decisions At 65
Most of the long-term consequences of Medicare come down to these four choices. Get them right and the system works for you.
1
Part B: enroll now or delay
Part B costs $202.90/month in 2026. You can delay it only if you have creditable employer or union coverage. Delaying without that coverage triggers a 10% lifetime penalty per 12 months delayed.
2
Advantage vs Original Medicare
This is the coverage path decision. Original Medicare gives you any provider who accepts Medicare. Medicare Advantage uses networks but bundles more benefits. Each path has trade-offs you live with year to year.
3
Part D (if choosing Original Medicare)
If you go with Original Medicare, you choose a stand-alone Part D plan for prescriptions. Plans differ in formulary (which drugs are covered), pharmacy network, and cost structure.
4
Medigap (if choosing Original Medicare)
Medigap fills the gaps Original Medicare doesn't pay. Plan G is the most comprehensive available to new enrollees. Plan N has lower premiums with small copays. Pricing varies across carriers, same benefits.
Common Lawrence Scenarios
Most people turning 65 in Lawrence fit one of these three situations. The right next step depends on which one is yours.
Retiring at 65 with no prior coverage
Enroll in Medicare during your IEP. Compare Original Medicare + Medigap + Part D against Medicare Advantage. Confirm your LMH Health and KU Med providers accept your chosen path before enrolling.
Turning 65 while still working
Work with HR to confirm whether your group coverage is creditable. If you have an HSA, stop contributions before Medicare enrollment. Employers with fewer than 20 employees usually require Medicare to be primary.
Turning 65 with retiree benefits
Retiree health plans usually require you to enroll in Medicare. The retiree plan often becomes secondary. Read your retiree plan documents carefully and coordinate enrollment timing with the plan administrator.
Penalty Warning
Late Enrollment Costs You For Life
Missing your Initial Enrollment Period without creditable coverage triggers a Part B late enrollment penalty of 10% per 12 months delayed, added to your premium for the rest of your life. The Part D penalty is 1% of the national base premium per month delayed.
Use the penalty calculator to see what a delay would cost.
Do I have to enroll in Medicare at 65 if I have employer insurance?
Not necessarily. If you (or your spouse) work for an employer with 20 or more employees and your group coverage is creditable, you can usually delay Part B without penalty. If the employer has fewer than 20 employees, Medicare typically becomes primary at 65 and you should enroll. Always confirm with HR in writing before delaying.
What happens if I miss my Initial Enrollment Period?
If you miss your IEP and don't have creditable coverage, you'll likely face a Part B late enrollment penalty of 10% per 12 months delayed, added to your premium for life. You'd also have to wait for the General Enrollment Period (Jan 1 to Mar 31) to enroll, with coverage starting the month after enrollment.
Do I need Part D if I don't take any medications?
Yes, in most cases. The Part D late enrollment penalty is 1% of the national base premium per month delayed, added to your premium for life. Even a low-cost Part D plan now can save thousands later if you ever need medications. The exception is creditable drug coverage from an employer or VA.
Can I change my Medicare plan after I enroll?
Yes. You can change Medicare Advantage and Part D plans during the Annual Enrollment Period (Oct 15 - Dec 7) each year. Medicare Advantage members also have an additional Open Enrollment from Jan 1 to Mar 31. Switching Medigap plans after your initial enrollment usually requires medical underwriting in Kansas.
Is Medicare free at 65?
Part A is premium-free for most people who paid Medicare taxes for at least 10 years. Part B has a standard premium of $202.90/month in 2026. Drug coverage (Part D), Medigap, or Medicare Advantage plans have their own premiums and out-of-pocket costs.
How do I actually sign up for Medicare?
Through the Social Security Administration: online at ssa.gov, by phone at 1-800-772-1213, or in person at the Lawrence Social Security office. If you're already receiving Social Security benefits before 65, enrollment in Parts A and B is automatic.
Adam
Licensed Kansas Agent · AHIP Certified
Lawrence native · Free State HS · BS Finance, KU
Talk With Adam. No Pressure, No Cost.
I grew up in Lawrence, graduated from Free State High School, and earned a BS in Finance from the University of Kansas. Most of the people I help are turning 65 or reviewing their current Medicare coverage.
No pressure, no sales pitch. Just clear answers when you're ready to talk.
