What Now?

Your Medicare Roadmap

When to Sign Up-Timing Is Everything

Initial Enrollment Period (IEP)

Your 7-month window around your 65th birthday:

- 3 months BEFORE your birthday month
- Your birthday month
- 3 months AFTER your birthday month

Best time to enroll — no penalties, no gaps. Sign up early to avoid coverage gaps!

Special Enrollment Period (SEP)

Still working with employer coverage at 65:

- You or spouse covered by active employer plan
- 8-month window after that coverage ends

Important: COBRA does NOT qualify for SEP. Retiree coverage does NOT qualify.

Missing your window = permanent late enrollment penalty.

Understanding Medicare Part A & Part B

Part A — Hospital Insurance

What it covers:
- Inpatient hospital stays
- Skilled nursing facility care
- Home health care
- Hospice care

Cost: FREE for most people (40+ work credits). Automatic if collecting Social Security.

Part B — Medical Insurance

What it covers:
- Doctor visits & outpatient care
- Preventive services & screenings
- Lab tests & X-rays
- Durable medical equipment

Cost: $185/month standard premium (2025). Higher income = higher premium (IRMAA).

Medicare Advantage vs. Medicare Supplement

Medicare Advantage (Part C)

Private insurance replacing Original Medicare.

- Often $0 or low monthly premium
- Usually includes Part D drug coverage
- May include dental, vision, hearing
- Network-based (HMO or PPO)
- Copays at time of service

Best for: lower upfront costs and added benefits

Medicare Supplement (Medigap)

Covers gaps left by Original Medicare.

- Higher monthly premium
- Very predictable out-of-pocket costs
- See any Medicare-accepting doctor
- No referrals needed
- Requires a separate Part D plan

Best for: maximum flexibility and predictability

Part D — Prescription Drug Coverage

What You Need to Know

Part D covers your prescription drugs — either as a standalone plan or bundled inside a Medicare Advantage plan.

Enroll during your Initial Enrollment Period — even if you don't take medications now. Waiting without creditable coverage triggers a permanent penalty.

How to choose the right plan:
- List all your medications (name, dose, frequency)
- Compare plans at medicare.gov/plan-compare
- Confirm your drugs are in the plan's formulary
- Compare total costs: premium + deductible + copays

The Late Enrollment Penalty

If you go without creditable drug coverage and don't have a valid reason, Medicare adds a permanent penalty to your Part D premium.

The penalty is 1% of the national base premium for every month you went without coverage.

It never goes away — it's added to your premium for as long as you have Part D.

Don't wait. Enroll on time even if you're healthy!

How to Sign Up for Medicare — 3 Ways to Enroll

Online & By Phone

Online (Fastest & Easiest):
Visit ssa.gov/medicare
- Create or log into your my Social Security account
- Click "Apply for Medicare"
- Takes about 10-20 minutes, available 24/7

By Phone:
Call 1-800-772-1213
TTY: 1-800-325-0778
Mon-Fri, 8am-7pm local time
A representative walks you through the application.

In Person & What to Bring

In Person:
Visit your local Social Security office.
Find yours at ssa.gov/locator
Schedule an appointment to reduce wait time.

What to bring:
- Birth certificate
- Proof of citizenship or residency
- W-2 or tax return if still working
- Medicare card if already enrolled in Part A

Best for complex situations or if you have questions.

Helpful Resources — Official Links

Sign Up & Coverage

Sign Up for Medicare:
ssa.gov/medicare

Compare Drug Plans (Part D):
medicare.gov/plan-compare

Medicare Official Site:
medicare.gov

Find a Social Security Office:
ssa.gov/locator

Extra Help & Counseling

Extra Help with Drug Costs (Low Income):
ssa.gov/extrahelp

Free Medicare Counseling (SHIP):
shiphelp.org

Medicare Handbook (free download):
medicare.gov/basics/get-started-with-medicare

Michigan SHIP Helpline:
1-800-803-7174

Medicare doesn't have to be confusing.

We Can Help Guide You Through It.