Question 1

When Should I Apply for Medicare?

Accepted Answer

Most people should apply for Medicare during their Initial Enrollment Period, which begins three months before their 65th birthday month, includes their birthday month, and ends three months after. Enrolling during this seven-month window helps ensure coverage starts on time and prevents late enrollment penalties. Individuals who are already collecting Social Security benefits are typically automatically enrolled in Medicare Parts A and B.

Additional questions on this topic:

Your enrollment timing depends on your situation.  Ask yourself:
• Am I already collecting Social Security benefits?
o	If yes, will I be automatically enrolled in Medicare Parts A and B?
o	If not, when should I apply through Social Security?
• When does my Initial Enrollment Period begin and end?
• What happens if I miss my enrollment window?

Question 2

Can I delay Medicare Part B if I am still working?

Accepted Answer

Yes. If you are still working and covered by employer group health insurance from an employer with 20 or more employees, you may delay enrolling in Medicare Part B without penalty. When you retire or lose that employer coverage, you qualify for a Special Enrollment Period to enroll in Part B.

Question 3

How do I apply for Medicare Part B if I delayed it while working?

Accepted Answer

To enroll in a delayed Medicare Part B, two forms must be submitted to the Social Security Administration.
The CMS-40B (Application for Enrollment in Medicare Part B) is completed by the applicant to request Part B coverage.
The CMS-L564 (Request for Employment Information) is completed by both the applicant and the employer to verify creditable employer health coverage.

Once submitted to Social Security, the process typically takes about 6–8 weeks from application to receiving the Medicare card.

Question 4

4. What costs should I expect with Medicare?

Accepted Answer

In 2026, most people pay a monthly Medicare Part B premium of $202.90. Medicare Part B also has an annual deductible of $283, after which Medicare generally pays 80% of approved medical costs and the beneficiary pays the remaining 20%.

Many beneficiaries also enroll in a Medicare Part D prescription drug plan, which has an average monthly premium of about $46.50, although the exact amount varies by plan.

Higher-income individuals may pay additional premiums called the Income-Related Monthly Adjustment Amount (IRMAA). For 2026, IRMAA applies when income is above $109,000 for individuals or $218,000 for married couples filing jointly based on tax returns from two years earlier.

2026 Medicare Part B monthly premiums based on income:

Up to $109,000 single / $218,000 married: $202.90

$109,001–$137,000 single / $218,001–$274,000 married: $284.10

$137,001–$171,000 single / $274,001–$342,000 married: $405.80

$171,001–$205,000 single / $342,001–$410,000 married: $527.50

$205,001–$500,000 single / $410,001–$750,000 married: $649.20

Above $500,000 single / $750,000 married: $689.90

Higher-income beneficiaries may also pay an additional Part D IRMAA surcharge ranging from about $14.50 to $91.00 per month, which is added to the premium of their prescription drug plan.

Question 5

What does Medicare not cover?

Accepted Answer

Original Medicare does not typically cover routine dental care, vision exams for glasses, hearing aids, most long-term care, or care received outside the United States. Many people choose additional coverage, such as a Medicare Supplement or Medicare Advantage plan, to help manage these expenses.

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Frequently Asked Questions About The Medicare Lady

When Should I Apply for Medicare?

Can I delay Medicare Part B if I am still working?

How do I apply for Medicare Part B if I delayed it while working?

4. What costs should I expect with Medicare?

What does Medicare not cover?

Brand Certified Facts from The Medicare Lady